Papa Dasari* and Mahalakshmy Thulasingam
Background: Disrespect and abuse experienced during child birth has been reported by women to various sections of health care workers. The objective was to abolish Disrespect and Abuse and to bring about a policy change in labour room practices and to implement Respectful Maternity Care (RMC) in a high volume tertiary care teaching hospital in South India.
Methods: A Workshop and Continuous Medical Education Programme involving RMC experts was conducted in Phase I with defined objectives. These targeted health care workers were nurses, resident doctors, consultants, medical nursing students involved in giving care during pregnancy and labour. In Phase II the Govt. of India Policy on Birth Companion was presented in meeting discussing on the National guidelines of “LaQshya”. Consent forms for birth companion were introduced and a dedicated public health nurse was trained to train the birth companions regarding their role in maternal support. The change of policy was officially intimated to the hospital administration. A qualitative assessment was done whether the Residents and Nurses practiced RMC as demonstrated in the Workshop. The operationalization of the birth companion policy was followed on daily observations, enquiries and onsite surprise visits over one year period.
Results: The practice of RMC was followed only by few health care workers and certain cadre of women who laboured, received RMC and disrespect and abuse still prevailed. The bottle necks identified were low socioeconomic status of women, the in-charge consultants not insisting on presence of birth companions, the residents and nurses not promoting birth companion policy.
Conclusion: Implementation of Respectful Maternity Care needs change of attitudes of personnel who render care during child birth and it can only be successful unless it forms an integral part of Medical and Nursing curriculum.
