Experiences of Respectful Maternity Care among postnatal women at a tertiary care hospital in new Delhi | BMC Pregnancy and Childbirth

Sociodemographic characteristics

A total of 300 women participated in the study, with a 100% response rate. The majority resided in urban areas (n = 287, 95.7%). The women’s ages ranged from 18 to 45 years, with the largest group aged 36–40 years (n = 112, 37.3%). The mean age was 27.3 ± 4.7 years, and the median age was 27 years (IQR: 24–30).

Regarding education, the most common educational attainment among both women and their husbands was high school completion (n = 112, 37.3%). A small proportion had attained graduate-level education (n = 3, 1% of women and n = 6, 2% of husbands), while 19.7%(n = 59) of husbands had studied only up to primary school. In terms of occupation (Figs. 1 and 2), 50%(n = 150) women were homemakers. In contrast, husbands were more evenly distributed across unskilled (n = 68, 22.7%), semi-skilled (n = 67, 22.3%), and skilled work (n = 66, 22.0%). Only a few women (n = 4, 1.3%) and husbands (n = 8, 2.7%) were employed in professional roles. These findings reflect traditional gender roles and workforce disparities influenced by social norms, educational opportunities, and economic structures.

Most women lived in nuclear families (n = 236, 78.7%). Socioeconomic classification using the Modified Kuppuswamy Scale (2022) revealed that the largest segment belonged to the upper-lower class (n = 120, 40.1%) (Table 1).

Distribution of the educational status of the postnatal women and their husbands (N = 300)

Distribution of the occupational status of the postnatal women and their husbands (N = 300)

Obstetric-related characteristics

In terms of parity, as summarised in Table 2, the majority (n = 176, 58.7%) had between 2 and 4 previous pregnancies. Regarding the type of labour, most women (n = 209, 96.7%) experienced spontaneous labour and 72%(n = 216) had vaginal deliveries.

Among the 180 women with previous pregnancies, 94.4%(n = 170) reported having had an institutional delivery, while 5.6%(n = 10) did not. 89.7%(n = 269) of women did not have difficulty initiating breastfeeding. Table 3 shows a significant association between the parity of the women and the administration of episiotomy (p < 0.0001).

Table 4 details the benefits availed under the Reproductive and Child Health Programme. The utilisation of the Janani Suraksha Yojana (JSY) was notably low (n = 2, 0.6%) and only 11.7% (n = 35) women used transport facilities. Additionally, 14.7%(n = 44) benefited from the Pradhan Mantri Matru Vandana Yojana (PMMVY), while 84.7%(n = 254) did not avail any government schemes.

Table 5 shows that a majority of the women, 99.3%(n = 298) were unaware of the provision of birth companions as per the LaQshya guidelines before coming to the facility. During the current delivery, 33.3%(n = 100) had a birth companion present, while 66.7%(n = 200) did not.

RMC perceived using the modified PCMC scale and its association with sociodemographic factors

The scoring of the Modified PCMC Scale among the women showed a variation of experiences with respectful maternity care. The mean score was 64.6 ± 4.5 (S.D.), indicating a generally positive experience. The median score was 64 (interquartile range = 62–67). The score range was 44–81, highlighting variability in experiences of care among women. Age, religion, caste and educational status of both the women and their husbands did not show significant associations with PCMC scores (p > 0.05). Additionally, socioeconomic status did not significantly affect PCMC scores (p = 0.914).

Domain wise proportion of RMC perceived

In examining the proportion of perceived disrespect using the Modified PCMC Scale as shown in Fig. 3, we compiled the responses of each domain/subscale. The distribution of Domains of Perceived Disrespect among the women reflects varied experiences across the different domains of maternity care and is as follows;

Distribution of domains of perceived disrespect according to Modified PCMC Scale among the women (N = 300)

Dignity and respect

Most women (48.7%) reported no disrespect and 39.7% experienced respectful treatment consistently.

Privacy and confidentiality

High scores seen here, with 93.7% of the responses consistently feeling their privacy was respected. Only 0.4% reported issues with confidentiality.

Communication and autonomy

This domain had mixed responses, with 37.4% reporting consistent communication and autonomy, while 27.9% only experienced these elements occasionally.

Supportive care

The perception of supportive care was less consistent, with only 19.6% of the responses indicating feeling fully supported all the time, while 33.1% experienced a lack of support at least occasionally.

Trust

Trust in healthcare providers was notably high, with 96.8% expressing full trust.

Facility and environment

While 60.3% of the responses reported satisfaction with the facility environment consistently, concerns about crowding were prevalent, with 68.3% describing the wards as somewhat crowded.

Predictability and transparency of payment

This domain achieved full positive responses, with all the women (100%) indicating that they were never asked for additional charges or required to buy items outside the facility.

Multivariate analysis of factors associated with respectful maternity care

A multivariate logistic regression analysis, presented in Table 6, was performed to identify independent predictors of respectful maternity care. Two variables were found to be significantly associated with higher RMC scores:

Presence of a birth companion during the current delivery was strongly associated with a higher likelihood of experiencing respectful maternity care (AOR = 4.593; 95% CI: 2.393–8.815; p < 0.001). Male sex of the newborn was also significantly associated with improved RMC perception (AOR = 1.718; 95% CI: 1.028–2.87; p = 0.039).

Other variables such as woman’s occupation, husband’s occupation, socio-economic status, parity, and marital satisfaction did not show statistically significant associations with the PCMC scores in the adjusted model (p > 0.05).