Athira Chullithala, Majumdar Anindo, Sutar Roshan F, Singh Bharti, Thampy Parvathy, Rupani Ashlesh, Dabar Deepti
Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
BMC Pregnancy Childbirth. 2025 Aug 21;25(1):869. doi: 10.1186/s12884-025-07454-x.
This study investigates Respectful Maternity Care (RMC) and its determinants in a rural area of Central India. RMC, which is crucial for reducing maternal mortality, emphasizes dignity, privacy, and autonomy during childbirth. The study aligns with the Sustainable Development Goals (SDG) to improve maternal health outcomes.
A mixed methods study with a convergent parallel design was conducted in the Obedullaganj block of Raisen district in Madhya Pradesh. Participants were mothers who had recently given birth in healthcare facilities of the district. Data measuring Respectful Maternity care was collected using the Person-Centered Maternity Care (PCMC) Scale and in-depth interviews. Descriptive data is presented in frequency tables. Quantitative data were analyzed using logistic regression and qualitative data through thematic analysis.
The mean PCMC score was 48.6, with 26.3% of women experiencing good Respectful Maternity Care. Significant determinants of poor RMC included delivery in government health facilities (OR:4.58, 95% CI: 1.79 - 11.66), fewer than four antenatal care visits (OR: 2.5, 95% CI: 1.47 - 4.26), vaginal delivery (OR: 5.59, 95% CI: 3.01 - 10.38), and normal birth weight babies (OR: 2.82, 95% CI: 1.44 - 5.52). Qualitative analysis revealed themes around perceived knowledge of Respectful Maternity Care, barriers to delivering respectful care, and health system factors related to the provision of maternity care.
Respectful maternity care is vital for maternal and child health. The findings highlight that health system constraints such as human resources and their sensitization and training in RMC, among other logistics, must be addressed systematically to ensure respectful maternity care for mothers. The study also revealed that patient-related factors such as social status, economic worth, cultural barriers, illiteracy, lack of autonomy, and gender bias are also predictors of respectful care for mothers. The study's findings emphasize the need for policy and practice changes to ensure respectful maternity care, particularly in rural healthcare settings in India.
本研究调查了印度中部农村地区的尊重孕产妇护理（RMC）及其决定因素。RMC对于降低孕产妇死亡率至关重要，它强调分娩过程中的尊严、隐私和自主权。该研究与可持续发展目标（SDG）一致，旨在改善孕产妇健康结果。
在中央邦赖森区的奥贝杜拉甘杰街区进行了一项采用收敛平行设计的混合方法研究。参与者为最近在该地区医疗机构分娩的母亲。使用以人为主的孕产妇护理（PCMC）量表和深入访谈收集衡量尊重孕产妇护理的数据。描述性数据以频率表呈现。定量数据采用逻辑回归分析，定性数据采用主题分析。
PCMC平均得分为48.6，26.3%的女性获得了良好的尊重孕产妇护理。RMC不佳的显著决定因素包括在政府卫生设施分娩（比值比：4.58，95%置信区间：1.79 - 11.66）、产前检查少于四次（比值比：2.5，95%置信区间：1.47 - 4.26）、阴道分娩（比值比：5.59，95%置信区间：3.01 - 10.38）以及出生体重正常的婴儿（比值比：2.82，95%置信区间：1.44 - 5.52）。定性分析揭示了围绕对尊重孕产妇护理的认知、提供尊重护理的障碍以及与提供孕产妇护理相关的卫生系统因素等主题。
尊重孕产妇护理对母婴健康至关重要。研究结果表明，必须系统地解决人力资源及其对RMC的认识和培训等卫生系统制约因素以及其他后勤问题，以确保为母亲提供尊重孕产妇护理。研究还表明，与患者相关的因素，如社会地位、经济价值、文化障碍、文盲、缺乏自主权和性别偏见，也是母亲获得尊重护理的预测因素。该研究结果强调需要进行政策和实践变革，以确保提供尊重孕产妇护理，特别是在印度农村医疗环境中。
