Promoting respectful maternity care: a quasi-experimental study on the effectiveness of an educational intervention in Iranian hospitals.

Abstract

Background: Respectful Maternal Care (RMC) is a crucial strategy for improving the quality of maternity care and reducing mortality and morbidity among mothers. This study aimed to evaluate the effect of an RMC educational intervention on reducing mistreatment during maternal care.

Methods: A quasi-experimental study was conducted in two intervention hospitals and two control hospitals affiliated with Tehran University of Medical Sciences. Initially, the provision of RMC in all four hospitals was assessed through an RMC questionnaire completed by newly delivered mothers (n = 357) in a cross-sectional study. Subsequently, an educational intervention was designed and implemented from September to November 2020 exclusively in the two intervention hospitals, targeting midwives working in the delivery department. Approximately four months post-intervention, in June 2021, the status of RMC was evaluated in all hospitals through a cross-sectional survey of 383 newly delivered women. The differences in RMC scores between pre- and post-intervention between the two groups of hospitals were assessed. The Generalized Estimating Equations (GEE) model was used to analyze the effectiveness of the educational intervention in practicing RMC while controlling for background variables.

Results: Mothers who received delivery services at certain hospitals, had lower levels of education, or were younger were more likely to experience disrespectful maternal care during labor and delivery. During the baseline phase, the intervention and control hospitals exhibited similar rates of mistreatment, with scores of 11.3 and 11.4, respectively. However, four months after implementing the intervention, the incidence of mistreatment in the control hospitals increased by approximately 7 points, while the score in the intervention hospitals decreased by around 10 points. Consequently, the difference between the intervention and control hospitals exceeded 17 points (p < 0.001), which was statistically significant.

Conclusions: The RMC educational intervention significantly reduced mistreatment during childbirth. To fully realize its potential, this intervention should be implemented alongside other strategies by all stakeholders, including providing specialized personnel, motivating staff, and educating mothers about their rights.