When a woman comes into an MSI maternity center, we want her to have a positive experience. Our new Respectful Maternity Care training is helping ensure that happens, giving providers a new perspective on preventing obstetric violence.
The term “obstetric violence” covers a wide range of experiences which take choice and autonomy away from the laboring woman. This can include everything from dismissive attitudes to truly aggressive behaviors by health care providers. But it also includes practices such as unnecessary episiotomies or unnecessary separation of mother and baby.
Obstetric violence includes:
Unfortunately, this kind of experience is sometimes deeply rooted in routine practices, and it’s more common than you might think. One study by the WHO followed over 2000 women pre- and post-childbirth in Ghana, Nigeria and Guinea. It concluded that four out of ten women experienced discrimination or verbal or physical abuse, such as slapping, mocking, and unnecessary medication or cesarean sections.
By contrast, respectful maternity care is care organized for and provided to all women in a manner that maintains and respects her dignity, privacy, and confidentiality. It ensures freedom of harm and mistreatment and enables informed choice and continuous support during prenatal care, labor, childbirth and postpartum. For example, it might include allowing birth companions; avoiding unnecessary episiotomy; or humanized Caesarean sections.
Negative birthing experiences deny women their bodily autonomy: Their fundamental right to decide what happens to their body, the right to informed consent, the right to privacy, and the right to equal treatment. This can have a lasting impact on women’s health, including higher incidence of postpartum depression, breastfeeding and bonding issues.
MSI operates high-quality maternity centers in 7 countries, including Ethiopia, Bangladesh and Madagascar. While MSI’s staff were already committed to providing a safe experience for women, a unique new Respectful Maternity Care training encourages medical providers to put themselves in clients’ shoes.
Using exercises inspired by Values Clarification and Attitudes Transformation workshops, long used by abortion activists, the training helps providers think about what would give them a positive experience through role play, case scenarios, and other exercises. By exploring the provider’s underlying beliefs and attitudes, these trainings encourage lasting change.
MSI launched Respectful Maternity Care training earlier this year, and the feedback from providers has been overwhelmingly positive. After a recent training in Nairobi, Kenya, providers from across MSI’s maternity programs came away surprised and inspired by the way the exercises made them think critically about their own practices. The training will be rolled out to all 31 MSI maternity care providers in 2023.
“In addition to feeling safe, we want women to have a positive, compassionate and respectful experience throughout her pregnancy, labor, delivery and postnatal period,” Patricia Lledo Weber, Head of Clinical Services, told us. “We must respect her dignity and privacy and enable informed choices about how she wants to deliver.”
Last year, MSI’s maternity centers saw more than 16,000 deliveries. They also saw 112,000 pre- and post-natal visits, primarily to women in urban areas. They also play a crucial role in our advocacy work. By offering maternity services, we help destigmatize MSI’s work offering post-abortion care and safe abortion services. Governments and insurance providers who might hesitate to speak to an abortion provider are far more willing to talk to us when we also offer safe delivery.