Project purpose

Every birth is unique and every experience personal! But, every mother should want to tell and share her birth story with a smile!

With this project, we want to move closer to this vision by taking local action towards promoting a culture of RESPECT in maternity-child health care services according to the principles of the WHO’s framework and White Ribbon Alliance’s Charter of Rights for Respectful Maternity Care (RMC).

Even if not intentional or always recognised as such (by healthcare providers), failure to uphold the highest professional clinical and ethical standards of care may lead to a range of situations, conditions, interactions or outcomes experienced as disrespectful (by pregnant/ birthing women service-users).

Based on the RMC framework, 'disrespect' in Maternity Care does not refer (exclusively) to unacceptable situations, such as physical, sexual or verbal abuse, prejudice and discrimination, suboptimal practices, undignified behaviours or other abusive phenomena . ‘Obstetric violence’, “obstetric mistreatment” or just “mistreatment” are some of terms used in the literature to describe such unwanted phenomena. The more general term “Disrespect and Abuse” corresponds - inversely – to the above standard of quality in care, under which a range of situations, conditions and suboptimal practices that do not ensure the right to a positive birth experience are collectively gathered and classified.

While Respectful Maternity Care is not just the converse of negative experiences,  negative experiences are common and vary. In fact, it has been suggested that, unlike low- and middle-income countries,  in high-income countries, to quote, “different subtypes [of Disrespect and Abuse] take precedence” ^[1]. More commonly mentioned are: lack of autonomy,  suboptimal or ineffective communication with healthcare providers about available care options, the medicalization of birth and unnecessary medical intervention, not respecting women’s wishes and preferences (including choice of birth partner and labour positions), and, generally, lack of support for pregnant women to make informed decisions about their own care, all of which can have a negative impact on their health, well-being and adjustment.

Several conditions and quality standards need to be met to uphold womens’ Rights to a positive childbirth experience. A cornerstone of the RMC framework is the fundamental Right to Iinformation and Informational Support. This requires maternity-child healthcare providers and women/ service-users are working in alliance (Shared-Decision Making), jointly taking decisions regarding maternity care and childbirth and practicing  principles of informed choice.

Taking a pragmatic approach to focus on a well-defined and amenable-to-change issue (i.e. the professional obligation of healthcare providers and right of women to present/be presented, respectively, with informed choices) holds the potential to improve standards of practice and the quality of user-provider communication which is a root cause of problematic situations, thus, a form of primary prevention of Disrespect and promotion of Respectful Maternity Care.

_{[1] Darilek U. A woman’s right to dignified, respectful healthcare during childbirth: a review of the literature on obstetric mistreatment. Issues Ment Health Nurs (2017)}