One Hundred Years of Seeking Respectful Maternity Care: History and Evolution

Growing awareness of poor maternal health outcomes and maternal health disparities in the United States has heightened urgency around the need to promote Respectful Maternity Care (RMC) as a fundamental tenet of obstetric/midwifery care and standardize efforts to improve safety, eliminate obstetric violence and racism, and optimize health outcomes for all birthing people. The historical context of prior and contemporary perspectives around childbirth influences our understanding of RMC and are shaped by varying scholarly, clinical, and community standards (e.g., religion, human rights, government, public health, midwifery, ethics, activism, and the law), which have changed significantly since the mid-19th century. In this commentary, we share results of a contextual question scoped as part of a larger systematic review of RMC to help inform consensus around a shared definition and development of a metric to standardize delivery and evaluation of RMC. Synthesis of this literature identified landmark historical influences on RMC over the past 100 years, highlighting the multidisciplinary scholarship and historical context influencing the progress toward RMC. Further understanding of this history may also inform policies and guidance for ongoing efforts to center respect and accountability in all aspects of maternity care, with particular attention to populations who are disproportionally impacted by disrespectful care. Understanding the historical context of prior and contemporary perspectives around childbirth influences our understanding of respectful maternity care, shaping both the proposed AHRQ Respectful MaternityCare framework and related definition that aim to facilitate consensus around a common definition and help standardize policies and guidance to center respect and accountability in all aspects of maternity care.image