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Respectful Maternity Care in Santa Cruz County, California

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Title:Respectful Maternity Care in Santa Cruz County, California
Authors:Stein, Cindy Aliza
Contributors:Shannon, Maureen (advisor)
Nursing (department)
Keywords:Nursing
Public health
maternal health
maternal morbidity
maternal mortality
show 3 moremidwife burnout
respectful maternity care
three delays model
show less
Date Issued:2019
Publisher:University of Hawai'i at Manoa
Abstract:Abstract
Background: In the global setting, despite access to lifesaving care in facilities that serve women during childbirth, many women delay or avoid using these services, as evidenced by vast amounts of literature on the topic. This has even proven true when controlled for variables that serve as obstacles to obtaining the care that they need. Global stakeholders have acknowledged the presence of disrespect and abuse (D&A) by staff within health facilities as a deterrent to women seeking lifesaving maternity services; the association between how respectfully a woman is treated during childbearing with how likely she is to utilize maternity services in the future. The movement to eliminate D&A in the maternity setting has resulted in the development of Respectful Maternity Care (RMC) as a model to combat this issue. However, a standardized definition of what respect means to childbearing women has never been established, making implementation of RMC universal standards and interventions difficult. This study was aimed at beginning to define what women consider respectful care to be so that minimum standards can be applied with an eye towards training staff, creating regulations that encourage or require RMC, or other potential interventions aimed at better serving women during childbirth.
Method and Findings: A qualitative descriptive study design was used in order to hear detailed accounts of women’s experiences and perceptions about respect. This emic approach allowed for an analysis of the experiences of participants while an iterative process was used to analyze the data resulting in codes, categories and themes via content analysis. Using semi structured interviews that explored themes in respectful maternity care through the lens of ten women who had recently given birth in Santa Cruz County, California. Recruitment stopped once saturation was achieved. Five themes emerged from the analysis: 1) Needs Were Met In a Timely Manner; 2) Care is Patient Centered; 3) Overall Feelings of Kindness; 4) Caregivers Are Experts; and 5) The Environment is Safe. The working definition of respect that can be derived from this study and its resulting themes is, “Respect in the maternity setting is a multivariate concept based on women feeling well cared for by health workers based on their attitudes and actions: attentiveness, a high level of knowledge, kindness, a focus on patient preference, and providing a safe environment to put women at ease.”
Limitations: Due to the homogenous nature of the study sample, saturation was reached at ten, a small sample size. Descriptions may be limited in that they are not generalizable to other populations. Also, contributing factors such as experiences during the prenatal period were not discussed in interviews.
Conclusions: The results of this small study indicated that women experiencing childbirth consider respectful care to involve attitudes and behaviors of maternity staff that encompass treating the women with kindness, providing care that is based on current evidence to ensure their and their infants’ safety, being attentive to their needs in a timely manner, and including them in conversations about plans of care while considering their desires reflecting a patient-centered approach to care.
Keywords: maternal mortality, maternal death, facility-based maternity care, barriers to obstetric care, maternal morbidity, maternal near-misses, disrespectful maternity care, respectful maternity care, burnout, midwife burnout, compassion fatigue, human rights and birth, three delay, three-delays model.
Description:Ph.D. Thesis. Ph.D. Thesis. University of Hawaiʻi at Mānoa 2019
Pages/Duration:129 pages
URI:http://hdl.handle.net/10125/63226
Rights:All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
Appears in Collections: Ph.D. - Nursing


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