Obstetric care navigation: a new approach to promote respectful maternity care and overcome barriers to safe motherhood

Austad, Kirsten; Chary, Anita; Martinez, Boris; Juarez, Michel; Martin, Yolanda Juarez; Ixen, Enma Coyote; Rohloff, Peter

doi:10.1186/s12978-017-0410-6

Cited by 37 publications

(36 citation statements)

References 31 publications

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“…13,31 Potential solutions that have been shown to improve care experience include care navigation and an emphasis on continuity of care. [32][33][34] The presence of racism and discrimination in participant encounters was not surprising and illuminates a disturbing reality that participants still experience multiple pervasive episodes of discriminatory care. The fact that several participants brought up the need for health care provider training, without knowledge that these trainings exist and are considered a compulsory part of continuing education for most health care facilities, further demonstrates how trainings often do not effect change in behavior.…”

Section: Discussionmentioning

confidence: 99%

Listening to Women: Recommendations from Women of Color to Improve Experiences in Pregnancy and Birth Care

Altman

McLemore

Oseguera

et al. 2020

J Midwife Womens Health

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Introduction Women of color are at increased risk for poor birth outcomes, often driven by upstream social determinants and socially structured systems. Given the increasing rate of maternal mortality in the United States, particularly for women of color, there is a pressing need to find solutions to improving care quality and access for racially marginalized communities. This study aims to describe and thematically analyze the recommendations to improve pregnancy and birth care made by women of color with lived experience of perinatal health care. Methods Twenty‐two women of color living in the San Francisco Bay Area and receiving support services from a community‐based nonprofit organization participated in semistructured interviews about their experiences receiving health care during pregnancy and birth. Interviews were audio‐recorded and transcribed, and transcripts were analyzed using thematic analysis to highlight recommendations for improving perinatal care experiences. Results Participants shared experiences and provided recommendations for improving care at the individual health care provider level, including spending quality time, relationship building and making meaningful connections, individualized person‐centered care, and partnership in decision making. At the health systems level, recommendations included continuity of care, racial concordance with providers, supportive health care system structures to meet the needs of women of color, and implicit bias trainings and education to reduce judgment, stereotyping, and discrimination. Discussion Participants in this study shared practical ways that health care providers and systems can improve pregnancy and birth care experiences for women of color. In addition to the actions needed to address the recommendations, health care providers and systems need to listen more closely to women of color as experts on their experiences in order to create effective change. Community‐centered research, driven by and for women of color, is essential to improve health disparities during pregnancy and birth.

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Section: Discussionmentioning

confidence: 99%

Listening to Women: Recommendations from Women of Color to Improve Experiences in Pregnancy and Birth Care

Altman

McLemore

Oseguera

et al. 2020

J Midwife Womens Health

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“…Promoting institutional delivery without the implementation of RMC may paradoxically increase maternal mortality [26]. Reevaluating women's childbirth experience is indispensable to fascinate women with facility delivery [27,28].…”

Section: Introductionmentioning

confidence: 99%

Respectful maternity care and associated factors among women who delivered at Harar hospitals, eastern Ethiopia: a cross-sectional study

Bante

Teji

Seyoum

et al. 2020

BMC Pregnancy Childbirth

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Background: In Ethiopia, approximately three-fourths of mothers do not deliver in health facilities. Disrespect and abuse during childbirth fallouts in underutilization of institutional delivery that upshots maternal morbidity and mortality. Thus, the ambition of this study was to assess respectful maternity care and associated factors in Harar hospitals, Eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted from April 01 to July 01, 2017. A total of 425 women, delivered at Harar town hospitals, were nominated using a systematic random sampling technique. A pretested and organized questionnaire was used to collect the data. After checking for completeness, the data were entered into EpiData version 3.1 and exported to SPSS version 22.0 for cleaning and analyses. Both bivariate and multivariable logistic regression was computed to identify factors associated with respectful maternity care. Statistical significance was declared at a P-value of < 0.05. Results: Data were collected on 425 women. Overall, only 38.4% (95% CI: 33.7, 42.0%) of women received respectful maternity care. Delivering at private hospitals [AOR: 2.3, 95% CI: 1.25, 4.07], having ANC follow-up [AOR: 1.8, 95% CI: 1.10, 3.20], planned pregnancy [AOR: 3.0, 95% CI: 1.24, 7.34], labor attended by male provider [AOR: 1.8, 95% CI: 1.14, 2.77] and normal maternal outcome [AOR: 2.3, 95% CI: 1.13, 4.83] were significantly associated with respectful maternity care. Conclusions: Only four out of ten women received respectful care during labor and delivery. Providing womenfriendly, abusive free, timely and discriminative free care are the bases to improve the uptake of institutional delivery. Execution of respectful care advancement must be the business of all healthcare providers. Furthermore, to come up with a substantial reduction in maternal mortality, great emphasis should be given to make the service woman-centered.

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“…We are also in the process of collecting and analyzing qualitative feedback from TBAs, patients, and staff at health facilities on the systems’ impact, in terms of improving the quality of healthcare for women and the integrations of TBAs into the healthcare system. Our overall goal remains improving linkages of TBAs in rural Guatemala to the formal healthcare system and respectful maternity care for indigenous mothers [32]. …”

Section: Discussionmentioning

confidence: 99%

mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial

et al. 2018

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Background/objectiveGuatemala’s indigenous Maya population has one of the highest perinatal and maternal mortality rates in Latin America. In this population most births are delivered at home by traditional birth attendants (TBAs), who have limited support and linkages to public hospitals. The goal of this study was to characterize the detection of maternal and perinatal complications and rates of facility-level referral by TBAs, and to evaluate the impact of a mHealth decision support system on these rates.MethodsA pragmatic one-year feasibility trial of an mHealth decisions support system was conducted in rural Maya communities in collaboration with TBAs. TBAs were individually randomized in an unblinded fashion to either early-access or later-access to the mHealth system. TBAs in the early-access arm used the mHealth system throughout the study. TBAs in the later-access arm provided usual care until crossing over uni-directionally to the mHealth system at the study midpoint. The primary study outcome was the monthly rate of referral to facility-level care, adjusted for birth volume.ResultsForty-four TBAs were randomized, 23 to the early-access arm and 21 to the later-access arm. Outcomes were analyzed for 799 pregnancies (early-access 425, later-access 374). Monthly referral rates to facility-level care were significantly higher among the early-access arm (median 33 referrals per 100 births, IQR 22–58) compared to the later-access arm (median 20 per 100, IQR 0–30) (p = 0.03). At the study midpoint, the later-access arm began using the mHealth platform and its referral rates increased (median 34 referrals per 100 births, IQR 5–50) with no significant difference from the early-access arm (p = 0.58). Rates of complications were similar in both arms, except for hypertensive disorders of pregnancy, which were significantly higher among TBAs in the early-access arm (RR 3.3, 95% CI 1.10–9.86).ConclusionsReferral rates were higher when TBAs had access to the mHealth platform. The introduction of mHealth supportive technologies for TBAs is feasible and can improve detection of complications and timely referral to facility-care within challenging healthcare delivery contexts.Trial registrationClinicaltrials.gov NCT02348840.

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Obstetric care navigation: a new approach to promote respectful maternity care and overcome barriers to safe motherhood

Cited by 37 publications

References 31 publications

Listening to Women: Recommendations from Women of Color to Improve Experiences in Pregnancy and Birth Care

Listening to Women: Recommendations from Women of Color to Improve Experiences in Pregnancy and Birth Care

Respectful maternity care and associated factors among women who delivered at Harar hospitals, eastern Ethiopia: a cross-sectional study

mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial

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