Implementing Respectful Maternity Care (RMC) Intervention to Improve Perinatal Mental Health

Several studies in low- and middle-income settings have shown that mistreatment and disrespectful care during childbirth is a major issue that needs addressing. A multi-country study by Bohren et al. showed that more than a third of women experience disrespectful care during childbirth. Mothers face physical and verbal abuse as well as discrimination based on age, ethnicity and social class . Other types of abuse are non-consented care or painful vaginal examination, and restraining from having companionship or food during childbirth . Lack of dignified care during the vulnerable time during birth not only violates the universal right of childbearing women but also influences the overall quality of care . There is some early evidence to suggest that women experiencing disrespect and abuse are more likely to experience common perinatal mental disorders. Common perinatal mental disorders include depressive, anxiety, adjustment and somatic disorders. In low- and middle-income countries, 19.7% of women suffer common perinatal mental disorders during pregnancy and 39.4% suffer from the disorders during postpartum period . While there is a growing body of literature on disrespectful care in sub-Saharan African and Latin America, there is limited literature on the topic from Asia, including Nepal.

General:

• To improve respectful maternity care in the hospital and reduce the perinatal mental health disorder.

Specific:

• To explore disrespect during childbirth and postnatal period with mothers and health workers.
• To assess the prevalence and factors associated with symptoms of common perinatal mental disorder (postpartum depression and anxiety)
• Assess the adequacy of Respectful Maternity Care intervention implementation to address disrespect to reduce perinatal mental disorder
• Impact of respectful childbirth package on perinatal mental disorder