Respectful maternity care and its determinants in public health facilities of thar desert district, India: a mixed methods approach.
7 affiliations
- 1Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Marudhar Industrial Area, MIA phase 2, Basni, Jodhpur, Rajasthan, 342005, India.
- 2Department of Community Medicine, Siddaganga Medical College and Research Institute (SMCRI), Tumkur, Karnataka, India.
- 3Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Marudhar Industrial Area, MIA phase 2, Basni, Jodhpur, Rajasthan, 342005, India. [email protected].
- 4Department of Community Medicine, Dr. S S Tantia Medical College Hospital and Research Centre, Sri Ganganagar, Rajasthan, India.
- 5Junior Resident, Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
- 6Department of Pharmacology, Siddaganga Medical College and Research Institute (SMCRI), Tumkur, Karnataka, India.
- 7Faculty of Medicine, University of Toronto, Toronto, Canada.
Abstract
Background
With the increasing proportion of institutional deliveries, improving the quality of maternity services is essential to ensure a positive childbirth experience. Respectful Maternity Care (RMC) has emerged as a key component in achieving this goal. This study aims to estimate the prevalence and determinants of RMC and to explore the perceptions of perinatal women and their caregivers in public health facilities of Jodhpur.Methods
A concurrent parallel mixed-methods study was conducted among 438 perinatal women attending health facilities in Jodhpur district. Using a multistage random sampling approach, four rural and nine urban facilities were selected. Data were collected through semi-structured interviews with perinatal women and their caregivers, supplemented by in-depth interviews with those reporting lack of RMC. Quantitative data were analyzed using regression models to identify determinants of RMC, while qualitative data were thematically analyzed and triangulated with quantitative findings.Results
Of the 438 enrolled participants, 407 completed the study. The overall prevalence of respectful maternity care (RMC) was low at 4.42%, with the domain of right to information, informed consent, and choice of preferences scoring only 12.28%. Other domains were substantially higher: protection from physical harm or ill-treatment (93.36%), never being detained at a health facility (95.08%), confidential care (92.12%), dignified care (77.64%), equal care without discrimination (86.24%), and never being denied care (78.62%). Higher parity (three or more births) emerged as a significant determinant of RMC. Mode of delivery with intervention such as episiotomy or LSCS (B=-0.222, p = 0.049) and the absence of a labour companion (B=-0.969, p = 0.006) were significantly associated with poor perception of RMC. Thematic analysis of in-depth interviews with women and caregivers highlighted experiences of physical and verbal abuse, neglect during care, and contextual factors underlying such mistreatment.Conclusion
The study highlights that several aspects of respectful maternity care are already being practiced in public health facilities, demonstrating the potential for further improvement. Nevertheless, the overall prevalence remains low, primarily due to the limited practice of informed choice and consent. Women who underwent delivery interventions such as episiotomy or caesarean section, as well as those without a labour companion, were more likely to report poor perception of Respectful Maternity Care. The qualitative findings underscore persistent challenges of abuse and neglect, emphasizing the urgent need for system-level interventions, including sensitization of healthcare providers, strengthening accountability mechanisms, and enhancing supportive infrastructure, to ensure a positive and dignified childbirth experience.
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BibTeX
@article{gowda2026respectful,
title = {{Respectful maternity care and its determinants in public health facilities of thar desert district, India: a mixed methods approach.}},
author = {Bindiya C Gowda and Neeti Rustagi and Ankit Mittal and Prasanna Thirunavukkarasu and Srikanth Srinivasan and J Sachin and Vijay Kumar Chattu},
journal = {Reproductive health},
year = {2026},
month = jul,
doi = {10.1186/s12978-026-02427-5},
url = {https://europepmc.org/article/MED/42958412},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Respectful maternity care and its determinants in public health facilities of thar desert district, India: a mixed methods approach.
AU - Bindiya C Gowda
AU - Neeti Rustagi
AU - Ankit Mittal
AU - Prasanna Thirunavukkarasu
AU - Srikanth Srinivasan
AU - J Sachin
AU - Vijay Kumar Chattu
PY - 2026
DA - 2026/07/30
JO - Reproductive health
DO - 10.1186/s12978-026-02427-5
UR - https://europepmc.org/article/MED/42958412
AB - Background With the increasing proportion of institutional deliveries, improving the quality of maternity services is essential to ensure a positive childbirth experience. Respectful Maternity Care (RMC) has emerged as a key component in achieving this goal. This study aims to estimate the prevalence and determinants of RMC and to explore the perceptions of perinatal women and their caregivers in public health facilities of Jodhpur.Methods A concurrent parallel mixed-methods study was conducted among 438 perinatal women attending health facilities in Jodhpur district. Using a multistage random sampling approach, four rural and nine urban facilities were selected. Data were collected through semi-structured interviews with perinatal women and their caregivers, supplemented by in-depth interviews with those reporting lack of RMC. Quantitative data were analyzed using regression models to identify determinants of RMC, while qualitative data were thematically analyzed and triangulated with quantitative findings.Results Of the 438 enrolled participants, 407 completed the study. The overall prevalence of respectful maternity care (RMC) was low at 4.42%, with the domain of right to information, informed consent, and choice of preferences scoring only 12.28%. Other domains were substantially higher: protection from physical harm or ill-treatment (93.36%), never being detained at a health facility (95.08%), confidential care (92.12%), dignified care (77.64%), equal care without discrimination (86.24%), and never being denied care (78.62%). Higher parity (three or more births) emerged as a significant determinant of RMC. Mode of delivery with intervention such as episiotomy or LSCS (B=-0.222, p = 0.049) and the absence of a labour companion (B=-0.969, p = 0.006) were significantly associated with poor perception of RMC. Thematic analysis of in-depth interviews with women and caregivers highlighted experiences of physical and verbal abuse, neglect during care, and contextual factors underlying such mistreatment.Conclusion The study highlights that several aspects of respectful maternity care are already being practiced in public health facilities, demonstrating the potential for further improvement. Nevertheless, the overall prevalence remains low, primarily due to the limited practice of informed choice and consent. Women who underwent delivery interventions such as episiotomy or caesarean section, as well as those without a labour companion, were more likely to report poor perception of Respectful Maternity Care. The qualitative findings underscore persistent challenges of abuse and neglect, emphasizing the urgent need for system-level interventions, including sensitization of healthcare providers, strengthening accountability mechanisms, and enhancing supportive infrastructure, to ensure a positive and dignified childbirth experience.
SN - 1742-4755
ER -