RESPECTFUL MATERNITY CARE:
A Worthwhile Investment for
Health Care Services,
Professionals, Clients and
Communities
General Concepts and Considerations
May 2013
General and Specific Session
Objectives
 General Objective: To share information
concerning Respectful Maternity Care
(RMC) and its promotion
 Specific Objectives:
 Define Respectful Maternity Care
 Describe the content of RMC
 Describe avenues for promotion of RMC
 Present key recommendations
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Respectful Maternity Care:
General Concept
 “Respectful Maternity Care” (RMC)
is an approach that:
 Focuses on the interpersonal aspect
of maternity care
 Emphasizes the fundamental rights
of the mother, newborn and families,
including protecting the mother-baby pair
 Recognizes that all childbearing women
need and deserve respectful care and
protection of the women’s right to choice
and preferences
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Rights in Respectful Maternity Care
Type of Abuse and
Disrespect
1. Physical abuse
2. Non‐consented care
Human Right in Maternity Care
Freedom from harm and ill treatment
Right to information, informed consent and refusal,
and respect for choices and preferences, including
the right to companionship of choice wherever
possible
3. Non‐confidential care
4. Non‐dignified care
(including verbal abuse)
Confidentiality, privacy
Dignity, respect
5. Discrimination based on
specific attributes
Equality, freedom from discrimination, equitable care
6. Abandonment or denial
of care
7. Detention in facilities
Right to timely healthcare and to the highest
attainable level of health
Liberty, autonomy, self‐determination, and freedom
from coercion
Source: Bowser and Hill 2010
Characteristics of Healthcare to be
Avoided
 Impersonal
 Centered on the professional and not on the
woman and her family
 Disempowerment of the woman
 Family unit separated during labor and birth
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Respectful Maternity Care Promotes:
 Respect for beliefs, traditions and culture
 Empowerment of the woman and her
family to become active participants in
health care
 Continuous support during labor
 Choice of companion during labor
and birth
 The right to information and privacy
 Freedom of movement during labor
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RMC Promotes (continued):
 Choice of position during birth
 Good communication between client and
provider
 Support of the mother-baby pair
 Improvement of working conditions and
respectful and collaborative relationships
among all cadres of health workers
 Prevention of disrespect and abuse and
institutional violence against woman
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Respectful Maternity Care Can Be
Life-Saving
 RMC is lifesaving— women may refuse to
seek care from a provider who abuses them
or does not treat them well, even if the
provider is skilled in preventing and
managing complications
(ACCESS Program. 2008. Best Practices in
MN Care: LRP)
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Historic Background
1975 Birth of the Humanizing Childbirth movement (Brazil)
1985 WHO/PAHO conference on appropriate technology
for birth (Brazil)
1996 Mother-Friendly Childbirth Initiative (USA)
2000 First international conference on Humanizing
Childbirth in Fortaleza (Brazil)
2010 USAID/URC–supported Landscape Analysis on
abuse and disrespect in childbirth care
2011 Respectful maternity care charter, White Ribbon
Alliance (WRA)
Respectful
Maternity Care
Charter
Respectful Maternity Care:
Recognizes Multiple Stakeholders
 Respect for women’s
rights and preferences
 Appreciation,
compensation and respect
for health care providers
 Central involvement of
women – community and
national leaders – in
planning and evaluating
maternal health programs
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Key Stakeholders in RMC
 Pregnant women
 Families
 Communities
Women’s Advocates
Healthcare Providers
 Individual providers
 Professional associations
RESPECTFUL
MATERNITY
CARE
Human Rights Activists
Training Institutions
Policy Makers
Donors
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Contributors to and Impact of Disrespect and
Abuse in Childbirth on Skilled Care Utilization
Source: Hill K and Stanton ME, 2010
Key Action Points
POLICY
RESEARCH
LEGAL ACTION
ADVOCACY
EDUCATION
COMMUNITY/
SOCIAL ACTIVISM
SERVICE DELIVERY
HEALTH SYSTEM
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General Recommendations
 Include advocacy at all levels to create functional
networks among the wider body of stakeholders
 Involve community and media in each step of the
process
 Where data is absent, conduct studies on women’s
preferences and choices related to respectful
maternity care
 Ensure political commitment at the national, district
and local levels so that appropriate policies and
standards are in place.
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General Recommendations
(continued)
 Professionals and communities should collaborate in
all planning, implementation, and evaluation of RMC
 Knowledge, skills and attitudes that support RMC
must be required in all education and training
programs that involve healthcare workers
 Mobilize resources to support implementation of
RMC
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WE ALL HAVE A ROLE IN ASSURING
THAT ALL WOMEN HAVE RMC!
THANKS!
References
 Bowser and Hill. 2010. "Exploring Evidence and Action
for Respectful Care at Birth”. USAID, TRAction Project.
 Hill K. and M.E. Stanton. 2010. Promoting Evidence and
Action for Respectful Care at Birth, a presentation at the
USAID Mini-University at Georgetown University.
 ACCESS Program. 2008. Best Practices in Maternal and
Newborn Care: Learning Resource Package. Module 4:
Women-friendly Care. Jhpiego: Baltimore-MD, USA.
 White Ribbon Alliance website:
http://www.whiteribbonalliance.org/
 URC website: http://www.urc-chs.com/
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