Respectful maternity care: A multinational survey of maternity care providers by the World Association of Trainees in Obstetrics and Gynecology
Akaninyene Eseme Ubom, Mawrah Mughal, Francisco Javier Ruiloba Portilla, Chidinma Peace Ohachenu, Munachiso Iheme Ndukwe, Ayda Linda Wanjiku, Hasmik Bareghamyan, Martin Stepan, Mei Yee Ng, Elif Göknur Topçu, Tamunokoro Christabel Kio, Jessica Lenu Daniel, Abuchi Chima Stephen, Odigonma Ikpeze, Rafal Zadykowicz, Adaeze Oreh, Ngozi Orazulike, Nestor Inimgba, John Igemo Ikimalo, Anne‐Beatrice Kihara, Frank LouwenAbstract
Objective
This study evaluates maternity care providers' knowledge, practice, and perspectives on respectful maternity care (RMC).
Methods
A global cross‐sectional online survey on RMC was conducted by the World Association of Trainees in Obstetrics and Gynecology (WATOG).
Results
A total of 458 maternity care providers from 48 countries across six global regions participated in the study. One in five providers (93, 20.3%) had never heard of RMC, and nearly half (223, 48.7%) had received no formal RMC training. Only 74 (16.2%) demonstrated good knowledge of the seven categories of maternal disrespect and abuse. There was no association between RMC knowledge and practice ( P = 0.066). Despite 429 (93.7%) of respondents agreeing that RMC could improve feto‐maternal outcomes, self‐reported practices inconsistent with RMC were common, including verbal abuse (285, 62.2%), detention for unpaid bills and non‐confidential care (262, 57.2%), discrimination (203, 44.3%), abandonment/denial of care (187, 40.8%), and physical abuse (119, 26.0%). The most frequently reported barriers to RMC implementation were time constraints owing to staff and resource shortages (361, 78.8%), inadequate training (356, 77.7%), lack of sanctions for disrespectful care (239, 52.2%), and restrictive cultural and religious norms (203, 44.3%).
Conclusion
There are critical gaps in maternity care providers' knowledge and practice of RMC, despite widespread recognition of its importance for good feto‐maternal outcomes. Institutionalized RMC education, adequate staffing and resources, strengthened institutional accountability and reporting mechanisms, and workplace cultures that prioritize patient dignity and autonomy are critical steps toward ensuring RMC for all women.