Evidence map›Paper›PMID 40500749›Full record

ArticleReproductive health2025

"You feel like you come up short over and over again": a qualitative study of provider perspectives of barriers to respectful maternity care in Boston.

Katherine Fachon, Sahana Narayan, Samantha Truong, Christina Duzyj, Katherine Vergara Kruczynski, Amber Trujillo Lalla, Autumn Cohen, Patricia Barbosa, Amanda Flynn, Annekathryn Goodman

Abstract read
In one paragraph

Article in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Katherine FachonDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA. kldoughty@mgh.harvard.edu.
Sahana NarayanDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.
Samantha TruongDepartment of Obstetrics and Gynecology, Boston Medical Center, Boston, MA, 02114, USA.
Christina DuzyjDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.
Katherine Vergara KruczynskiDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.
Amber Trujillo LallaDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.
Autumn CohenDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.
Patricia BarbosaDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.
Amanda FlynnDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.
Annekathryn GoodmanDepartment of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA.

Funding

Massachusetts General Hospital endowed Global Health Fund - Strength & Serenity 1200 020707
6 · The paper itself

Abstract

backgroundRespectful maternity care is a human right. Disrespect in childbirth has been implicated in adverse maternal and child outcomes globally, including in the United States. Up to 30% of U.S. birthing people report being disrespected when giving birth, with reported rates being higher amongst racial/ethnic minorities and those who do not primarily speak English. Disrespect in childbirth leads to increased rates of postpartum depression and lower healthcare utilization.

methodsSemi-structured qualitative interviews were conducted with 18 maternity health care providers at Massachusetts General Hospital in Boston, Massachusetts. Respondents included physicians, midwives, and nurses. Transcripts of the interviews were coded using an inductive approach, and themes were developed from the codes.

resultsFour major themes emerged: (1) patient-provider communication and dynamics, (2) structural and organizational drivers of care, (3) patterns in disrespect, and (4) clinician knowledge and beliefs about respectful and disrespectful care. Key barriers to respectful care included workload, facility infrastructure, and constraints in the provision of clinical care. Providers perceived that certain social vulnerabilities (e.g., race, age, ethnicity, language) predisposed some patients to greater levels of disrespect. Consent processes and procedures were also identified to be a crucial leverage point in preventing disrespectful maternity care.

conclusionAlthough respondents generally perceived care to be of high quality, they noted that challenges to respectful maternity care are present even in high-resource settings. Future research in disrespect and abuse in maternity care is necessary to further develop sustainable solutions. It is imperative to continue exploring the perspectives of maternity care providers, as they are key stakeholders and are uniquely positioned to identify root causes of mistreatment in care provision.

Indexed as

Attitude of Health PersonnelMaternal Health ServicesQuality of Health CareRespectAdultBostonDelivery, ObstetricFemaleHumansPhysician-Patient RelationsPregnancyProfessional-Patient RelationsQualitative ResearchChildbirthDisrespect and abuseObstetricsRespectful maternity care

Identifiers

PMID40500749
PMCPMC12160462

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.