April 29, 2025

Dr. Ellen Tilden, PhD, CNM, FACNM, FAAN, is a member of the Science of Birth cluster and a nurse-midwifery clinical-scientist and Associate Professor in the Schools of Nursing and Medicine at Oregon Health & Science University.

Dr. Tilden’s review summarizes current research on respectful maternity care (RMC), focusing on its definitions, measurements, and effectiveness. The study analyzed over 4,000 records, and reported on 37 key studies. Among these, 12 tools for measuring RMC were assessed, with the Mother’s Autonomy in Decision-Making (MADM), the Mothers on Respect index (MORi) – both published by Cluster Co-Lead Saraswathi Vedam – and the Revised Childbirth Experience Questionnaire (CEQ-2) showing good validity. Dr. Vedam also served as a key consultant for this work and importantly shaped the RMC AHRQ funded report that informed two subsequent publications [1) Cantor AG, Jungbauer RM, Skelly AC, Hart EL, Jorda K, Davis-O'Reilly C, Caughey AB, Tilden EL. Respectful Maternity Care : A Systematic Review. Ann Intern Med. 2024 Jan;177(1):50-64. doi: 10.7326/M23-2676. Epub 2024 Jan 2. Erratum in: Ann Intern Med. 2024 Mar;177(3):406. doi: 10.7326/L24-0036. PMID: 38163377; 2) Tilden EL, Jungbauer R, Hart EL, Cantor AG. One Hundred Years of Seeking Respectful Maternity Care: History and Evolution. Birth. 2025 Mar;52(1):129-137. doi: 10.1111/birt.12876. Epub 2024 Oct 16. PMID: 39412007.]. While frameworks defining RMC overlap in themes such as consent, dignity, and justice, there is no current consensus on a single operational definition of RMC. A definition of RMC is offered in this review. 

Respectful maternity care:

1) Honors the dignity, personhood, autonomy, and preferences of birthing people;
2) Prevents disrespect, mistreatment, or abuse toward individuals who are utilizing maternal care services;
3) Provides a practical paradigm for the delivery and receipt of peripartum care through a rights- and reproductive justice-based framework;
4) Includes standard elements of respectful care:

  • Freedom from abuse and violence
  • Consent
  • Privacy
  • Communication and shared decision making centered around the birthing person
  • Dignity and respect
  • Safety (safe care environment)
  • Justice

Future research should examine the relationship between respectful maternity care and perinatal outcomes as well as RMC implementation strategies. A standard RMC definition and wider testing of promising RMC metrics will help to guide future research and practice. 

Find the link to the full review here: https://scienceofbirth.ubc.ca/sites/default/files/2024-07/cer-269-respectful-maternity-care.pdf 

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Advancing the Science of Physiologic Birth Research Cluster


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Research Excellence Clusters at UBC Vancouver is a joint initiative of the Provost and Vice-President, Academic, UBC Vancouver and the Vice-President, Research and Innovation. Funding support for the clusters is provided by Academic Excellence Funds – UBC Vancouver.

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