Providers’ Perceptions of Barriers to Respectful Maternity Care at Massachusetts General Hospital

Background/Objectives: Disrespectful care during childbirth has been observed as a global issue and a factor influencing maternal morbidity and mortality. While the United States has experienced worsening rates of maternal mortality, perceptions of respectful maternity care have been understudied. Methods A cross-sectional study was conducted Boston from April 2023 to January 2024 among 46 labor and delivery physicians, midwives, and nurses at Massachusetts General Hospital. The survey evaluated their observation of disrespectful care, performance of respectful care, and stress and support factors influencing respectfulness of care. Results: The most reported observed disrespectful behaviors were dismissing patients’ pain (87.0%), discriminatory care based on physical characteristics (67.4%) and race (65.2%), and uncomfortable vaginal examinations (65.2%). Respondents self-reported very high levels of respectful maternity care performance. Reported barriers to respectful care included workload (76.1%) and fatigue (60.9%). Conclusions: Disrespectful care in childbirth is an issue reported by health care providers. Implicit bias and working conditions of health care providers are factors in disrespectful care. This information can be used to strategize future training and other areas of intervention to improve maternity care.