TITLE:
Health Care Providers’ Perceptions of Respectful and Disrespectful Maternity Care in Facility-Based Births Worldwide: A Mixed Methods Systematic Review
AUTHORS:
Katherine Doughty Fachon, Sahana Narayan, Mary Greenwald, Annekathryn Goodman
KEYWORDS:
Respectful Maternity Care, Disrespect and Abuse, Childbirth
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.10,
October
30,
2025
ABSTRACT: Background: Respectful maternity care is critical to the health of birthing people and infants worldwide. However, there is global evidence of disrespectful or abusive care in childbirth, which negatively impacts maternal experiences and health outcomes. Maternal health care providers hold key insights into the dynamics of quality of care in childbirth. The aim of this systematic review is to synthesize the perspectives of health care providers’ perceptions of respectful and disrespectful care in childbirth. Methods: We searched PubMed, CINAHL, HOLLIS (Harvard Medical Library), and Medline database for peer-reviewed quantitative and qualitative research studies examining health care providers’ perceptions of respectful and disrespectful maternity care published between January 2014 and July 2024. Quantitative studies were summarized, and qualitative studies were synthesized thematically. A mixed-method summary integrated findings from both quantitative and qualitative findings. Results: Sixty studies (15 quantitative, 39 qualitative, and 6 mixed methods) were included. Prevalence of witnessing disrespect and abuse in childbirth ranged widely, from 21.9% to 93.2%. Types of respectful and disrespectful care witnessed and performed by maternal health care providers varied greatly. Four themes were identified from qualitative studies: 1—facility and structural issues, 2—clinician responsibilities, 3—hierarchy and power, and 4—(mis)understanding and interpreting the mother’s experience. Both qualitative and quantitative studies identified three issues. Reduced staffing was a barrier to respectful maternity care. A lack of privacy was a key issue. Finally, providers expressed a need for training on respectful maternity care. Conclusions: This review found a wide variety of metrics quantifying respectful and disrespectful maternity care, and a diversity of knowledge and perceptions held by health care providers. The global scope of the review revealed that the manifestation of respectful and disrespectful care varied greatly by cultural and institutional context, and that organizational resources significantly impacted quality of care.