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Amended EJOB 143427

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Respectful Care in a Facility-Based Child Birth in Kingdom of Saudi
Arabia
Definitions of Respectful Care
Respectful care is an important professional, ethical, and cultural aspect of the provision of
obstetric services. The White Ribbon Alliance (WRA), a voluntary international level
organisation, introduces the concept of respectful care in maternity services as follows
(WRA, 2019): “Respectful maternity care (RMC) is defined as a universal human right
which is admissible to the entire childbearing women in each health system across the
globe.
The World Health Organization (WHO), which is the premier global-level organisation
patronising the provision of healthcare services across the world, defines respectful care in an
elaborate manner. The World Health Organization defines respectful care as the maternity
care, the organisation of and provision to all the females undergoing child birth is arranged in
such a way which ensures the maintenance of their self-respect, dignity, privacy, and
confidentiality, whilst ensuring protection from harm and manhandling/mistreatment and at
the same time enabling the women to make informed choices and provides continual support
throughout the various stages of labour and childbearing (WHO, 2019).
The concept of respectful care is thoroughly supported by the Johns Hopkins Program for
International Education in Gynaecology and Obstetrics (JHPIEGO). The organization has the
mission of creating and delivering transformational healthcare initiatives aimed at saving
lives. JHPIEGO, by partnering with the governments of various countries, healthcare experts
and local community members, improves on the service providers’ skill-level while
developing such systems which are capable of saving lives and guaranteeing a future with
better prospects to the females and their family (JHPIEGO, 2019).JHPIEGO defines
respectful care as the birth processes conducted respectfully, and with dignity so as to
increase the births taking place at the facility level while making sure that women-rights are
upheld (JIHPIEGO, 2019)
Freedman et al. (2014) define respectful care in terms of defining what constitutes disrespect
and abuse in women while they are in the process of childbirth based on a policy and rights

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agenda. The researcher based the definitions of disrespect and abuse on two projects which
had the aim of promoting mother care during child birth, one being undertaken in Kenya,
while the other being undertaken in the United Republic of Tanzania. The researcher
describes the literature on the subject matter as being anecdotal and not comprehensive, and
having defined to exist as seven categories adopted from the Bowser and Hill classification.
Critical Comparison and contrast amongst the definitions and classification of
disrespect & abuse during childbirth
Various researchers have identified various definitions and scopes of Respectful Maternity
Care. Similarly, the various researchers classify them in various ways. A comparison (Table
1) and contrast (Table 2) of the same is presented as under with reference to the work of
Bowser and Hill (2010) and Bohren et al. (2015).
Bohren et al. (2015) define respectful care as a key component of the mother-friendly as well
as baby-friendly births initiative. Bohren et al. (2015) focus their attention on the various
aspects of the disrespectful and abusive care (D&A), which is frequently seen and defines the
instances which can be considered to be D&A during the process of child birth.
This compares well with Bowser and Hill (2010), who also emphasise on the concept of
disrespect and abuse during child birth. However, Bowser and Hill define the concept of
disrespect and abuse during child birth in terms of non-dignified and non-patient-centred
maternity care in contrast to the desired dignified and patient-centred care.
According to Bowser and Hill (2010), the definition and classes of disrespect and abuse
during child bearing process is based on an extensive review of the literature and evidence in
the subject matter. Therefore, the Bowser and Hill classification is quite comprehensive and
takes into account a large number of publications which have been made on the subject
matter in the past. Bowser & Hill describe as many as seven categories of disrespect and
abuse during childbearing, which include physical-abuse, care without consent, care without
confidentiality, care without dignity, discriminating on the basis of peculiar attributes of the
patients, care abandonment and detention of the patient in facilities. A critical review of these
seven categories of disrespect and abuse demonstrates that they depict the various faces of
disrespect women often encounter during their childbearing process within a healthcare
facility. Furthermore, the nature of abuse defined by Bowser and Hill is objective.

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Respectful Care in a Facility-Based Child Birth in Kingdom of Saudi Arabia Definitions of Respectful Care Respectful care is an important professional, ethical, and cultural aspect of the provision of obstetric services. The White Ribbon Alliance (WRA), a voluntary international level organisation, introduces the concept of respectful care in maternity services as follows (WRA, 2019): “Respectful maternity care (RMC) is defined as a universal human right which is admissible to the entire childbearing women in each health system across the globe.” The World Health Organization (WHO), which is the premier global-level organisation patronising the provision of healthcare services across the world, defines respectful care in an elaborate manner. The World Health Organization defines respectful care as the maternity care, the organisation of and provision to all the females undergoing child birth is arranged in such a way which ensures the maintenance of their self-respect, dignity, privacy, and confidentiality, whilst ensuring protection from harm and manhandling/mistreatment and at the same time enabling the women to make informed choices and provides continual support throughout the various stages of labour and childbearing (WHO, 2019). The concept of respectful care is thoroughly supported by the Johns Hopkins Program for International Education in Gynaecology and Obstetrics (JHPIEGO). The organization has the mission of creating and delivering transformational healthcare ...
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