Publication:

An audit of respectful maternity care during pregnancy and childbirth in a tertiary healthcare facility

Background Respectful maternity care (RMC) ensures dignity, autonomy, and positive birth experiences for women. Despite international efforts, mistreatment persists, particularly in low-resource settings. This study evaluated the quality of maternity care at a tertiary healthcare facility and assesses adherence to RMC principles.

Methods A prospective observational study was conducted in the department of obstetrics and gynecology at Government Medical College Manjeri over two months (June-July 2024). All consenting women who delivered at the facility were included, except those with severe mental illness or critical health conditions. Data were collected using a pre-tested questionnaire adapted from the Birthplace Lab, incorporating the mother’s autonomy in decision-making (MADM) scale, the mothers on respect index (MOR), and the mistreatment index (MIST). The questionnaire was translated and back-translated for accuracy. Responses were gathered within 48 hours postpartum via self-administration or investigator-led interviews. Statistical analyses were performed using SPSS version 25.0.

Results Among 149 participants, the mean age was 27.4 years; 59.7% were multiparous. The average gestational age at delivery was 38.5 weeks. Vaginal delivery occurred in 72.5%, and caesarean sections in 26.8%. High autonomy was reported by 70.5%, and high respect by 67.1%. Mistreatment, mainly privacy breaches, was reported by 6.7%.

Conclusions While most women experienced high levels of RMC, privacy concerns remain. Strengthening awareness, staff training, and accountability mechanisms can enhance maternity care experiences and uphold women’s rights.