Respectful maternity care during childbirth: postnatal women's perspectives. Cross-sectional study from central India: February - December 2023.

OBJECTIVE

This study assesses postnatal women's perceptions of Respectful Maternity Care (RMC), aiming to identify key areas for improvement.

METHODS

A cross-sectional quantitative study was carried out in selected urban areas of Bhopal, India. Women aged 18 years and above, who had given birth to a healthy newborn within the previous 42 days, were eligible to participate if they resided in the study area, could understand Hindi or English, and had no cognitive impairments. Estimated sample size was 238 with 77% estimated prevalence, 5% margin of error, and 95% confidence level; 270 women were recruited using purposive sampling from 18 urban wards and 98 Anganwadi centres. Participants were approached directly and interviewed in person using a structured questionnaire and the validated RMC Scale by Sheferaw et al. The primary outcome was the level of perceived respectful maternity care, while independent variables included socio-demographic and obstetric factors such as age, education, place of delivery, and number of antenatal visits. Data were analysed using descriptive statistics and Fisher's exact test due to the non-normal distribution of variables.

RESULTS

Of the 270 participants, 51.2% were aged 25-30 years and 75.3% were Hindus. Most deliveries (57.4%) were normal vaginal deliveries, and 75.6% occurred in government hospitals. Overall, 82.6% of women reported experiencing RMC. Domain-wise, 91% experienced Friendly Care, 93.3% Abuse-Free Care, 79.7% Timely Care, and 87.7% Discrimination-Free Care. Item-wise analysis revealed strengths in provider kindness and clear communication, though about 15-25% of women experienced delays, verbal mistreatment, or felt disrespected. Socioeconomic status had a significant influence in all four domains (p < 0.05), with women from higher income groups reporting more positive experiences. Higher education level was also associated with greater awareness and recognition of discriminatory practices (p = 0.014), Obstetric variables such as mode of delivery (p = 0.031), time of delivery (p = 0.003), antenatal visits (p = 0.017, 0.029), and high-risk pregnancy (p = 0.037) showed domain-specific associations.

CONCLUSION

Although most women described their childbirth experience as respectful, notable gaps remain in timely and equitable care. Addressing delays and reducing discrimination, particularly in public healthcare settings, are essential to ensuring that all women receive dignified, person-centred maternity care, regardless of their background.