ARCHIVES OF MATERNAL AND CHILD HEALTH
Original Article
Aug 17, 2026 167 100

Women’s Perception of Respectful Maternity Care During Childbirth: A Facility-Based Cross-Sectional Survey in Uttarakhand, India

Prasuna Jelly 1,
Rizu Negi 2,
Punitha Muruganantham 3,
Suresh K Sharma 4,
Ritu Rani 1,
Farzaneh Pazandeh 5,
Rakesh Sharma 1,
Manikandan Thirunavukkarasu 6,
Inamul Hasan Madar 3 6 *
1 College of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India2 College of Nursing, Government Institute of Medical Sciences (GIMS), Greater Noida, Uttar Pradesh, India3 Womy Foods and Nutraceuticals Pvt Ltd, Yenepoya Technology Incubator (YTI), Yenepoya (Deemed to be University), Mangalore, Karnataka, India4 Multiomics and Precision Medicine Unit (MPMU), Yenepoya Research Centre (YRC), Yenepoya (Deemed to be University), Mangalore, Karnataka, India5 Shahid Beheshti University of Medical Sciences, Tehran, Iran6 Centre for Integrative Omics Data Science, Yenepoya (Deemed to be University), Mangalore, Karnataka, India* Corresponding Author
Archives of Maternal and Child Health, 1(1), 2026, amch004, https://doi.org/10.63946/amch/19167
Publication date: Aug 17, 2026
Full Text (PDF)

ABSTRACT

Background: In India, pregnant women and their families face considerable challenges when trying to access expert-level maternity care, primarily due to the inadequately rendered services within poorly managed healthcare facilities. Among these challenges, one of the most profound discouragements is the documented evidence of disrespect and mistreatment of women during childbirth within healthcare facilities. This type of mistreatment undermines the dignity and the psychological wellness of mothers and discourages them from pursuing prompt care within the facility. While it is of significant relevance, the disrespect and mistreatment of women during the childbirth process remain poorly documented, thus limiting the understanding of the phenomenon's size. This paper could be the first of its kind to document the ubiquity of discourtesy and mistreatment in maternity care in the context of facility childbirth in Uttarakhand, India, and to contribute to the understanding of disrespect and mistreatment in maternity care across the healthcare continuum.
Methods: A cross-sectional facility-based study was conducted from March 2021 to October 2021. In total, 120 women were selected using a total enumeration technique. A standardized tool (Women's Perception of Respectful Maternity Care) was used to retrieve the data. Data were entered into SPSS version 22.0 for analysis. Significant statistics were confirmed at a P-value of < 0.05.
Results: From 120 women’s data, 83% of them received respectful maternity care. The mean whole respectful maternity care score was 86.4 with a range of 19 to 95. Subsequently, after adjusting for sociodemographic and obstetric features, the correlation between respectful maternity care and the mode of delivery (P=0.96), age (P=0.77), and gravida (P=0.79) was not significant.
Conclusions: Respectful maternity care is clearly practiced in Rishikesh's designated public wellness services. Positive experiences with perinatal care can increase use of parental care services. A more intensive study is needed to better recognise appropriate local factors, social norms, and patient-provider interactions.

KEYWORDS

Respectful Maternity Care Childbirth Intrapartum Care Postnatal Mothers Institutional Delivery Services

CITATION (Vancouver)

Jelly P, Negi R, Muruganantham P, Sharma SK, Rani R, Pazandeh F, et al. Women’s Perception of Respectful Maternity Care During Childbirth: A Facility-Based Cross-Sectional Survey in Uttarakhand, India. Archives of Maternal and Child Health. 2026;1(1):amch004. https://doi.org/10.63946/amch/19167
APA
Jelly, P., Negi, R., Muruganantham, P., Sharma, S. K., Rani, R., Pazandeh, F., Sharma, R., Thirunavukkarasu, M., & Madar, I. H. (2026). Women’s Perception of Respectful Maternity Care During Childbirth: A Facility-Based Cross-Sectional Survey in Uttarakhand, India. Archives of Maternal and Child Health, 1(1), amch004. https://doi.org/10.63946/amch/19167
Harvard
Jelly, P., Negi, R., Muruganantham, P., Sharma, S. K., Rani, R., Pazandeh, F., . . . Madar, I. H. (2026). Women’s Perception of Respectful Maternity Care During Childbirth: A Facility-Based Cross-Sectional Survey in Uttarakhand, India. Archives of Maternal and Child Health, 1(1), amch004. https://doi.org/10.63946/amch/19167
AMA
Jelly P, Negi R, Muruganantham P, et al. Women’s Perception of Respectful Maternity Care During Childbirth: A Facility-Based Cross-Sectional Survey in Uttarakhand, India. Archives of Maternal and Child Health. 2026;1(1), amch004. https://doi.org/10.63946/amch/19167
Chicago
Jelly, Prasuna, Rizu Negi, Punitha Muruganantham, Suresh K Sharma, Ritu Rani, Farzaneh Pazandeh, Rakesh Sharma, Manikandan Thirunavukkarasu, and Inamul Hasan Madar. "Women’s Perception of Respectful Maternity Care During Childbirth: A Facility-Based Cross-Sectional Survey in Uttarakhand, India". Archives of Maternal and Child Health 2026 1 no. 1 (2026): amch004. https://doi.org/10.63946/amch/19167
MLA
Jelly, Prasuna et al. "Women’s Perception of Respectful Maternity Care During Childbirth: A Facility-Based Cross-Sectional Survey in Uttarakhand, India". Archives of Maternal and Child Health, vol. 1, no. 1, 2026, amch004. https://doi.org/10.63946/amch/19167

REFERENCES

  1. Jewkes R, Penn-Kekana L. Mistreatment of Women in Childbirth: Time for Action on This Important Dimension of Violence against Women. PLoS Med. 2015;12(6):e1001849. https://doi.org/10.1371/journal.pmed.1001849
  2. Likis FE. The Lancet Series on Midwifery: A Momentous Opportunity to Improve Maternal and Newborn Health. J Midwifery Womens Health. 2014;59(5):477–8. https://doi.org/10.1111/jmwh.12241
  3. White Ribbon Alliance. Respectful maternity care: The universal rights of childbearing women [Internet]. 2011 [cited 2026 Aug 11]. Available from: https://www.whiteribbonalliance.org
  4. van den Broek NR, Graham WJ. Quality of care for maternal and newborn health: the neglected agenda. BJOG. 2009;116(Suppl 1):18–21. https://doi.org/10.1111/j.1471-0528.2009.02333.x
  5. Mousa O, Turingan O. Quality of care in the delivery room: Focusing on respectful maternal care practices. J Nurs Educ Pract. 2019;9(1):1. https://doi.org/10.5430/jnep.v9n1p1
  6. Ayoubi S, et al. A questionnaire to assess women's perception of respectful maternity care (WP-RMC): Development and psychometric properties. Midwifery. 2020;80:102573. https://doi.org/10.1016/j.midw.2019.102573
  7. Kumar S. Reducing maternal mortality in India: policy, equity, and quality issues. Indian J Public Health. 2010;54(2):57–64. https://doi.org/10.4103/0019-557X.73271
  8. Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review. PLoS Med. 2015;12(6):e1001847. https://doi.org/10.1371/journal.pmed.1001847
  9. Waldenstrom U, et al. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17–27. https://doi.org/10.1111/j.0730-7659.2004.0271.x
  10. Henriksen L, et al. Factors related to a negative birth experience – A mixed methods study. Midwifery. 2017;51:33–9. https://doi.org/10.1016/j.midw.2017.05.004
  11. Ghanbari-Homayi S, et al. Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study. BMC Pregnancy Childbirth. 2019;19(1):182. https://doi.org/10.1186/s12884-019-2333-4
  12. Tani F, Castagna V. Maternal social support, quality of birth experience, and post-partum depression in primiparous women. J Matern Fetal Neonatal Med. 2017;30(6):689–92. https://doi.org/10.1080/14767058.2016.1182980
  13. Smarandache A, et al. Predictors of a negative labour and birth experience based on a national survey of Canadian women. BMC Pregnancy Childbirth. 2016;16(1):114. https://doi.org/10.1186/s12884-016-0903-2
  14. Mousa O, Turingan OM. Quality of care in the delivery room: Focusing on respectful maternal care practices. J Nurs Educ Pract. 2019;9(1):1. https://doi.org/10.5430/jnep.v9n1p1
  15. Asefa A, Bekele D. Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia. Reprod Health. 2015;12:33. https://doi.org/10.1186/s12978-015-0024-9
  16. Sando D, et al. The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy Childbirth. 2016;16:236. https://doi.org/10.1186/s12884-016-1019-4
  17. Sheferaw ED, et al. Respectful maternity care in Ethiopian public health facilities. Reprod Health. 2017;14(1):60. https://doi.org/10.1186/s12978-017-0323-4
  18. Sudhinaraset M, et al. Women's status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory. BMC Pregnancy Childbirth. 2016;16(1):332. https://doi.org/10.1186/s12884-016-1124-4
  19. Abuya T, et al. Exploring the prevalence of disrespect and abuse during childbirth in Kenya. PLoS One. 2015;10(4):e0123606. https://doi.org/10.1371/journal.pone.0123606
  20. Sharma G, et al. An investigation into mistreatment of women during labour and childbirth in maternity care facilities in Uttar Pradesh, India: a mixed methods study. Reprod Health. 2019;16(1):7. https://doi.org/10.1186/s12978-019-0674-0
  21. Bhattacharya S, Sundari Ravindran TK. Silent voices: institutional disrespect and abuse during delivery among women of Varanasi district, northern India. BMC Pregnancy Childbirth. 2018;18(1):338. https://doi.org/10.1186/s12884-018-1970-3
  22. Raj A, et al. Associations Between Mistreatment by a Provider during Childbirth and Maternal Health Complications in Uttar Pradesh, India. Matern Child Health J. 2017;21(9):1821–33. https://doi.org/10.1007/s10995-017-2298-8
  23. Nawab T, et al. Disrespect and abuse during facility-based childbirth and its sociodemographic determinants – A barrier to healthcare utilization in rural population. J Family Med Prim Care. 2019;8(1):239–45. https://doi.org/10.4103/jfmpc.jfmpc_249_18
  24. World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth [Internet]. Geneva: World Health Organization; 2014 [cited 2026 Aug 11]. Available from: https://apps.who.int/iris/handle/10665/134588
  25. Kruk ME, et al. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey. Health Policy Plan. 2018;33(1):e26–33. https://doi.org/10.1093/heapol/czu079
  26. Kujawski SA, et al. Community and health system intervention to reduce disrespect and abuse during childbirth in Tanga Region, Tanzania: A comparative before-and-after study. PLoS Med. 2017;14(7):e1002341. https://doi.org/10.1371/journal.pmed.1002341
  27. Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth: Report of a Landscape Analysis. USAID/TRAction Project. 2015. Available from: https://www.tractionproject.org/
  28. Kreuter MW, et al. Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health. Annu Rev Public Health. 2021;42:329–44. https://doi.org/10.1146/annurev-publhealth-090419-102204
  29. Kumar S. Reducing maternal mortality in India: policy, equity, and quality issues. Indian J Public Health. 2010;54(2):57–64. https://doi.org/10.4103/0019-557X.73271
  30. Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review. PLoS Med. 2015;12(6):e1001847. https://doi.org/10.1371/journal.pmed.1001847
  31. Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy Childbirth. 2010;10:81. https://doi.org/10.1186/1471-2393-10-81

LICENSE

Creative Commons License
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.