1. Callister, Lynn Clark PhD, RN, FAAN

Article Content

In 2018, a compelling commentary by the World Health Organization (WHO) covering the respectful maternity care spectrum ranging from neglect to overuse of medical interventions noted a good birth goes beyond having a healthy baby. Lack of respectful maternity care is an ongoing issue in the United States and around the world. Disrespectful care is physical, sexual, or verbal abuse; stigma and discrimination; failing to meet professional standards of care; poor communication between women and their providers; and health system conditions and constraints (Bohren et al., 2019). Respectful maternity care is a human right, not simply a nicety. Nurses must advocate for respectful maternity care and make sure each woman is treated appropriately (Callister, 2017; Simpson, 2019).


Bohren et al. (2019) reported on care provided to 2016 women in Ghana, Guinea, Myanmar, and Nigeria giving birth in healthcare facilities based on researcher observations during labor and birth and surveys of postpartum women. Over 40% of women observed and 35% of women who were interviewed experienced mistreatment. Women at risk for mistreatment were young and less educated. Summarizing growing evidence of mistreatment across the globe, Morton and Simkin (2019) ask if respectful maternity care can save and improve lives. They conclude inadequate and disrespectful care is experienced by women globally, noting in the United States, African American, American Indian, and Alaskan Native women are particularly at risk. Such disparities in care potentially compromise the health of women and their newborns everywhere. The World Health Organization (2018) has provided clear and comprehensive recommendations designed to enhance care of childbearing women and their newborns, with the focus being on essential physical resources and competent and motivated staff.


Research is needed on the relationship between quality of care and emotional and physical outcomes for birthing women and their newborns, how to honor and respect the cultural beliefs and practices of childbearing women within the sociocultural context of birthing facilities, and perceptions of childbearing women and perinatal care providers on what constitutes disrespectful and abusive care. Listening to the voices of birthing women is critical in gaining increased understanding of quality of their experiences when giving birth in healthcare facilities. Outcomes data reporting implementation of the WHO (2018) recommendations are needed.


In a classic work, the essential nature of respecting birthing women by ensuring the care provided supports them during a significant life event is described: The perinatal experience, an act of procreation, rite of passage, sacrifice of love, obligation or conscience, choice of fulfillment, or what it represents in the minds and hearts of birth-giving women and their communities, is a life-transforming object of respect (Delellis, 2000, p. xxii). Nurses are pivotal in the provision of quality childbirth care. We can and should make a difference for those women for whom we are privileged to attend. Women should be able to routinely experience respectful maternity care as part of high-quality clinical services and not be expected to be happy simply to have survived the process.




Bohren M. A., Mehrtash H., Fawole B., Maung T. M., Balde M. D., Maya E., ..., Tuncalp O. (2019). How women are treated during facility-based childbirth in four countries: A cross-sectional study with labour observations and community-based surveys. Lancet, 394(10210). 1750-1763. doi:10.1016/S0140-6736(19)31992-0 [Context Link]


Callister L. C. (2017). How are women giving birth in healthcare facilities treated? MCN. The American Journal of Maternal Child Nursing, 42(1), 59. doi:10.1097/NMC.0000000000000295 [Context Link]


Delellis A. J. (2000). Respect in the perinatal experience. The Journal of Perinatal Education, 9(4), viii-xii. doi:10.1624/105812400X87842 [Context Link]


Morton C. H., Simkin P. (2019). Can respectful maternity care save and improve lives? Birth, 46(3), 391-395. doi:10.1111/birt.12444 [Context Link]


Simpson K. R. (2019). Listening to women, treating them with respect, and honoring their wishes during childbirth are critical aspects of safe, high-quality maternity care. MCN. The American Journal of Maternal Child Nursing, 44(6), 368. doi:10.1097/NMC.0000000000000578 [Context Link]


World Health Organization. (2018). WHO recommendations for a positive childbirth experience. Geneva, Switzerland: Author. [Context Link]