Background: Disrespectful maternity care is a key impediment to achieving a good quality care. Identifying predicting factors can be used in mitigating any potential risk in for disrespect and abuse in maternity care. The present study was conducted to determine prevalence and predictors of perceived disrespectful maternity care among Iranian women. Methods: A cross-sectional study was conducted in three public and three private hospitals in the city of Tabriz involving 334 postpartum women. Tools included socio-demographic, pregnancy, labour and birth characteristics questionnaires, and disrespect and abuse scales. Data were collected in 6 to 18 h after birth. Multivariate logistic regression was used to determine predictors of disrespectful maternity care. Results: A majority of the women (253; 75.7%) reported one or several types of perceived disrespectful maternity care. The most frequent types related to not allowing women to choose labour positions (142; 44.3%) and not allowing them to move during labour (148; 42.5%). Nighttime childbirth (aOR 3.07; 95% CI 1.61 to 5.88) increased the likelihood of perceived disrespectful maternity care. However, presence of spouses to accompany their wives in waiting rooms (aOR 0.32; 95% CI 0.11 to 0.88), the attendance of private physicians (aOR 0.05; 95% CI 0.02 to 0.12), and midwives (aOR 0.22; 95% CI 0.11 to 0.45) decreased the likelihood of perceived disrespectful maternity care. Conclusion: The results showed high levels of perceived disrespectful maternity care in postpartum women. Therefore, appropriate interventions, such as encouraging spouses' presence, increasing the number of night shift staff, and training obstetric residents and midwives by holding ethics classes, with particular emphasis on empathy with patients.

Background: Intrapartum respectful maternity care is defined as a fundamental human right that can affect the mother's experiences. This study aimed to determine the status of respectful maternity care and its relationship with childbirth experience among Iranian women. Methods: This prospective cohort study recruited 334 postpartum women in postpartum wards of two public and four private hospitals in Tabriz, Iran. Quota sampling was used based on the number of births in each hospital. Data were collected through interviews with the use of the following tools: sociodemographic and obstetrics characteristics questionnaire, respectful maternity care scale (6 to 18 h postpartum), and childbirth experience questionnaire (30 to 45 days postpartum). The General Linear Model was used to determine the relationship between respectful maternity care and childbirth experience. Results: The mean respectful maternity care score was 62.58 with a range of 15 to 75, and the total childbirth experience score was 3.29 with a range of 1 to 4. After adjusting for sociodemographic and obstetrics characteristics, a statistically significant direct correlation was found between respectful maternity care and a positive childbirth experience (P < 0.001). Conclusions: The findings reveals a direct relationship between respectful maternity care and positive childbirth experience. Therefore, it is recommended that mangers and policy makers in childbirth facilities reinforce facilitating a respectful maternity care to improve women's child birth experience and prevent potential adverse effects of negative childbirth experiences.

Background: Disrespect and abuse (D&A) can violate human rights, affect women's decisions on the type of delivery method, and exacerbate their mental health conditions; therefore, this study aims to: a) assess the status of D&A and respectful maternity care (RMC) during childbirth and their relationships with childbirth experience, sociodemographic and obstetrics characteristics; b) explain women's perceptions of various RMC aspects and determinants during childbirth; and c) present a guideline for promoting of RMC. Methods/design: A mixed methods sequential explanatory design will be used to conduct this study in 3 phases. The first phase is a quantitative study with a longitudinal descriptive-analytical design to identify any D&A and RMC and their relationships with childbirth experience among 334 women who have given birth in public and private hospitals in Tabriz, Iran. The sample will be selected proportional to each population. The second phase is a qualitative study to explore women's perceptions of various RMC aspects and their determinants during childbirth. The conventional content analysis approach will be used to analyze the data. The third phase is focused on developing a guideline to improve the quality of maternity care. The literature review, findings of phase one and two, and focus group discussion (FGDs) with staff in the labour ward and using a Delphi technique will be used to complete the final phase. Discussion: Considering the vulnerability of women during labor and delivery and the effect of D&A on cesarean section rates, a supportive guideline can improve the quality of maternity care and reduce D&A during childbirth, and improve women's childbirth experiences. Ethical code: IR.TBZMED. REC.1398.202.

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Background There is no comprehensive guideline for respectful maternity care (RMC) promotion in Iran. This study aimed to design a RMC guideline based on a multiphase study. Methods In this multiphase mixed-methods study, recommendations were made for RMC promotion through the data obtained from Phase I (i.e., the quantitative section with a cross-sectional design), Phase II (i.e., the qualitative section with a content analysis method), and Phase III (i.e., focus group discussions with birth attendants as well as opinions of the specialized panel through the Delphi technique). The composed recommendations were then analyzed and finalized by relevant specialists in terms of execution capacity, approvability, and cost-effectiveness within the current context of Iran. Eventually, the resultant guideline were evaluated and approved by two members of the research team specializing in the research area in accordance with the Appraisal of Guideline for Research and Evaluation (AGREE). Results The results of this multiphase study led to 80 recommendations for RMC promotion. The recommendations were classified as eight areas called recommendations for the pregnancy period, recommendations for the labor period and delivery, recommendations for the neonatal period, occupational recommendations, supervision recommendations, national policy recommendations, recommendations for training students and staff, and general public recommendations. Discussion Based on the outcomes of disrespect and abuse, it is recommended to provide comprehensive guideline for policymakers and planners to formulate plans through the RMC promotion approach. Healthcare service policymakers can use this guideline to design some interventions to meet women’s financial, psychological, and legal needs.