Module 04:
Promoting Respectful Maternity and Newborn Care
Welcome to the fourth module in the ERMC course. This module has been developed to further your knowledge of the consequences of disrespectful care for women during labor and birth and ways to promote ERMC. A list of resource requirements to promote ERMC is also provided, as well as an example of a case scenario of providing ERMC. Finally, this module will end with a post-course completion survey that includes reflection on equity and respect in maternity care.
Module 04:
Promoting Respectful Maternity and Newborn Care
Welcome to the fourth module in the ERMC course. This module has been developed to further your knowledge of the consequences of disrespectful care for women during labor and birth and ways to promote ERMC. A list of resource requirements to promote ERMC is also provided, as well as an example of a case scenario of providing ERMC. Finally, this module will end with a post-course completion survey that includes reflection on equity and respect in maternity care.
Dignity
Key Recommendations
D1:
Protect patients’ physical and informational privacy. Limit the amount of hospital personnel in the patient’s room to only essential staff according to maternal and fetal conditions.
D2:
Listen to and take seriously any concerns or complaints raised by patients or their support persons.
D3:
Maximize safe freedom to move and encourage patients to labor in positions that they choose.
D4:
Respect and welcome the presence of support people chosen by the patient and include support people and doulas as part of the care team.
Rationale
The process of labor and birth can be one of marked vulnerability in which pregnant people experience a variety of assessments and interventions that are intimate and invasive.
A lack of privacy, or non-confidential care, is experienced as a violation of rights and can be considered a form of mistreatment or abuse. Lack of privacy can increase stress and fatigue during healthcare encounters.
Healthcare providers should try to create a birth environment that is comforting and free from distractions and ensure that all patients are provided privacy during labor and birth.
When dignity is fully protected, all staff will listen to and take seriously the concerns that patients and their support persons raise. Women have reported that when staff fail to take their concerns or reports of disrespectful care seriously, they experience a loss of their dignity.
Nurses and other healthcare providers should ask for and facilitate women’s choices for positioning and movement throughout labor and birth. Women should be encouraged to find comfortable positions during labor and delivery.
Providing options for movement and encouraging upright positioning instead of supine or semi supine positions during labor and birth can help encourage comfort and control and prevent some negative sequelae, such as maternal hypotension and reduced fetal blood flow.
The presence of support persons for the mother is critical to respecting the patient’s and family’s dignity.
The presence of support persons can help to meet a patient’s psychological needs, increase the patient’s relaxation, and increase the likelihood of positive birth outcomes.