Respectful Maternity Care as perceived by the Birth Companions of Women who gave birth in a Tertiary care Teaching Hospital in South India: A pilot study

Background: Continuous maternal support during labour and childbirth is one of the evidence based interventions that proved to be associated with good maternal and perinatal outcomes. It is also reported to increase maternal satisfaction and decrease the disrespect and abuse. But few studies report the occurrence of D&A even in presence of birth companion. Objective: To determine the proportion of women treated with Disrespect and Abuse and to identify the type of disrespect and abuse as perceived by the birth companions of women who gave birth at Women and Children Hospital. Methods: Prospective observational mixed method pilot study undertaken from September 2020-December 2020 as a part of the Project on Respectful Maternity Care. Thirty birth companions were recruited randomly after informed consent to participate soon after (72hrs) delivery of their ward (postpartum women). They were asked to fill the answers to USAID-MCHIP Questionnaire on RMC, Rate the Disrespect and abuse on a 10 point scale to measure D&A quantitatively. They were interviewed to tell their views on the care given during labour and postpartum period for qualitative analysis. Results: As per their observations, 43.3% opined that the women experienced at least one type of D&A, 13.3% opined women experience 2 types of D&A, 10% percent witnessed 3 types of D&A; 3.3% felt 5 types of D&A as per the USAID Standards. On rating scale they felt that D&A was experienced by only 20% and 3.3% experienced severe D&A. The most common type of D&A was non-dignified care followed by physical abuse. Qualitative analysis revealed 93% felt the women received quality care and had positive experience and appreciated RMC as good and 6.7% gave suggestions to improve RMC. Conclusion: RMC as witnessed by birth companions and assessed quantitatively by Questionnaire was high but on rating scale it is low. Only few felt, women in labour still experience D&A in their presence and the most common type was non-dignified care. The overall experience of childbirth care was perceived as good and they were grateful to have allowed them to give maternal support