The psychometric properties of the respectful maternity care (RMC) for an Iranian population

Hajizadeh, Khadije; Jafarabadi, Mohammad Asghari; Vaezi, Maryam; Meedya, Shahla; Mohammad‐Alizadeh‐Charandabi, Sakineh; Mirghafourvand, Mojgan

doi:10.1186/s12913-020-05729-x

Cited by 7 publications

(5 citation statements)

References 19 publications

(28 reference statements)

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“…There are limited studies on mistreatment during childbirth in Iran; and most of them have focused on the prevalence [ 14 , 24 ], development and psychometrics of instruments [ 25 , 26 ] and description of midwives' and women experiences [ 27 , 28 ]. To our knowledge, there was no comprehensive study that could shed light on the nature and types of mistreatment and especially its influencing factors in Iran; and this may be stunting intervention efforts.…”

Section: Introductionmentioning

confidence: 99%

Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study

et al. 2023

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Background Mistreatment during labour and childbirth is a common experience for many women around the world. This study aimed to explore the manifestations of mistreatment and its influencing factors in public maternity hospitals in Tehran. Methods A formative qualitative study was conducted using a phenomenological approach in five public hospitals between October 2021 and May 2022. Sixty in-depth face-to-face interviews were conducted with a purposive sample of women, maternity healthcare providers, and managers. Data were analyzed with content analysis using MAXQDA 18. Results Mistreatment of women during labour and childbirth was manifested in four form: (1) physical abuse (fundal pressure); (2) verbal abuse (judgmental comments, harsh and rude language, and threats of poor outcomes); (3) failure to meet professional standards of care (painful vaginal exams, neglect and abandonment, and refusal to provide pain relief); and (4) poor rapport between women and providers (lack of supportive care and denial of mobility). Four themes were also identified as influencing factors: (1) individual-level factors (e.g., providers’ perception about women’s limited knowledge on childbirth process), (2) healthcare provider-level factors (e.g., provider stress and stressful working conditions); (3) hospital-level factors (e.g., staff shortages); and (4) national health system-level factors (e.g., lack of access to pain management during labour and childbirth). Conclusions Our study showed that women experienced various forms of mistreatment during labour and childbirth. There were also multiple level drivers for mistreatment at individual, healthcare provider, hospital and health system levels. Addressing these factors requires urgent multifaceted interventions.

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Section: Introductionmentioning

confidence: 99%

Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study

et al. 2023

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“…The paucity of research in HICs may reinforce biases that lack of respectful maternity care is a problem only in other countries. While giving birth in a well-equipped facility with well-trained healthcare providers reduces maternal morbidity and mortality, lack of respectful care in any country contributes to poor outcomes [3][4][5][6][7][8][9][10][11][12]. With the increasing MMR seen in the United States and increasing MMR disparities, particularly among marginalized groups, it is crucial to explore RMC in all countries working to improve maternal health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The lack of research in HICs may lead to biases that respectful maternity care is not an issue in these countries; however, this review provides strong evidence that disrespectful care also exists in HICs. Lack of respectful maternity care in any country contributes to poor outcomes, particularly in marginalized groups [3][4][5][6][7][8][9][10][11][12]82]. More research in HICs is needed to provide a better picture of RMC and lead to the development of interventions that embrace an equitable, patient-centric empowerment model of maternity care and improve outcomes in childbearing patients.…”

Section: Discussionmentioning

confidence: 99%

“…The United Nation's Sustainable Development Goals implemented in 2015 focus on reducing the global MMR to fewer than 70 per 100,000 live births by 2030 [2]. Recent research shows that disrespectful maternity care contributes to a higher MMR by deterring mothers from seeking care in hospital settings, which adversely affects mental health and contributes to poor health outcomes [3][4][5][6][7][8][9][10][11][12]. Therefore, emphasizing respectful maternity care (RMC) that empowers and promotes the autonomy of all people giving birth could be a powerful avenue for improving maternal wellbeing [2].…”

Section: Introductionmentioning

confidence: 99%

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Approaches and geographical locations of respectful maternity care research: A scoping review

Shuman,

Grupp,

Robb

et al. 2023

PLoS ONE

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Background Peripartum mistreatment of women contributes to maternal mortality across the globe and disproportionately affects vulnerable populations. While traditionally recognized in low/low-middle-income countries, the extent of research on respectful maternity care and the types of mistreatment occurring in high-income countries is not well understood. We conducted a scoping review to 1) map existing respectful maternity care research by location, country income level, and approach, 2) determine if high-income countries have been studied equally when compared to low/low-middle-income countries, and 3) analyze the types of disrespectful care found in high-income countries. Methods A systematic search for published literature up to April 2021 using PubMed/MEDLINE, EMBASE, CINAHL Complete, and the Maternity & Infant Care Database was performed. Studies were included if they were full-length journal articles, published in any language, reporting original data on disrespectful maternal care received from healthcare providers during childbirth. Study location, country income level, types of mistreatment reported, and treatment interventions were extracted. This study was registered on PROSPERO, number CRD42021255337. Results A total of 346 included studies were categorized by research approach, including direct labor observation, surveys, interviews, and focus groups. Interviews and surveys were the most common research approaches utilized (47% and 29% of all articles, respectively). Only 61 (17.6%) of these studies were conducted in high-income countries. The most common forms of mistreatment reported in high-income countries were lack of informed consent, emotional mistreatment, and stigma/discrimination. Conclusions Mapping existing research on respectful maternity care by location and country income level reveals limited research in high-income countries and identifies a need for a more global approach. Furthermore, studies of respectful maternity care in high-income countries identify the occurrence of all forms of mistreatment, clashing with biases that suggest respectful maternity care is only an issue in low-income countries and calling for additional research to identify interventions that embrace an equitable, patient-centric empowerment model of maternity care.

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“…There were also lacks of precise guidance on their effective implementation. Furthermore, the available research evidence on respectful/disrespectful maternity care in Iran has focused on the prevalence [ 9 , 10 ], development and psychometrics of instruments [ 22 , 23 ], and descriptions of women and healthcare providers’ experiences [ 24 , 25 ], and few interventional studies have been conducted to reduce D&A or promote RMC, including workshops for midwives [ 26 , 27 ]. It seems that healthcare providers training alone is not a sufficient solution [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Challenges to the implementation of a multi-level intervention to reduce mistreatment of women during childbirth in Iran: a qualitative study using the Consolidated Framework for Implementation Research

Mirzania,

Shakibazadeh,

Bohren

et al. 2024

Reprod Health

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Background Mistreatment during childbirth is a growing concern worldwide, especially in developing countries, such as Iran. In response, we launched a comprehensive implementation research (IR) project to reduce mistreatment during childbirth and enhance positive birth experiences in birth facilities. This study identified the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth using the Consolidated Framework for Implementation Research (CFIR). Methods An exploratory qualitative study, involving 30 in-depth interviews, was conducted between July 2022 and February 2023. Participants included a purposive sample of key stakeholders at different levels of the health system (macro: Ministry of Health and Medical Education; meso: universities of medical sciences and health services; and micro: hospitals) with sufficient knowledge, direct experience, and/or collaboration in the implementation of the studied interventions. Interviews were transcribed verbatim and coded using directed qualitative content analysis (CFIR constructs) in MAXQDA 18. Results The identified challenges were: (1) individual level (childbirth preparation classes: e.g., adaptability, design quality and packaging, cosmopolitanism; presence of birth companions: e.g., patient needs and resources, structural characteristics, culture); (2) healthcare provider level (integrating respectful maternity care into in-service training: e.g., relative priority, access to knowledge and information, reflecting and evaluating); (3) hospital level (evaluating the performance of maternity healthcare providers: e.g., executing, external policies and incentives); and (4) national health system level (implementation of pain relief during childbirth guidelines: e.g., networks and communications, patient needs and resources, executing, reflecting and evaluating). Conclusions This study provides a clear understanding of the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth and highlights potential implications for policy makers and practitioners of maternal health programs. We encourage them to take the lessons learned from this study and revise their current programs and policies regarding the quality of maternity care by focusing on the identified challenges.

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The psychometric properties of the respectful maternity care (RMC) for an Iranian population

Cited by 7 publications

References 19 publications

Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study

Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study

Approaches and geographical locations of respectful maternity care research: A scoping review

Challenges to the implementation of a multi-level intervention to reduce mistreatment of women during childbirth in Iran: a qualitative study using the Consolidated Framework for Implementation Research

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