Evidence & Action for Respectful Care at Birth

This effort aims to address the significant barriers posed by disrespect and abuse of women in childbirth facilities worldwide. Disrespect and abuse in childbirth constitute both a human rights issue and an important quality of care problem. Disrespect and abuse in childbirth can take various forms, including physical abuse, non-dignified care, non-consented care, non-confidential care, discrimination, abandonment of care, and detention in facilities. These forms of disrespect and abuse are often perpetuated by individuals and communities that normalize such behavior during childbirth. National laws and policies that do not exist or are not enforced also contribute to disrespect and abuse in childbirth. Leadership and governance for respect and non-abuse are lacking in many facilities, and standards of care and mechanisms for accountability are not available. Providers may demonstrate prejudices or be demoralized due to weaknesses in the health system. A review of the evidence identifies seven categories of disrespect and abuse in childbirth, including physical abuse, non-dignified care, non-consented care, non-confidential care, discrimination, abandonment of care, and detention in facilities. Numerous factors contribute to disrespect and abuse in childbirth, including the normalization of disrespect and abuse during childbirth, the lack of national laws and policies, and the absence of leadership and governance for respect and non-abuse. Providers may also demonstrate prejudices or be demoralized due to weaknesses in the health system. A patient satisfaction survey may reveal high levels of satisfaction among women, but this may be due to their reluctance to speak out against mistreatment. Civil society organizations are promoting human rights efforts and public interest litigation to raise awareness and hold governments accountable for disrespect and abuse in childbirth. Various approaches have been developed to address these issues, including quality improvement, stigma reduction, and accountability measures. These efforts aim to promote respectful care at birth and address the significant barriers posed by disrespect and abuse of women in childbirth facilities worldwide.