TUESDAY, Jan. 2, 2024 (HealthDay News) — The lack of a gold standard for measuring respectful maternity care (RMC) limits evaluation of other tools, according to a review published online Jan. 2 in the Annals of Internal Medicine.

Amy G. Cantor, M.D., M.P.H., from Oregon Health & Science University in Portland, and colleagues conducted a systematic review on definitions and valid measurements of RMC and its effectiveness for improving maternal and infant health outcomes.

Data were included from 37 studies; one provided insufficient evidence on the effectiveness of RMC to improve maternal outcomes, and none of them studied RMC to improve infant outcomes. The authors identified 12 RMC frameworks to define RMC, from which two main concepts were identified: (1) disrespect and abuse, which focused on recognizing birth mistreatment, and (2) rights-based frameworks, which incorporated aspects of reproductive justice, human rights, and antiracism. Freedom from abuse, consent, privacy, dignity, communication, safety, and justice were identified as five overlapping framework themes. In 24 studies, 12 tools were validated to measure RMC, but the lack of a gold standard limited the assessment of criterion validity. At least one study demonstrating consistency internally was found for three tools specific for RMC; no single tool stood out as the best RMC measure.

“Tools to measure RMC demonstrate consistency but lack a gold standard, requiring further evaluation before implementation in U.S. settings,” the authors write. “Evidence is lacking on the effectiveness of implementing RMC to improve any maternal or infant health outcome.”

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