BackgroundWhat constitutes respectful maternity care (RMC) operationally in research and programme implementation is often variable.ObjectivesTo develop a conceptualisation of RMC.Search strategyKey databases, including PubMed, CINAHL, EMBASE, Global Health Library, grey literature, and reference lists of relevant studies.Selection criteriaPrimary qualitative studies focusing on care occurring during labour, childbirth, and/or immediately postpartum in health facilities, without any restrictions on locations or publication date.Data collection and analysisA combined inductive and deductive approach was used to synthesise the data; the GRADE CERQual approach was used to assess the level of confidence in review findings.Main resultsSixty‐seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesised: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women's dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women's choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women's perspectives of what constitutes RMC are quite consistent.ConclusionsThis review presents an evidence‐based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programmes.Tweetable abstractUnderstanding respectful maternity care – synthesis of evidence from 67 qualitative studies.

Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage.

ObjectiveTo characterise the current clinical practice patterns regarding the use of magnesium sulphate (MgSO 4) for eclampsia prevention and treatment in a multi‐country network of health facilities and compare with international recommendations.DesignCross‐sectional survey.SettingA total of 147 health facilities in 15 countries across Africa, Latin America and Asia.PopulationHeads of obstetric departments or maternity units.MethodsAnonymous online and paper‐based survey conducted in 2015.Main outcome measuresAvailability and use of MgSO 4; availability of a formal clinical protocol for MgSO 4 administration; and MgSO 4 dosing regimens for eclampsia prevention and treatment.ResultsMagnesium sulphate and a formal protocol for its administration were reported to be always available in 87.4% and 86.4% of all facilities, respectively. MgSO 4 was used for the treatment of mild pre‐eclampsia, severe pre‐eclampsia and eclampsia in 24.3%, 93.5% and 96.4% of all facilities, respectively. Regarding the treatment of severe pre‐eclampsia, 26.4% and 7.0% of all facilities reported using dosing regimens that were consistent with Zuspan and Pritchard regimens, respectively. Across regions, intramuscular maintenance regimens were more commonly used in the African region (45.7%) than in the Latin American (3.0%) and Asian (22.9%) regions, whereas intravenous maintenance regimens were more often used in the Latin American (94.0%) and Asian (60.0%) regions than in the African region (21.7%). Similar patterns were found for the treatment of eclampsia across regions.ConclusionsThe reported clinical use of MgSO 4 for eclampsia prevention and treatment varied widely, and was largely inconsistent with current international recommendations.Tweetable abstractMgSO 4 regimens for eclampsia prevention and treatment in many hospitals are inconsistent with international recommendations.

Analysis 4.4. Comparison 4 IV hexoprenaline versus no tocolytic agent, whilst awaiting emergency delivery, Outcome 4 Fetal heart rate tracing not improved.

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