4 years ago

Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis

Olufemi T. Oladapo, Arash Rashidian, Vicky Nogueira Pileggi, Meghan A. Bohren, Elham Shakibazadeh, Sebastian Leathersich, João Paulo Souza, Ӧzge Tunçalp, Ahmet Metin Gülmezoglu, Sofia Madeira, Joshua P. Vogel, Masoumeh Namadian
Background What constitutes respectful maternity care (RMC) operationally in research and program implementation is often variable. Objectives To develop a conceptualization of RMC. Search Strategy Key databases including PubMed, CINAHL, EMBASE, Global Health Library; grey literature and reference lists of relevant studies. Selection Criteria Primary qualitative studies focusing on care occurring during labour, childbirth and/or immediate postpartum in health facilities without any restrictions on locations or publication date. Data Collection and Analysis A combined inductive and deductive approach was used to synthesize data; the GRADE CERQual was used to assess the level of confidence in review findings. Main Results Sixty-seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesized: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women's dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women's choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women's perspectives of what constitutes RMC are quite consistent. Conclusions This review presents an evidence-based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programs. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/1471-0528.15015

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