Share-Net Report: Thematic Meeting – Respectful Maternity Care in Various Settings

Posted by Share-Net Intl on November 16, 2017 at 2:58 pm

Respectful maternity care: urgency requires us to really do something, together.

Share-Net’s thematic meeting on respectful maternity care well attended by practitioners, policy makers and researchers

Amsterdam, 7 November 2017

Over 70 practitioners, policy makers and researchers came together on November 7th to discuss respectful maternity care during a Share-Net organized thematic meeting. This meeting aimed to bridge the gap between global policy and local practice in maternal health care around the world.

The meeting was chaired by Prof. Dr. Jelle Stekelenburg, gynaecologist/obstetrician and Professor ‘International aspects of Reproductive Health, in particular Safe Motherhood’. Spoken word artist Marly provided creative intermezzos as spirited reflections on the topic.

Respectful maternity care is a global issue, and long received insufficient attention. Three keynote speakers reflected on the topic and clarified on links with practical frameworks, human rights and human resources for health. Dr. Metin Gülmezoglu, WHO Coordinator of the maternal and perinatal health and preventing unsafe abortion unit, called for better ways to measure disrespect in childbirth in order to create effective strategies to prevent and reduce mistreatment. In addition, tools are needed to improve quality of maternal and new-born care in health facilities. The WHO contributes to this with  a quality framework to guide national standards of care around the time of childbirth.

Prof. Tarek Meguid, consultant obstetrician/gynaecologist at  Mnazi Mmoja Hospital Zanzibar, provided a profound reality check of the quality of care women receive in many health facilities in low-resources settings: ‘there are many theoretical frameworks on human rights, but what matters is the context and contexts change over time. Women and health care practitioners need agency to be get back their power’. Agency is created by providing space and respectful maternity care is a mean to do so. He pointed out the way forward for practitioners, policy makers and researchers: ‘Change is possible and walls can be demolished. But, it requires us to really do something. You actually need to have people on the ground, working and ‘give a shit’’.

Franka Cadée, president of the International Confederation of Midwives (ICM) and Dr. Sally Pairman, chief executive, underlined the importance of respectful maternity care and called for a paradigm shift: ‘If safety comes first, respect doesn’t always follow, if respect come first, safety must follow. She added: ‘Midwives are pivotal in providing respectful care, but they need to be accepted and respected in society themselves’ and identified ICM’s role to strengthen midwives’ position around the world and promote respectful maternity care through the Midwifery Services Framework. This framework brings together all stakeholders who work with mothers and maternity care in particular countries and identify a common goal and the path to work towards this.

After these keynote speakers, an interactive ‘world café’ session followed, where participants discussed  how respectful maternity care can be implemented in local settings, and what the role of each stakeholder is (see practical recommendations below).

Francoise Jenniskens, Share-Net International coordinator, thanked the audience for their active participation and indicates that Share-Net is committed to explore and identify further actions. In conclusion, spokesperson from the Ministry of Foreign Affairs, Lily Talapessy, complimented Share-Net for brining all the relevant people together: practitioners, policy makers and researchers – as together they are paramount to reduce the gap between policy and practice, and ultimately ensure respectful maternity care is available for every woman in the world.

Key practical recommendations

  • A clear definition of respectful maternity care is urgently needed.
  • There is a big disconnect between global recommendations and what is happening on local level. Recommended is to work much more on a local level, for example by incorporating respectful care in training of healthcare providers.
  • Local providers should do their own research to create more awareness for respectful maternity care, and evidence to promote and provide this effectively.
  • Gender inequities are a barrier to implementing respectful maternity care, and this should be addressed as part of any solution.
  • The social, cultural and real life context of health care professionals should be recognized. If they feel respected themselves they are more likely to behave respectful to other women.
  • This solution does not depend on one stakeholder to provide the answer. Organise interdisciplinary meetings to reflect on care provided, and identify effective strategies to ensure respectful maternity care.
  • Grassroots organisations are necessary to implement respectful maternity care tools in a local setting.
  • Special attention is needed for work overload and stress of healthcare providers, as this is a source for disrespectful care and ‘compassion fatigue’.
  • In settings with many refugees from neighbouring countries with conflict: ensure sufficient attention for local people, and not only for refugees.
  • Healthcare professionals can make their own small contributions by:
    • Friendliness and kindness, listening to women, ask women what they want, incorporate attention for mental health and ensuring privacy.
    • Involve women in the decision-making process, get their informed consent.
    • Encourage women to have a birth companion to ensure respectful care, but especially to deal with disrespectful care.
    • Being a role model, and/or identify role models who are an example for your colleagues.

About the organizers
This meeting was organized by Share-Net international, in collaboration with the Royal Dutch Organisation of Midwives (KNOV), Dutch Working Party for Safe Motherhood and International Reproductive Health, Royal Tropical Institute (KIT), Netherlands Society for Tropical Medicine and International Health (NVTG), Cordaid and the UMC Utrecht.

Share-Net International combines the expertise and strengths of Dutch organisations, Southern partners and key international actors working in the area of SRHR to achieve the SRHR and HIV related Sustainable Development Goals (SDGs). Share-Net Netherlands is the Dutch network on SRHR and HIV and has been in operation since 2000. Share-Net Netherlands, within the Knowledge Platform, functions as the Dutch country node: sharing and disseminating knowledge and information, and as the national network. Relevant Dutch knowledge partners who are members of Share-Net Netherlands automatically became a member of Share-Net International.