Respectful Maternity Care in the US [15T

Abstract

INTRODUCTION: To understand the status of respectful maternity care (RMC) in the U.S. METHODS: A cross-sectional survey of U.S. women age 18-50 in April 2018. SurveyMonkey Audience distributed this anonymous survey online. Women were eligible if they gave birth in the U.S. in the last 5 years. Participants were those who answered at least one question about RMC from their most recent birth. Quantitative survey data consisted of demographics and responses about RMC indicators and comments about their birth experience. RESULTS: Of 1081 eligible, 1036 women (95.8%) participated. The locations of births from this group spanned the entire U.S. Most births (95%) occurred in hospitals. 36.7% of births were cesarean deliveries. The median maternal age was 32. 19.5% of respondents felt neglected at some point during their birth experience; more than half in the postpartum phase of care only. 333 left decipherable comments. When women reported issues, they were almost always one of the following: clinical staff performance or competency, neglect, interpersonal communication issues, lack of respect for wishes, negative experience with breastfeeding services, peri-partum complications, or perceived discrimination. CONCLUSION: This is the first study on RMC from women who have delivered in the U.S. Overall, the women surveyed were treated with dignity during their birth experiences. However, this data suggests that care for women during their birth experiences can be more respectful and that women feel more neglected during the postpartum period. Strategies to improve quality of maternal health care in the U.S. should include attention to the provision of RMC.