The Mothers on Respect (MOR) index: measuring quality, safety, and human rights in childbirth

Vedam, Saraswathi; Stoll, Kathrin; Rubashkin, Nicholas; Martin, Kelsey; Miller-Vedam, Zoe; Hayes-Klein, Hermine; Jolicoeur, Ganga

doi:10.1016/j.ssmph.2017.01.005

Cited by 147 publications

(190 citation statements)

References 38 publications

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“…Our results correlate with and build on national maternity care discussions 5,6,19 suggesting that the experience in this hospital system may inform studies of other systems. Experiences with doulas may differ by geographic region, or in hospitals or obstetric practices with pre-existing policies on doulas and doula care.…”

Section: Strengths and Limitationssupporting

confidence: 74%

“…Experiences with doulas may differ by geographic region, or in hospitals or obstetric practices with pre-existing policies on doulas and doula care. Our results correlate with and build on national maternity care discussions 5,6,19 suggesting that the experience in this hospital system may inform studies of other systems.…”

Section: Strengths and Limitationssupporting

confidence: 74%

“…27,34 Interviews highlighted the conflict between many patients' preference for lower intervention births and hospital policies or cultural norms that make medical interventions more likely. 1,5 Practitioners described the challenges of negotiating this tension with or without a doula present, but noted that the presence of a doula can exacerbate the tension. Doulas were seen by some practitioners as markers of patient dissatisfaction with hospital care.…”

Section: Discussionmentioning

confidence: 99%

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Hospital‐based maternity care practitioners’ perceptions of doulas

Neel

Goldman

Marte

et al. 2019

Birth

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Introduction A birth doula provides continuous informational, physical, and emotional support during pregnancy, labor, and immediately postpartum. Existing data on the benefits of doulas, especially for low‐resource, high‐need patients, do not address how and why individual practitioners decide to recommend this model of care. This project aims to describe best practices of integrating doulas into hospital‐based maternity care teams to facilitate access to this evidence‐based service for improving maternal health outcomes. Methods Semi‐structured interviews using open‐ended questions were conducted in person with 47 maternity care practitioners—OB/GYNs, family medicine physicians, RNs, and nurse‐midwives—across three hospitals. Interview analysis was conducted using the Template Organizing Style qualitative analysis approach. Results Results demonstrated varied support for doula care given practitioners’ experiences. Positive experiences centered on doulas’ supportive role and strong relationships with patients. Some conflicts between practitioners and doulas may stem from a cross‐cultural divide between mainstream obstetric/physician culture and a natural birth “counter culture.” Suggestions to facilitate good working relationships centered on three overlapping themes: mutual respect between doulas and hospital staff, education about doulas’ training, and clarification of roles on maternity care teams especially among staff with overlapping roles. Conclusions Among maternity care practitioners, some frustration, anger, and resentment persist with respect to work with doulas. Adequate staff training in the doula model of care, explicit role definition, and increasing practitioner exposure to doulas may promote effective integration of doulas into hospital maternity care teams.

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Section: Strengths and Limitationssupporting

confidence: 74%

Section: Strengths and Limitationssupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hospital‐based maternity care practitioners’ perceptions of doulas

Neel

Goldman

Marte

et al. 2019

Birth

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“…There were, however, instances where some women experienced poor communication following a breakdown in collaborative relationships between midwives and doctors, or where antenatal care was offered in group sessions. Future survey research of maternal perceptions of quality care could incorporate validated tools that measure women's experiences of respect 34 and involvement in decision-making during maternity care. Pregnant women may have concerns or questions they perceive cannot wait until the next appointment but do not warrant an additional visit; in these instances, the ability to contact the care practitioner directly by means of telephone is important.…”

Section: Discussionmentioning

confidence: 99%

The impact of caseload midwifery, compared with standard care, on women's perceptions of antenatal care quality: Survey results from the M@NGO randomized controlled trial for women of any risk

Allen

Kildea

Tracy

et al. 2019

Birth

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Background:The measurement and interpretation of patient experience is a distinct dimension of health care quality. The Midwives @ New Group practice Options (M@NGO) randomized control trial of caseload midwifery compared with standard care among women regardless of risk reported both clinical and cost benefits. This study reports participants' perceptions of the quality of antenatal care within caseload midwifery, compared with standard care for women of any risk within that trial. Methods: A trial conducted at two Australian tertiary hospitals randomly assigned participants (1:1) to caseload midwifery or standard care regardless of risk. Women were sent an 89-question survey at 6 weeks postpartum that included 12 questions relating to pregnancy care. Ten survey questions (including 7-point Likert scales) were analyzed by intention to treat and illustrated by participant quotes from twofree-text open-response items. Results: From the 1748 women recruited to the trial, 58% (n = 1017) completed the 6-week survey. Of those allocated to caseload midwifery, 66% (n = 573) responded, compared with 51% (n = 444) of those allocated to standard care. The survey found women allocated to caseload midwifery perceived a higher level of quality care across every antenatal measure. Notably, those women with identified risk factors reported higher levels of emotional support (aOR 2.52 [95% CI 1.87-3.39]), quality care (2.94 [2.28-3.79]), and feeling actively involved in decision-making (3.21 [2.35-4.37]). Conclusions: Results from the study show that in addition to the benefits to clinical care and cost demonstrated in the M@NGO trial, caseload midwifery outperforms standard care in perceived quality of pregnancy care regardless of risk. K E Y W O R D S antenatal care, midwifery, randomized controlled trial, survey 440 | ALLEN Et AL.

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“…[2][3][4][5][6][7][8] Work in this area reflects a growing recognition that quality maternity care requires more than increasing access to facility-based care and skilled attendants and that highly medicalized and impersonal care is not just disrespectful, but increasingly unsafe for women and their infants. 1 Respectful maternity care is not a luxury, but a human right with the potential to improve maternal and infant outcomes in all countries.…”

Section: Introductionmentioning

confidence: 99%