As featured on Maternal Health Task Force blog on April 8, 2013.
At Jacaranda Health, we are working to build a model of maternity care that is more respectful and mother-centered. In a health system where respect is not the norm, its contribution to quality of care cannot be understated. Respectful care for us has two components: patient-centered processes and a culture of empathy.
Many of our team members have first-hand experience with childbirth in Kenya, and these experiences are the foundation of a culture of empathy. For example, Nyambura* chose to deliver her second child outdoors with a traditional birth attendant because the nearby public facility was unhygienic. Rahab*, on bed rest for the week before her delivery in a public hospital, watched mothers around her separated from their newborns and detained in the hospital until they could afford to pay for the delivery services. Wanjiku* had a supportive nurse respect her decision to refuse an operation and helped her to turn and deliver the breech baby safely.
After listening to these personal experiences with maternity services, we asked our colleagues: so, what does respectful maternity care mean to you? A few of their responses:
‘It means your decision, as a woman, is respected. You need to be given the right information; you need to be granted your privacy; and you need to be getting equal rights in terms of service delivery – it doesn’t matter who you are or where you come from.’ – Kathy, Nurse-in-Charge, Mobile Clinic
‘When there is a nurse there to fully support her, to walk her around, to rub her back, to give her food, to take the food back if she complains, then the client really feels respected and loved’ – Fridah, Maternity Hospital Janitor
‘You have to respect the client’s decisions, and respect the information they have come in with. You have to put yourself in their shoes and imagine who they are and where they are coming from. I explain the procedures again and again and again so they can understand if they didn’t understand the first time, to create a space where they can feel free to ask questions, to let them know that I, too, am learning from them.’ – Maria, Patient Care Assistant
‘A pregnant woman is not a sick woman. To me, it’s about customer service, not just about delivering the baby and moving on to the next, it’s about supporting the Mum, speaking kindly, reassuring them, holding her hand, just being there with her.’ – Dennis, Human Resources Manager
We see these sentiments reflected in interactions with clients, from the waiting room to the labor ward to postpartum visits. To us, this is where respectful maternity care begins.
*names have been changed to respect privacy