January 16, 2013
Long recognized as a high priority by maternal health activists, public health professionals, human rights activists, and frontline providers, respectful maternal care has gained increasing attention since a 2010 landmark report by University Research Co., LLC (URC) and the Harvard School of Public Health documented extensive qualitative evidence for widespread disrespect and abuse in institutional childbirth services in over 30 high-, middle- and low-income countries. Examples of disrespect and abuse reported extensively in the literature include subtle and overt humiliation of women, discrimination against certain sub-groups of women, abandonment of care, physical and verbal abuse during childbirth, and detention in maternities due to failure to pay.
“In many settings, disrespect and abuse may actually be considered normal by providers, managers and even patients themselves. Every woman deserves to be treated with dignity and respect during childbirth,” said Mary Ellen Stanton, Senior Maternal Health Advisor for US Agency for International Development (USAID).
Since the release of the 2010 report, Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth, the USAID Translating Research into Action (TRAction) project, managed by URC, has awarded implementation research grants to the Population Council and the Averting Maternal Death and Disability Program, Mailman School of Public Health, Columbia University to try to measure manifestations and potential drivers of disrespect and abuse in facility childbirth services and to develop and test interventions that may help reduce disrespect and achieve dignified care.
Although the evidence remains limited, promising approaches for promotion of respectful maternal care include social movements like the “Humanization of Childbirth Movement” in Latin America. Others include quality improvement, cultural adaptation of care, human rights and accountability, policy and legal, interpersonal care, and community engagement approaches. URC is supporting several innovative efforts to promote more-respectful and culturally responsive maternity health services, including the Essential Obstetric Newborn Care Networks project in Ecuador, which engages community and maternity representatives in an ongoing quality improvement initiative.
Dr. Kathleen Hill, Senior Technical Advisor to the TRAction project, and one of four featured plenary speakers said, “Disrespect and non-dignified care during childbirth is particularly egregious because it hurts women and their families at a highly vulnerable time and appears to deter women from seeking potentially life-saving health care in facilities.”
Established in 1965, URC is a global company dedicated to improving the quality of health care, social services, and health education worldwide through programs in over 40 countries. With its non-profit affiliate, the Center for Human Services, URC is based in Bethesda, Maryland, USA, and has more than 900 employees worldwide.
Media contactElizabeth Ransom, Communication Director