SANDRA SHROFF COLLEGE OF

NURSING VAPI

SUBJECT: OBSTETRIC AND GYNECOLOGICAL NURSING

TOPIC: WRITTEN ASSIGNMENT ON

RESPECTFUL MATERNITY CARE

SUBMITTED TO: [Link] PATEL SUBMITTED BY: SONALI TANDEL

HOD OF OB AND GYNEC DEPT. 1ST YR MSC NURSING

SSRCN,VAPI SSRCN, VAPI

SUBMITTED ON: 12/12/25

INTRODUCTION

Respectful Maternal Care (RMC) is an evidence-based, human-rights–focused approach that

ensures women receive dignified, person-centered care during pregnancy, childbirth, and
postpartum period. It aims to eliminate mistreatment, promote women’s autonomy, and
improve maternal and neonatal outcomes.

RMC involves treating patients with dignity and humanity by ensuring privacy, providing
clear information with informed consent, and allowing for continuous support from family
or companions. It also means delivering equitable, effective, and continuous care while
being free from harm and mistreatment, and respecting the patient's autonomy and
choices. This approach fosters a positive birth experience and is a fundamental human right .

DEFINITION

WHO (2018): “Respectful maternal care

involves providing women with care that
maintains dignity, privacy, confidentiality,
freedom from harm, and informed choice.”

White Ribbon Alliance: “RMC is the universal

right of every childbearing woman to receive
humane and dignified care.”

White Ribbon Alliance 2011: "RMC

encompasses respect for women's basic
human rights that includes respect for
women's autonomy, dignity, including
companionship during maternity care ".
THE NEED FOR RMC

Maternal and neonatal death rates have decreased over the past few decades, and there
has been notable improvement made in maternal and neonatal healthcare worldwide. The
standard of services offered has increased as a result of strengthened legislative
frameworks, efficient clinical procedures, and programmatic best practices. Despite these
advancements, not everyone has access to high-quality services, particularly in
underdeveloped nations during pregnancy and childbirth.

MISTREATMENT IN MATERNITY CARE AREAS

In reality, disrespect and abuse can take many different forms, from overt instances of
physical violence to more subtle (and possibly unintended) behaviours. For instance, more
overt behaviours can involve slapping a woman during labor by a medical professional or
forcibly detaining her in the hospital due to unpaid bills. Being punished, suffering
interventions without the availability of information, consent, or shared decision-making,
and being denied privacy are examples of more subtle behaviours.

Inadequate privacy, committing damaging acts, lack of knowledge regarding the care
offered, insufficiently informed consent, denying the ability to choose a birth position,
verbal abuse (insults, threats, extortion, and intimidation), no preference for a partner,
abandoning the care of (leaving the woman alone or unattended), insufficient
confidentiality denying food and drink during giving birth, preventing freedom of movement
while working, discrimination on the basis of ethnicity, color, or economic circumstance,
separation of the mother and child after delivery that is not essential, physical mistreatment
(hitting/slapping), The woman is being held in the facility because the facility costs have not
been paid.

ASPECTS OF RMC

Twelve aspects of RMC include preserving women’s dignity, avoiding injury and abuse,
maintaining privacy and secrecy, and providing potential information and obtaining
informed consent. Assuring ongoing access to family and community assistance and
enhancing the standard of the surrounding environment and resources. Providing fair
maternity care, engaging in good communication, respecting women’s decisions that
increase their ability to give birth, and having access to qualified and motivated human
resources are all important. Continuity of care; efficient and effective care delivery.

Strategic areas to aid in developing a methodical, evidence-based strategy for delivering

high-quality care are as follows:

 Clinical recommendations
 Care standards
 Successful interventions
  Quality indicators
 Useful research and capacity development

PRINCIPLES OF RESPECTFUL MATERNAL CARE

RMC is often described through 7 Universal Rights of Childbearing Women:

1. Freedom from Harm and Ill-treatment

o No physical, verbal, or emotional abuse.
o Evidence-based practice to avoid unnecessary interventions.

2. Right to Information, Informed Consent and Refusal, and Respect for Choices
o Clear communication
 o Shared decision-making
o Respect for birthing position preferences.

3. Confidentiality and Privacy

o Maintaining a private environment and safeguarding personal information.

4. Dignity and Respect

o Compassionate behaviour
o Non-discrimination regardless of age, caste, socioeconomic status, religion.

5. Right to Equality, Freedom from Discrimination

o Fair treatment for all women, including adolescents, migrants, and marginalized
groups.

6. Right to Liberty, Autonomy, and Freedom from Coercion

o No detention in facilities for inability to pay.
o No forced medical procedures.

7. Right to Timely, High-quality Healthcare

o Skilled maternity services
o Proper pain management
o Referral services when needed.

 apply the following principles across the different stages of maternity care

Preconception Care
 Health Promotion and Education: Educate women about wellness, nutrition, and
disease prevention to foster optimal health before pregnancy.
 Informed Choice and Autonomy: Support women in making informed decisions
about their reproductive health and family planning, respecting their preferences
and choices without coercion.
 Non-discrimination: Ensure that care is provided equitably, regardless of age,
socioeconomic status, or other personal attributes.
 Confidentiality and Privacy: Maintain the privacy of all personal health information.

Antenatal Care
 Effective Communication: Speak to women in a language they understand and
provide clear, polite, and truthful information about their health and their baby's
status.
 Dignity and Respect: Greet patients respectfully, address them by their name, and
treat them with kindness and empathy during all visits.
 Informed Consent: Obtain informed consent before any examination or procedure,
ensuring the woman understands the risks and benefits.
  Continuous Support: Build trust and a supportive relationship, and allow for a
companion of choice during visits if feasible and desired by the woman.

Postnatal Care
 Abuse-Free Environment: Ensure the mother and newborn are free from physical,
verbal, or emotional abuse.
 Physical Comfort and Safety: Provide a clean, safe, and comfortable environment,
including proper hygiene facilities and attention to physical comfort needs.
 Support for Mother-Baby Pair: Provide comprehensive support for breastfeeding
and newborn care, involving the family in the care process.
 Timely and Responsive Care: Respond promptly to the needs of the mother and
baby, avoiding unnecessary delays in care.
 Debriefing and Follow-up: Counsel on post-delivery care, monitor for complications,
and provide information on when to seek further help. A formal debriefing process
can address any negative experiences.

COMPONENTS OF RESPECTFUL MATERNAL CARE

CLINICAL CARE
•Evidence-based practices
•Adequate monitoring using partograph
•Proper infection control
•Safe childbirth practices
COMMUNICATION & INTERPERSONAL INTERACTION
•Empathy and active listening
•Clear explantions
•Allowing questions
•Supportive child birth
EMOTIONAL SUPPORT
•Encouraging mobility
•Continuous labor support
•Pain relief options
•Respecting cultural practices when safe
FACILITY ENVIRONMENT
•Clean and safe environment
COMPONENTS OF •Basic amenitities (water,sanitation,toilets)
•Privacy curtains or screens
RESPECTFUL ACCOUNTABILITY
MATERNAL CARE •Compaint and feedback mechanisms
•Regular audits
•Policies against abuse

1. Clinical Care
 Evidence-based practices
 Adequate monitoring using partograph
 Proper infection control
 Safe childbirth practices
2. Communication & Interpersonal Interaction
 Empathy and active listening
 Clear explanations
 Allowing questions
 Supportive birth companionship

3. Emotional Support
 Encouraging mobility
 Continuous labour support
 Pain relief options
 Respecting cultural practices when safe

4. Facility Environment
 Clean and safe environment
 Basic amenities (water, sanitation, toilets)
 Privacy curtains or screens

5. Accountability
 Complaint and feedback mechanisms
 Regular audits
 Policies against abuse

FORMS OF DISRESPECT AND ABUSE IN MATERNITY CARE

(As identified in Bowser & Hill Framework)

1. Physical abuse

2. Non-consented care

3. Non-confidential care

4. Non-dignified care
(verbal abuse,
humiliation)

5. Discrimination

6. Abandonment or
neglect

7. Detention in facilities
ROLE OF NURSES IN PROMOTING RMC

1. Care provider role

 Deliver safe, evidence-based maternal care
 Encourage birthing companions
 Ensure informed consent

2. Educator role
 Educate pregnant women about birth process
and rights
 Provide childbirth preparation

3. Advocate role
 Protect women from mistreatment
 Report violations
 Promote patient rights

4. Communicator role
 Provide emotional reassurance
 Use respectful language
 Maintain privacy

5. Manager/Leader role
 Coordinate care team
 Support environment changes (privacy screens, triage)
 Facilitate quality improvement programs

INTERVENTIONS FOR PROMOTING RMC

Training staff in interpersonal communication skills, transforming values and attitudes,
establishing quality improvement teams, monitoring disrespect and abuse, staff mentoring,
improving privacy in the wards (by placing curtains or partitions between the beds),
improving staff conditions (by offering tea to those working shifts), maternity open days,
community workshops, and mediation/alternative dispute resolution.

RECOMMENDATIONS FOR ACTION

Health institutions must provide women with privacy through the use of curtains or
partitions and the freedom to select their own support person.
Every pregnant woman deserves consistent access to expert routine and emergency care in
a safe, courteous, and economical manner.

Pregnancy care for all women should be free from all forms of discrimination, including
physical, verbal, and sexual abuse.

Women have the right to information and communication on the care of themselves and
their children. Women’s capacity to give birth is increased when they are included in the
decision-making process and their choices are respected.
Maternity health workers need to be valued and appreciated, as well as given the support,
guidance, and training they require, as well as working conditions that allow them to deliver
inclusive and respectful care.

PRACTICAL APPLICATIONS IN NURSING

During labour:
o Allow the mother to move around and choose her own birthing position.
o Permit a companion of choice to provide emotional support.
o Avoid unnecessary interventions like induction, augmentation, or routine
pain medication.
o Maintain a calm environment by ensuring cleanliness and privacy.

During and after birth:

o Promote immediate and continuous skin-to-skin contact between mother
and baby.
o Encourage early breastfeeding.
o Avoid separating the mother and baby unless medically necessary.
o Share information with the mother about her care and her baby's well-being.

Building trust:
o Encourage positive interactions with the care team.
o Avoid using language or actions that could be perceived as stressful, crude, or
demeaning.
o Understand that a positive birth experience can have lasting benefits for the
mother and family.

STRATEGIES TO IMPROVE RMC

 Establish RMC guidelines and protocols

 Regular staff training (communication, ethics, cultural sensitivity)
 Strengthening staffing and workload distribution
  Incorporating RMC into nursing curriculum
 Encouraging birth companionship
 Implementing patient feedback systems
 Use of respectful language and behaviour change interventions

OUTCOMES OF RESPECTFUL MATERNAL CARE

Maternal Outcomes
 Increased satisfaction
 Reduced fear and anxiety
 Increased uptake of institutional delivery
 Reduced postpartum depression

New born Outcomes

 Improved breastfeeding initiation
 Better neonatal bonding
 Increased early skin-to-skin contact

Health System Outcomes

 Improved trust in healthcare
 Better quality of maternity care
 Reduced maternal and neonatal morbidity/mortality

CONCLUSION

Respectful Maternal Care is a cornerstone of quality maternity services. For Nursing

students, understanding RMC is essential to promote women’s rights, enhance childbirth
experience, and achieve global maternal health goals such as WHO’s vision for quality,
people-centered maternity care. Nurses play a critical role in ensuring every woman
receives dignified, respectful, and compassionate care during one of the most vulnerable
periods of life.

Respectful Maternal Care is an integral component of quality obstetric care and is essential
for safeguarding the dignity, rights, and well-being of women during childbirth. Healthcare
providers, especially nurses, play a critical role in advocating for and delivering respectful
and compassionate maternity care. Implementing RMC not only improves clinical outcomes
but also enhances the overall birthing experience, thereby strengthening the health system.
BIBLIOGRAPHY

1. Perry, S.E., Hockenberry, M.J., Lowdermilk, D.L., & Wilson, D. “MATERNAL CHILD
NURSING CARE” ,7th Edition, Elsevier, Reference Pages: pp. 212–220 (Topics: patient rights,
communication, dignity in maternity care)

2. Lowdermilk, D.L., Perry, S.E., Cashion, M.C., Alden, K.R. “MATERNITY AND WOMEN’S
HEALTH CARE”, 13th Edition, Elsevier,Reference Pages: pp. 145–150 (Humanized childbirth,
respectful maternity care principles)

3. Adele Pillitteri “ MATERNAL & CHILD HEALTH NURSING: CARE OF THE CHILDBEARING
AND CHILDREARING FAMILY” ,8th Edition, Jaypee Brothers Medical Publishers, Reference
Pages: pp. 118–124 (Interpersonal care, informed consent, privacy during labour)

4. Annamma Jacob “Maternal and Neonatal Nursing Care Plans”, 5th edition, Jaypee
Brothers publication,Reference Pages: pp. 32–35 (Nursing responsibilities, respect, dignity,
privacy)

5. WHO – “Compendium on Respectful Maternal and Newborn Care”, World Health

Organization (WHO, UNICEF, UNFPA, Jhpiego) publication ,Reference Pages: pp. 1–25 (7
Universal Rights, RMC framework, respectful care guidelines

ONLINE LINKS (LISTED BELOW)

1. WHO – Compendium on Respectful Maternal and Newborn Care

👉 [Link]

2. WHO – Operational Guidance for Respectful Maternity Care Providers

[Link]
documents/operational-guidance/afg-mn-32-01-operationalguidance-2017-eng-
[Link]

3. AHRQ – Respectful Maternity Care: Systematic Review (Full Report)

[Link]
[Link]

4. Research Article – Respectful Maternity Care Interventions

[Link]
e_interventions_to_address_women_mistreatment_in_childbirth_What_has_been
_done
5. Promoting Respectful Maternity Care – Community Workshop Guide
[Link]
training_guide_for_community_based_workshops_Community_facilitators_guide