The role of the respectful maternity care model in São Paulo, Brazil: A cross‐sectional study

Abstract

Introduction The promotion of a positive birth experience has been a main goal of the World Health Organization’s (WHO) recent work on improving maternity care. The purpose of this study was to assess the cesarean rates, the prevalence of birth practices, perinatal outcomes, and maternal satisfaction, in women involved with the respectful maternity care (RMC) support groups in Sao Paulo, Brazil. Methods This was a cross‐sectional study of women with low‐risk pregnancies who were assisted by professionals recommended by the RMC groups. An online questionnaire was administered. Variables to assess birth practices were classified as positive, negative, or unspecified according to the WHO guidelines. The Pearson chi‐square tests and odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were computed to assess differences between the groups. Results Five‐hundred and eighty women completed the questionnaire. The cesarean rate was 14.7%, and the operative vaginal birth rate was 9.5%. The VBAC rate was 87.1%, and there was no significant difference in risk for cesarean between women with or without a prior cesarean. Of all women, 83.1% had a midwife's assistance and 75.5% hired a doula; 81.4% gave birth in a nonlithotomic position. The practices of enema, fasting and episiotomy were all under 2%. All 5‐minute Apgar scores were ≥7. Most (83.1%) women reported having a positive birth experience. Conclusions Woman's engagement with the birth support groups and a transdisciplinary team focused on RMC are key elements to achieve positive perinatal outcomes and high women's satisfaction.

Operationalizing respectful maternity care at the healthcare provider level: a systematic scoping review

“…Doctors/nurses/midwives provide to women in labor and birth (to strengthen their capabilities): a. Pharmacological and b. Non-pharmacological pain relief options and supportive care Reis et al [ 36 ]; International Federation of Gynecology and Obstetrics and others. [ 27 ]; Rosen et al [ 37 ]; Thompson et al [ 38 ]; Warren [ 15 ]; Miller et al [ 39 ]; Sheferaw et al [ 40 ]; Sheferaw [ 41 ] ; World Health Organization [ 22 ]; Kujawski [ 42 ]; Oosthuizen [ 43 ]; Asefa [ 44 ]; Bohren [ 45 ]; Dynes [ 46 ]; Shakibazadeh [ 47 ]; Taavoni [ 48 ]; Wassihun [ 49 ]; World Health Organization [ 50 ]; Afulani [ 51 , 52 ]; Giordano [ 53 ]; Oliveira [ 54 ]; Perkins [ 55 ]; Afulani [ 56 ]; Bante [ 57 ]; Bohren [ 58 ]; Butler [ 59 ]; Lothian [ 24 ]; Montoya [ 60 ]; Moridi [ 61 ]; Devries [ 62 ] Page [ 63 ] Wagner [ 64 ] GarciadeLimaParada [ 65 ] Behruzi [ 66 ] Behruzi [ 67 ] Behruzi [ 68 ] Binfa [ 69 ] Ouedraogo [ 70 ] ConesaFerrer [ 71 ] Binfa [ …”

“…Provide honest and complete information, b .Involve clients in decision making about their care, c. Solicit consent for all interventions, and d. Respect choices including refusal of interventions Reis et al [ 36 ]; Warren et al [ 73 ]; International Federation of Gynecology and Obstetrics and others. [ 27 ]; Rosen et al [ 37 ]; Thompson et al [ 38 ]; Warren [ 15 ]; Miller et al [ 39 ]; Patel et al [ 74 ]; Sheferaw et al [ 40 ]; Solnes et al [ 75 ]; World Health Organization [ 22 ]; Kambala [ 76 ]; Kujawski [ 42 ]; Ndwiga [ 77 ]; Oosthuizen [ 43 ]; Sheferaw [ 41 ]; Vedam et al [ 78 , 79 ]; Asefa [ 44 ]; Bohren [ 45 ]; Dynes [ 46 ]; Shakibazadeh [ 47 ]; Taavoni [ 48 ]; World Health Organization [ 50 ]; Afulani [ 51 , 52 , 80 ]; Feijen-deJong [ 81 ]; Giordano [ 53 ]; Perkins [ 55 ]; Afulani [ 56 ]; Ayoubi [ 82 ]; Bohren [ 58 ]; Butler [ 59 ]; Lothian [ 24 ]; Moridi [ 61 ]; Montoya [ 60 ]; Page [ 63 ] Wagner [ 64 ] Guimaraes [ 84 ] GarciadeLimaParada [ …”

“…Doctors/nurses/midwives keep patient information confidential and do not share patient information unless indicated for the provision of effective care Warren et al [ 73 ]; International Federation of Gynecology and Obstetrics and others. [ 27 ]; Rosen et al [ 37 ]; Thompson et al [ 38 ]; Miller et al [ 39 ]; Patel et al [ 74 ]; Solnes et al [ 75 ]; World Health Organization [ 22 ]; Kambala [ 76 ]; Kujawski [ 42 ]; Ndwiga [ 77 ]; Vedam et al [ 78 , 79 ]; Asefa [ 44 ]; Bohren [ 45 ]; Dynes [ 46 ]; Shakibazadeh [ 47 ]; Taavoni [ 48 ]; World Health Organization [ 50 ]; Afulani [ 51 , 52 , 80 ]; Giordano [ 53 ]; Afulani [ 56 ]; [ 82 ] Ayoubi 2020; [ 24 , 59 – 61 ] Butler; Lothian; Moridi; Montoya; Behruzi [ 67 ] Ouedraogo [ 70 ] ConesaFerrer [ 71 ] Right to non-discrimination, equality and equitable care 1. Doctors/nurses/midwives adhere to policies on non-discrimination 2.…”

Coverage, associated factors, and impact of companionship during labor: A large‐scale observational study in six hospitals in Nepal

“…26 Consistent with other studies on the effect of companionship during labor on intrapartum care, companionship during labor facilitates spontaneous vaginal delivery and reduces the intensity of pain 27 and maternal satisfaction. 28 Given the global epidemic of unnecessary cesarean birth, increasing coverage of nonclinical interventions such as companionship during labor can reduce the risk of unnecessary cesarean births. 29,30 In low-income families, providing support during labor may be more difficult as family members working on a daily wage basis may lose the household income.…”

Perceptions on respectful maternity care in Sri Lanka: Study protocol for a mixed-methods study of patients and providers

“…Higher rates of maternal as well as neonatal and infant mortality and morbidity is associated with disrespectful maternity care in LMICs [4]. Existence of RMC has good short-term and long-term outcomes on the mother and her family [8]. A review by Shakibazadeh et al, in 2018 have concluded that the concept of RMC is broader than just reduction of disrespectful care or minimising mistreatment of women during childbirth [9].…”