Respectful maternity care: Disconnect between perspectives and practices of midwives from a referral hospital in Kampala, Uganda.

Abstract

Introduction: Disrespectful and undignified care during childbirth is a global challenge, particularly in less developed countries. Despite the increase in health facility births, women continue to suffer from disrespect and abuse during childbirth. This practice counters the efforts to encourage women to deliver in health facilities by a skilled birth attendant as a strategy to reduce maternal and neonatal mortality. The purpose of the study was to explore midwives' understanding of respectful maternity care and observe how their practice conforms to this concept. Methods: We conducted a qualitative study combining one-on-one interviews and observation methods of data collection. In-depth interviews were conducted with 17 midwives and 20 observations were done. Audio-recorded data were later transcribed verbatim and analyzed using the content analysis method. Observation data was summarized into a table 2 below.Results: Midwives understood respectful maternity care (RMC) as treating women with respect, dignity, politeness, providing information to clients, and ensuring privacy and confidentiality. However, there was a discrepancy between their understanding of RMC and what they practiced. They also lacked an in-depth understanding of the domains of RMC. Conclusion: There is a need to strengthen midwife's knowledge and skills to enable them to provide respectful maternity services. We recommend in-service training and mentoring to equip midwives with knowledge and skills to offer RMC. Also, RMC should be integrated into pre-service curricula for midwifery and nursing training in Uganda. Furthermore, efforts should be put in to strengthen health systems, and support healthcare providers to provide RMC. More research is needed into locally relevant solutions to promote respectful maternity care.