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Universal Journal of Obstetrics and Gynecology
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  5. Volume 3, Number 1, 2024
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  7. Table 1

The Role of Dignity and Respect in Maternity Care: An Integrative Literature Review

Table 1.

Summary of the included articles
Reference Country Study Main Findings
Solnes Miltenburg, A., Lambermon, F., Hamelink, C., & Meguid, T. (2016). Maternity care and Human Rights: what do women think? Tanzania The study conducted with 36 women aged 31-63 in Magu District, focusing on dignity, autonomy, equality, and safety, involved 36 semi-structured interviews and one focus group discussion. Women's experiences with maternal health services reveal substandard care, violating human rights principles. They advocate for equal treatment, respect, and appropriate medical treatment, valuing human rights.
Jolly, Y., Aminu, M., Mgawadere, F., & van den Broek, N. (2019). “We are the ones who should make the decision”–knowledge and understanding of the rights-based approach to maternity care among women and healthcare providers. Malawi A total of 8 focus group discussions and 9 in-depth interviews involving 64 women and 9 key informant interviews with health care providers were conducted. The study highlights the importance of respectful maternity care, patient-provider relationships, education, women's involvement, confidentiality, and insufficient human resources in addressing issues of disrespect and abuse in healthcare facilities.
Srivastava, A., Avan, B. I., Rajbangshi, P., & Bhattacharyya, S. (2015). Determinants of women’s satisfaction with maternal health care: a review of literature from developing countries. Canada A survey of 4082 women from diverse backgrounds, including 2323 with past childbirth experiences, was conducted to understand their maternity care experiences. The study focused on maternity experiences of women with a single provider during pregnancy, excluding experiences from other provinces, countries, or those where the primary care provider was a nurse or 'other'. Respectful care in childbearing requires careful assessment of various domains. Changing Childbirth in BC supports the USAID report and global researchers' focus on decision-making. Effective reform requires understanding patient experience and safety concepts. No official tool exists to measure respectful care over time in resource-limited countries.
Debela, A. B., Mekuria, M., Kolola, T., Bala, E. T., & Deriba, B. S. (2021). Maternal satisfaction and factors associated with institutional delivery care in central Ethiopia: a mixed study. Ethiopia This study involved 451 respondents with a 98% response rate, focusing on maternal satisfaction with birth care. Data was collected through a community-based cross-sectional study, using standardized questionnaires and face-to-face interviews. The study found low maternal satisfaction with delivery services, attributed to inadequate ambulance service, unwelcoming healthcare providers, un-respectfulness and unfriendly attitudes. Factors contributing to this satisfaction included female health worker attendance, clean delivery rooms, and respectful care.
Chigwenembe, L. (2011). Dignity in maternal health service delivery: Cross sectional survey on factors that promote or compromise dignity in maternal health service delivery: Perspectives of Women and Midwives from Southern Malawi. Malawi A cross-sectional survey was conducted in Malawi between August and December 2010, involving 126 postnatal mothers and 17 labor ward midwives. Data was analyzed using descriptive statistics and content analysis. The study found that physical environment, attitudes, and care processes significantly influence patient dignity, with six out of 17 midwives expressing that infrastructure size and design significantly impact their practices.
John, M. E., Duke, E. U., & Esienumoh, E. E. (2020). Respectful maternity care and midwives' caring behaviours during childbirth in two hospitals in Calabar, Nigeria.  Nigeria The study analyzed data from 83 postnatal women who spontaneously gave birth and 51 midwives who cared for them using SPSS version 18. The study found that women experienced disrespectful care, including lack of privacy, information about labor progress, denying preferences, verbal abuse, and detention for non-payment of bills. This highlights the need for respectful and rights-based maternity care to improve utilization and access to skilled care.
Ige, W. B., & Cele, W. B. (2021). Provision of respectful maternal care by midwives during childbirth in health facilities in Lagos state, Nigeria: a qualitative exploratory inquiry. Nigeria The study used an exploratory descriptive research design, interviewing 20 midwives from two Lagos State health facilities, to investigate respectful maternity care during childbirth. The study found that midwives provided adequate confidentiality, showers, water, meals, and pain relief during labor and delivery, but also faced issues like physical abuse, privacy, and discrimination. Despite these issues, all midwives claimed to provide respectful care.
Daniel, G., Afolaranmi, T., Mfuh, A., Wina, F., & Dioso, R. I. (2023). Experiences of Midwives in Providing Respectful Maternity Care During Childbirth in Jos, Nigeria.  Nigeria The study used a qualitative, phenomenological approach, conducting in-depth interviews with selected midwives in a Nigerian hospital's labour ward, and analyzed descriptively using NVivo software. Midwives prioritize patient dignity and expect pregnant women to respect their actions. Health system constraints also influence their experience, as some patients exhibit unacceptable behaviors.
Ojong, I. N., Chukwudozie, C. C., Nsemo, A. D., & Enebeli, E. C. (2022). Midwives’ perception and practice of respectful maternity care during pregnancy and childbirth in selected health facilities in cross river state, Nigeria.  Nigeria The study investigates midwives' perception and practice of respectful maternity care during labor and childbirth in Cross River State, using a correlational design and data collected from 144 midwives at the University of Calabar Teaching Hospital and General Hospital Calabar. The study found that midwives have moderate knowledge and positive perception of respectful maternity care, with high practice, but still face some aspects of disrespect.
Sharon Morad, B. A., & Parry-Smith, W. (2013). Dignity in maternity care.  United Kingdom The authors analyzed 170 complaints over two years, mapping them against the dignity domains used in the trust's 'Care with Dignity Indicator Tool'. Dignity in care requires respectful, trusting relationships between women and caregivers, often resulting in complaints.  Complaints primarily involve communication and pain, with few indicating autonomy violations. Departments aim to improve dignity by addressing feedback received in complaints.
Mousa, O., & Turingan, O. M. (2019). Quality of care in the delivery room: Focusing on respectful maternal care practices.  Egypt A retrospective study was conducted at Minia University's postpartum department in Egypt from May to October 2017. Participants included postpartum women who delivered their babies, spoke Arabic, and provided written consent. Out of 580 questionnaires, 501 were completed, achieving a retrieval rate of 86.4%. Postpartum mothers reported friendly, abuse-free, and timely care during childbirth, with a moderate degree of respectful maternity care, despite high discrimination levels.
Mocumbi, S., Högberg, U., Lampa, E., Sacoor, C., Valá, A., Bergström, A., & Sevene, E. (2019). Mothers’ satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique.  Mozambique A cross-sectional study involving 4358 mothers from 12 months before June 2016 estimated satisfaction with childbirth care using structured interviews and regression analysis. Negative experiences during care, such as abandonment, disrespect, humiliation, or physical abuse, resulted in lower satisfaction levels for mothers compared to those without such experiences (68.5% vs 93.5%). 
Agbi, F. A., Lvlin, Z., & Asamoah, E. O. (2021). Women’s Satisfaction with Maternal care in Ghana: The Doctor’s Behaviour as a Regulating Factor.  Ghana The study used multiple linear regression to test hypotheses and found a positive impact of healthcare services on women's satisfaction, using data from a cross sectional survey of 643 women. The study suggests that brief doctor-patient involvement can lead to positive changes and improve women's satisfaction in healthcare. It also suggests that government should focus on hiring additional employees to overcome workload.
Manu, A., Zaka, N., Bianchessi, C., Maswanya, E., Williams, J., & Arifeen, S. E. (2021). Respectful maternity care delivered within health facilities in Bangladesh, Ghana and Tanzania: a cross-sectional assessment preceding a quality improvement intervention. BMJ open, 11(1), e039616.