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.
Accountability
AC1:
Implement RMC training for nurses, providers, and other members of the interprofessional team during onboarding and at regular, ongoing intervals including topics such as:
- Communication techniques
- Shared decision making
- Obstetric violence
AC2:
Regularly and systematically collect data on RMC performance measures. Data collection should be guided by a structured model or measurement tool for RMC. Data collection tools include but are not limited to:
- Mothers Autonomy in Decision-Making Scale
- Person-Centered Maternity Care Scale
- Women’s Perception of Respectful Maternity Care Questionnaire
- Mothers on Respect Index
AC3:
Document information about patient identities, care preferences, and specific needs and communicate that information to all interprofessional team members.
AC4:
Create and implement a formal approach to debriefing following emergency situations and adverse incidents.
- The process should include patients and their identified support persons, and results should be shared with patients and support persons promptly
AC5:
Create and implement formal mechanisms for inviting patient feedback, including a clear and accessible grievance process to report instances of disrespect and abuse.
AC6:
Include shared decision-making and respectful care standards in written policies and payment and reimbursement models.
- Include patients and families in the policy development process, whenever possible.
Rationale
Healthcare providers should have formal training on providing respectful care. These training courses allow providers to reflect on their practice and how it aligns with professional and ethical standards. Education on obstetric violence can lead to better interpersonal relationships between the patient and the healthcare professional. Training for healthcare professionals can be key to preventing obstetric violence.
Systematically collecting data on RMC performance and public performance reporting can lead to productive change and progress toward providing RMC to all patients and families.
Publicly reporting performance measures can motivate organizations to invest in quality improvement efforts for respectful care and align respectful care goals with broader care quality and payment incentives.
Continuity of care and minimizing changes in caregivers are experienced as signs of respect. Interprofessional collaboration and coordination allow patients to receive streamlined information rather than conflicting advice.
Opportunities to discuss the events leading up to and during the birth may help women ease feelings of guilt and process traumatic events, as well as identify women who may be at risk for depression or post-traumatic stress.
A culture of accountability for RMC should include formal mechanisms through which women can report experiences of disrespect and abuse.
Healthcare organizations could strengthen their quality improvement systems by including projects to assess, address, report, and resolve instances of disrespect and abuse. Nurses should play key roles in these grievance processes or quality improvement systems.
Organizational policies and protocols are a powerful tool that can be leveraged to foster respectful, supportive care and shared decision making