Ensuring Dignity at Birth: Bridging Gaps in Respectful Maternity Care in India and Beyond

Abstract

Introduction: Respectful maternity care (RMC) is a human-rights-based approach ensuring dignity, privacy, confidentiality, informed consent, effective communication, non-discrimination, emotional support, pain relief, choice of birthing position, and companionship during labour. These components are essential for improving maternal satisfaction, reducing mistreatment, and encouraging facility-based childbirth.

Four studies were analyzed: tertiary care hospitals in Bhopal (n≈150) and Odisha (n=246), a community-based study in Northern India (n=485), and a global scoping review (10 studies).

Results

Gandhi Medical College, Bhopal, Madhya Pradesh – Tertiary Care (Shwetha et al., 2023): Patient satisfaction scores in labour rooms and OT ranged 4.55–4.59/5, indicating generally positive experiences.

All India Institute of Medical Sciences, Bhubaneswar Odisha–Tertiary care (Yadav et al., 2023 n=246): 35% reported good RMC; dignified care (82%) and non-discrimination (79%) were strong; consent (48%) and confidentiality (52%) were weak. Barriers: staff shortage, workload.

All India Institute of Medical Sciences, New Delhi, northern India rural villages – Community-based (Kaur et al., 2023, n=485): 88.7% experienced RMC; communication and autonomy scored 62.9%. Gaps: poor communication, no choice of birthing position, inadequate pain relief, absence of companion.

Global Review – Multi-country (Mira-Catalá et al., 2024, 10 studies, Africa, Mexico, USA): Interventions like provider training, maternity open days, checklists, and continuous user feedback improved RMC. Reductions were noted in physical abuse (4%→2%), non-consented care (83%→65%), and verbal abuse (18%→11%), while women’s reports of respectful care increased from 12% to 64%.

Conclusion: Although RMC practices are improving in India, significant gaps remain, particularly in consent, communication, autonomy, and emotional support. Prioritizing continuous provider training, patient-centered policies, monitoring mechanisms, and empowerment of women during childbirth is essential to ensure universally dignified, equitable, and high-quality maternity care.

Keywords: Pregnancy, Privacy, Respect, Physical abuse, Patient Centered Care