Every contact counts: a call for inclusion of meaningful relational maternity care in low-income and middle-income countries

Summary Within maternity services, much emphasis has been placed on continuity of care and continuity of carer as key conduits for trusting relationships and positive experiences, which are essential for improved outcomes. However, continuity models remain aspirational in most settings, with national scale-up being a rarity. At the crux of the philosophies that support these approaches is relational care, something that should be achievable regardless of context. Relational care supports quality of care by emphasising mutuality of trust, effective two-way communications, and shared decision making. However, the development of a therapeutic relationship between health-care provider and health-care recipient, a key element of relational care, has been identified as a particular challenge in low-income and middle-income countries (LMICs). Using an iterative, narrative approach, we reviewed the literature on relational care within maternity settings, with a focus on LMICs. We explored experiences of relational care in LMICs, as well as obstacles and facilitators to achieving it and the effects of relational care across the maternity continuum.