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.
Autonomy
Key Recommendations
AU1:
Demonstrate support for the patient’s individual choices by explaining information and options calmly, using neutral language, and by avoiding judgment, coercion or pressure, threats, blame, or trivializing patients’ concerns.
AU2:
Select an evidence-based framework or model that centers patient autonomy in providing RMC and incorporate the model into universal clinical practice expectations.
Rationale
Any coercion, threat, or pressure toward a particular patient’s decision or option is clearly disrespectful and unethical. Coercive actions may also include withdrawing care or providing nonconsenting care, and some view repeated counseling after a decision is made as coercive as well.
Examples of coercive language include the following:
- Exaggeration or lying about risks to the fetus
- Using medical jargon or terms associated with negative emotions when discussing risks
- Shouting at or scolding mothers
Many nurses and health care professionals may think they practice without a theoretical or ideological framework, viewing medical practice as neutral. However, birth-related care in the developed world, especially in the U.S., often follows a technocratic approach that emphasizes science and technology, prioritizes economic profit, supports powerful institutions, and tends to avoid risks.
Various effective models and evidence-based frameworks support patient autonomy and foster respectful clinical practices, ensuring patients are true partners in their care.
One significant example is the “International Childbirth Initiative: 12 Steps to Safe and Respectful Mother-Baby-Family Maternity Care.” Every healthcare organization should adopt a model that demonstrates its commitment to promoting autonomy and providing respectful care.