NAME: MUCHETE SYLVIA

STUDENT ID: 029-170

COURSE: Bn MwSc

MODULE: ANATOMY AND PHYSIOLOGY OF OBSTETRICS

YEAR OF STUDY: YEAR THREE SEMESTER 1

ASSIGNMENT No.: 1

LECTURER: SISTER CHANSA R.

DUE DATE: 1ST MARCH, 2021.

MODE OF STUDY: FULLTIME

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RESPECTFUL MATERNITY CARE

Introduction

Childbirth is an important event in women’s life and all women need and deserve to receive
respectful care during labor and childbirth. Recommendation from WHO in 2018 emphasized the
quality of interactions as a pre-requisite for positive outcomes of childbirth. This interaction
involves health care professionals preserving women’s respect and providing essential
information and emotional support during labor and childbirth.

Definition

Respectful maternal care has been recognized as essential strategy for improving quality and
utilization of maternity care. It is defined as a universal human right that encompasses the
principles of ethics and respect for women’s feelings, dignity, choices and preferences. Indeed it
is an approach to care which emphasizes the fundamental rights of women, newborns, families
and that enhances adequate access to evidence-based care while recognizing the unique needs
and preferences of both women and newborns.

Maternity care – what it means

Maternity care refers to the health services provided to women, babies and families throughout
the whole pregnancy, during labor and childbirth, and after birth for up to 6 weeks. Midwives,
general practitioners sometimes called family physicians and specialists obstetricians all provide
maternity care.

Intrapartum respectful maternity care

Intrapartum respectful maternity care is a fundamental human right that include respecting
women’s beliefs, independence, emotions, dignity and preferences to reserve their rights of
having a companion or performing their cultural rituals. It is a fundamental human right that can
affect the mother’s experience.

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Why Respectful Maternity Care is important

A woman’s autonomy should be recognized and respected, as should her emotional wellbeing,
choices and preferences, including the right to have a companion of choice during labor and
childbirth. Respect and recognition of women can benefit the newborn, who also has rights and
requires respect and recognition.

In seeking and receiving maternity care before, during and after childbirth. Every woman has the
right to;

 Be free from harm and ill treatment.

 Information, informed consent and refusal, and respect for her choices and preferences,
including companionship during maternity care.
 Privacy and confidentiality.
 Be treated with dignity and respect.
 Equality, freedom from discrimination and equitable care.
 Health care to the highest attainable level.
 Liberty, autonomy, self-determination and freedom from coercion.

Disrespect and abuse during maternity care

Disrespect and abuse during maternity care are a violation of women’s basic human rights.
According to the White Ribbon Alliance for Safe Motherhood 2011 and endorsed by the WHO,
the International Federation of Gynecology and obstetrics and the international confederation of
midwives.

There are a multitude of factors that lead to disrespect and abuse of Respectful Maternity Care;

- Gender norms and values.

- Power and status relationships.
- Lack of motivation to practice respectful maternity care.
- Poor workplace environment.
- Perceptions of health workers in society and media.

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 - Inadequate training opportunities.
- Pervasive lack of accountability for disrespect at both local and national levels.

Gender norms and power dynamics have a profound influence on people everywhere including
hospital staff. And many health workers are expected to work in poor conditions that exacerbate
this behavior. If a woman does not feel safe and respected when she visits a maternity center, she
is less likely to attend her antenatal care appointments or come to a health facility when in labor,
which increases her risk of both pregnant relate mobility and mortality. And if she does make it
to a facility for delivery but receives poor care, she and her child remains at risk.

Abuse occur in all societies

Disrespect and abuse can include but not limited to;

 Any kind of physical or verbal abuse or humiliation.

 Discrimination
 Non-confidential or nonconsensual care.
 Detainment due to unpaid fees.
 Denial of access to a health facility.
 Abandonment of care.

It occurs in all societies but is particularly prevalent in low and middle income countries where
there is only minimal accountability in the health systems and health facilities are poorly
resourced. Prevalence rate for any kind of violence against women are notoriously difficult to
determine due to lack of documentation and societal norms that tolerate abuse against women.
However, World Health Organization estimated that 35% of women worldwide have
experienced physical/or sexual intimate partner violence or non-partner sexual violence at some
point in their lives. That is one in every three women. All women have a universal human right
to be respected and cared for during pregnancy, childbirth and thereafter.

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How can we protect women from disrespect and abuse in maternity?

Health systems in crisis need support to effectively implement and sustain respectful maternity
care practices that includes addressing the rights and needs of both clients and health workers.
Health workers, women and their families need to know the rights of a woman seeking maternity
care. And health sectors must address the needs of their health workforces.

To sustain respectful maternity care, health sectors should provide health workers with;

 Safe working conditions and reasonable working hours.

 Policies that mandate health workers are treated with respect by other staffs and clients.
 Support from their managers and ministries of health.
 Training on cultural sensitivity and continual education on evidence-based practices.
 Mentors who model respectful maternity care.
 Adequately resourced facilities.
 Physical and psychosocial support to combat stress and fatigue.

Conclusion

Improving the experience of care for women during delivery is an issue of critical importance
from both health outcomes and human rights perspectives. In recent years, a growing body of
research has demonstrated that disrespect and abuse is prevalent around the globe and has
identified a range of different factors which impacts behavior of providers. Identifying the
specific features in the environment of providers, whether personal experience, social norms,
organizational priorities among others which inhibit provision of respectful care, drawing from
the behavioral science, decision making and follow through. Bringing together insights from
multiple disciplines can lead to a more nuanced understanding of this challenging problem and
lead to different complementary solutions which can help transform the experience of delivery
for both providers and clients.

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References

Smith, I et al (2012). Respectful Maternity Care: Country Experience; Survey report.

Washington DC: United States Agency for International Development.

White Ribbon Alliance (2011). Respectful Maternity Care: The Universal Rights of Childbearing
Women. Washington DC: White Ribbon Alliance.

Windau-Melmer, T. (2013). A guide for advocating for Respectful Maternity Care. Washington
DC: Futures Group, Health Policy project.

World Health Organization (2018). Recommendations on Intrapartum care for a positive

childbirth experiences. Hague: WHO.