Respectful Maternity Care Worldwide: A Systematic Review of Global Practices, Gaps, and Progress

Abstract

Disrespect and abuse during facility-based childbirth remain significant barriers to maternal health care utilization and quality, particularly in low- and middle-income countries. Respectful Maternity Care (RMC) emphasizes the preservation of women's dignity, rights, and autonomy during childbirth. This review aimed to explore the types and effectiveness of interventions promoting RMC, existing measurement tools, and current gaps in research, policy, and practice. A narrative review of peer-reviewed literature, global reports, and programmatic documents was conducted. Key domains were synthesized, including intervention types, implementation effectiveness, measurement tools, and policy integration. Interventions such as health worker training, facility-level improvements, companionship during labor, and community engagement have demonstrated moderate to strong evidence in reducing mistreatment and improving maternal satisfaction. Tools like the MCHIP RMC Toolkit, WHO Quality Standards, and the Disrespect and Abuse Measurement Tool provide frameworks for evaluating RMC, although standardisation and application vary widely. Gaps remain in longitudinal research, legal enforcement, provider accountability, and inclusion of marginalized groups. Despite growing attention to RMC, implementation and evaluation remain inconsistent. Strengthening policies, integrating RMC into health systems, standardizing measurement tools, and enhancing community involvement are essential for ensuring respectful care for all women during childbirth.