Reflections on meeting women's childbirth expectations.

When care providers support their personal worth, use caring communication, facilitate consumer participation in decision making, seek optimal outcomes, and know the patient holistically, female patients feel that their dignity is respected. We compare women's expectations for dignified care in contemporary society with the expectations of women 40 years ago. Some progress has been made toward valuing women's voices and participation in decision making, the availability of interventions for optimal outcomes, and recognition of the importance of cultural competence. Continued work is needed to meet women's expectations for receiving individualized and tailored care, information about intervention effectiveness and risks, and support for the birth process that the family desires. A renewed focus on the recipient of care as a coparticipant in her birthing experiences may result in improved outcomes and resolution of tensions between childbearing women and sociopolitical forces and standards of care.