Researchers develop universal definition of respectful maternity care

By Chandler Watkins

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    PORTLAND, Oregon (KPTV) — Oregon Health & Science University says it is leading national research efforts to determine the role of respectful maternity care as maternal mortality rates in the U.S. continue to rise.

“Rates of maternal death and maternal illness in this country are some of the worst of any comparable country,” said Dr. Amy Cantor, associate professor medical informatics and clinical epidemiology, family medicine and obstetrics and gynecology at the OHSU School of Medicine. “The U.S. spends quite a bit on healthcare, but has some of the worst maternal healthcare outcomes and what’s worse is that there are really big disparities and these outcomes are much worse for Black women.”

Dr. Cantor was the principal investigator and lead author of a recent study aimed at establishing a better understanding of RMC, or respectful maternal care. The study was recently published in the Annals of Internal Medicine.

“Currently there isn’t a gold standard and when we’re thinking about research, it’s really helpful when we are all talking about the same thing and we are comparing to the same thing,” Dr. Cantor said. “In this space, unfortunately, there isn’t a gold standard. Fortunately, there is widespread agreement that respectful maternity care should be a part of how healthcare is given and received. Importantly, this research really highlights the need to come to a consensus around a definition and also come to an agreement on how we should best measure this so that we can implement respectful maternity care on a widespread scale.”

The study, which was funded by the Agency for Healthcare ad Quality Research at the U.S. Department of Health and Human Services, came after HHS launched an effort to improve maternal health outcomes in 2020.

“Part of the problem in this country is that there are huge disparities between rates of maternal death and maternal illness,” Dr. Cantor said. “Our research and some of the background is really informed by the fact that some of this stems from mistreatment during care and disrespect. Feelings of abuse, trauma. There are differences in the way that women arrive at and experience healthcare, specifically maternal healthcare.”

Dr. Cantor said what’s most important is that health professionals are on the same page with what constitutes providing respectful maternity care.

“What our research has really evaluated is that there are some working definitions, some of the earlier definitions and frameworks come from perspectives on the fact that there is disrespect and abuse that has been experienced by women who are giving birth or people who are giving birth,” Dr. Cantor said. “Later frameworks really focus on rights and justice, so eliminating those inequities, improving health disparities and making sure that there aren’t differences in the way that people who are giving birth receive and experience healthcare. That they are part of the decision making process, that they have consent for the way that procedures and decisions around those procedures are made and that they are part of the team.”

The team of researchers developed a definition of respectful maternal care using the data they collected: “Respectful maternity care: An approach to maternity care that honors the dignity, personhood, autonomy, and preferences of birthing people; prevents disrespect, mistreatment, or abuse toward individuals who are using maternal care services; and provides a practical paradigm for the delivery and receipt of peripartum care through a rights and reproductive justice-based framework.”

They hope this study will have widespread impacts on health systems, clinicians and patients.

“Ultimately, this will lead to quality improvement initiatives and improving the quality of care more broadly,” Dr. Cantor said. “Coming together around a definition is important so that when we decide to measure how that care is delivered, we are all on the same page. This work will be used by clinicians and policy makers, as well as the start to begin to measure how care is delivered.”

Dr. Cantor said this is a positive step in providing RMC.

“Our research is not definitive.”Dr. Cantor said. “There are ongoing efforts to improve maternity care, respectful care. This is just the start as part of this federal initiative. We are all, I think, in agreement that every person who is giving birth deserves respectful care and that we are all working to find a way to do that and provide that care.”

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