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12 June 2026

16 Pages

Maathru Samman Pants: Enhancing Privacy and Dignity for Pregnant Women and Birth Companions in Primary Health Care

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1
Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri 522503, India
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Indian Council of Medical Research–National Institute for Research on Women’s Health, Mumbai 400012, India
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Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda 151001, India
4
Centre for Chronic Disease Control, New Delhi 110016, India
Prim. Hosp. Care2026, 25(1), 5;https://doi.org/10.3390/phc25010005
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Abstract

Background: Respectful maternity care (RMC) prioritizes dignity, privacy, and autonomy during childbirth. In low-resource primary health centers (PHCs), the lack of delivery gown availability compromises these aspects, leading to discomfort and reduced patient satisfaction in PHCs. This study on Maathru Samman Pants (MSPs), a culturally sensitive garment designed with functional flaps, aims to enhance privacy, comfort, and dignity during labor, as well as assess the satisfaction, acceptability, and demand for MSPs among pregnant women and their birth companions in PHC settings across four Indian regions. Methods: A cross-sectional study was conducted across eight PHCs in North, South, East, and West India. A total of 80 pregnant women and 60 birth companions participated. Data were collected through structured questionnaires and in-depth interviews. The quantitative data covered satisfaction, acceptability, and demand using Likert scales, yes/no, and open-ended formats. The qualitative data were analyzed thematically. Results: Most PW (pregnant women) were aged 21–30 years, mainly Hindu, 34 (42.5%), or Christian, 27 (33.75%), with 71.25% homemakers. PW highly rated MSPs for covering the body, preventing cold, comfort, and ease of use. They felt cared for and respected, with a mean ± SD of 4.47 ± 0.57, and agreed that MSPs maintained privacy and cultural norms. Demand was strong, with 76 (95%) supporting the introduction of MSPs and 74 (92.5%) willing to use them again. Most PW, 66 (82.5%), and BCs (birth companions), 49 (81.67%), accepted MSPs positively, with a few reporting discomfort or changes. Conclusions: MSPs demonstrated high satisfaction, strong acceptability, and future demand among PW. This study addresses key gaps in respectful maternity care at the PHC level by enhancing privacy, preserving cultural norms, and improving comfort. Integrating MSPs into maternal health protocols could significantly improve birthing experiences in resource-limited settings.

1. Introduction

Respectful maternity care is a cornerstone of modern obstetrics, emphasizing the importance of upholding dignity and privacy for antenatal mothers during childbirth. In the labor room, where vulnerability is often heightened, ensuring these aspects is crucial to significantly impact a woman’s experience and overall well-being. Traditional practices have sometimes overlooked the emotional and psychological needs of birthing mothers, leading to feelings of exposure and discomfort [1].
In considering maternity care, it is essential to ensure the comfort and dignity of the expectant mother during childbirth. The non-availability of the routine delivery of dresses or hospital gowns for normal delivery often falls short in providing privacy and confidence. To address this concern, Maathru Samman Pants (MSPs) were introduced. This dress is composed of a top and pants that together ensure that the entire body of the pregnant woman is covered during normal labor. There is a strategically placed hole in the pants that facilitates childbirth. On both sides of the pants, flaps are included, which cover the opening during the examination and procedure of normal labor and offer practicality and modesty. The details of MSPs are published elsewhere [2,3].
Maathru Samman Pants redefine the birthing experience by providing comprehensive coverage and easy access for medical procedures such as per vaginal examination or the childbirth process. MSPs support the importance of maintaining privacy in the labor room, protecting a woman’s dignity and helping the pregnant woman concentrate on the precious moments of welcoming her newborn baby to the world. The introduction of Maathru Samman Pants not only supports the women’s physical requirements but also contributes to reassuring and empowering the childbirth environment [3].
Maathru Samman Pants address common concerns of exposure and discomfort during labor, which is a significant shift towards respectful maternity care. This innovative approach highlights the commitment to enhancing the childbirth experiences of women and advocates that healthcare providers strive for compassionate and equitable maternity practices.
Primary health care (PHC) is fundamental to providing accessible, continuous, and comprehensive health services, with maternity care being a critical component of this [4]. PHC offers a range of services, from prenatal care and risk screening to normal delivery and postpartum care. However, the feasibility and quality of conducting deliveries within PHC settings can vary significantly depending on the availability of facilities, equipment, and trained personnel. In some settings, particularly in low-resource areas, the quality of care provided at primary care facilities may be suboptimal [5,6]. Integrated primary care, which emphasizes a patient-centered and family-focused approach, is increasingly recognized as a key strategy for enhancing the quality and effectiveness of maternity services within PHC [7].

2. Materials & Methods

A cross-sectional multicentric study was conducted in four different regions of India, covering all the North, South, East, and West regions, and covering diversified cultures, geographical regions, and socioeconomic statuses. The participatory sites were the All India Institute of Medical Sciences, Mangalagiri, Guntur, Andhra Pradesh; the All India Institute of Medical Sciences, Bathinda, Punjab; North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya; and the–Indian Council of Medical Research–National Institute for Research on Women’s Health (ICMR–NRWoH). Institutional Ethics Committee approvals were obtained from all participating sites [AIIMS/MG/IEC/2023-24/11, D/ICEC/Sci-07/08/2024, NEIGR/IEC/F5/2022, IEC/AIIMS/BTI/401]. The sample size was calculated using multi-stage, stratified random sampling based on delivery load. Two primary health care levels were chosen from each site. The sites include Primary Health Center Kotashmir, Primary Health Center Balluana in the North site, Primary Health Center Thullur, Primary Health Center Pedapalakaluru in the South site, Primary Health Center Golvad, Primary Health Center Ganjad in the West site, and Primary Health Center Jongksha, Primary Health Center Smith in the East site. A sample of 20 pregnant women from each site, with 10 participants from each PHC setting, was studied; where the birth companion was present with the enrolled pregnant woman, they were also included in the study. A total of 80 pregnant women and 60 birth companions from primary health care centers were studied using a structured questionnaire. Subsequently, every 10th even-numbered pregnant woman and every 10th odd-numbered birth companion were selected for in-depth interviews.
In addition to the general socioeconomic, respectful maternity care, obstetrics history, labor data, etc., the questionnaire for pregnant women has three main subsections. The Satisfaction subsection includes 10 questions using a 5-point Likert scale. The Acceptability subsection has 9 questions, also using a 5-point Likert scale. The Demand subsection contains 15 questions, which include 5 questions on a 5-point Likert scale, 7 yes/no questions with reasons, and 3 open-ended questions. For birth companions, the questionnaire has the same number of questions for Satisfaction and Acceptability as the pregnant women’s questionnaire, with 10 and 9 questions, respectively, all using a 5-point Likert scale. The Demand subsection for birth companions includes 10 questions, with 3 on a 5-point Likert scale, 4 yes/no questions, and 3 open-ended questions.
For the qualitative data, an in-depth interview guide was composed of 28 questions and probes. All the pregnant women and birth companions who gave informed written consent were asked questions, and each interview was audio recorded. The audio recordings were translated and coded into themes of satisfaction, Acceptability, Demand, Adaptation, Practicality, and Integration, consistent with the objectives of the study, along with the sub-themes of Comfort, Design, Respect, Shy-Free Environment, Acceptability, Desirability, Past Experience, Challenges, Implementation, and Program Success.

3. Results

Table 1 shows that the majority of PW (pregnant women), 53 (66.2%), were aged 21–30 years, with most identifying as Hindu, 34 (42.5%), or Christian, 27 (33.7%). The majority of PW studied up to the 9th–10th standard, 26 (32.5%), and only 7.5% were graduates. Homemakers made up the majority, 57 (71.2%), of participants. Most belonged to middle, 23 (39.7%), or lower-middle, 14 (24.1%), socioeconomic strata. Nearly all the women, 72 (90%), were married and living with their spouses. Most of the PW preferred female healthcare providers, 65 (81.3%), for normal labor.
Table 1. Sociodemographic details of the studied pregnant women.
Table 2 shows that the majority of BCs, 34 (56.7%), were aged 41–60 years. Most BCs were female, 59 (98.3%). Their relationship to the pregnant woman (PW) varied: 34 (56.7%) of PW were mothers or mothers-in-law, 18 (30%) were grandmothers or grandmothers-in-law, 6 (10%) were sisters or sisters-in-law, and 1 (1.7%) was a husband or other. Most BCs preferred a female healthcare professional, 56 (93.3%), with 4 (6.7%) expressing no preference.
Table 2. Sociodemographic details of the studied birth companion.
Table 3 represents how PW perceived the effectiveness of MSPs for covering the body during labor, showing a mean range of 4.10 ± 0.31 to 4.90 ± 0.31. The MSPs’ perceived ability to prevent cold exposure had a mean range of 4.20 ± 0.41 to 4.85 ± 0.37. The front flap’s utility for vulval covering ranged from 4.55 ± 0.69 to 5.00 ± 0.00, while the back flap’s utility ranged from 3.70 ± 0.87 to 4.95 ± 0.22. Ease of dressing/undressing had a mean range of 4.45 ± 0.69 to 4.55 ± 0.51, and supporting movement had a mean range of 3.70 ± 0.80 to 4.65 ± 0.49. Comfort during childbirth ranged from 4.15 ± 0.49 to 4.70 ± 0.47, while comfort using toilets had a lower mean range, from 3.10 ± 0.31 to 4.15 ± 0.37. The ease of use during delivery ranged from 3.90 ± 0.45 to 4.70 ± 0.47. Overall usefulness was rated highly, with a mean range from 4.0 ± 0.22 to 5–4.95 ± 0.23. Birth companion satisfaction followed a similar trend, with most means ranging from 4.05 ± 0.22 to 4.95 ± 091.
Table 3. Mean satisfaction of pregnant women and birth companions after using Maathru Samman Pants during labor at the primary healthcare level.
Table 4 presents the mean acceptability of Maathru Samman Pants (MSPs) for delivery. PW felt cared for and respected using MSPs (mean: 4.47 ± 0.57). They also agreed that MSPs helped deliveries respect cultural norms (mean: 4.56 ± 0.50), maintained privacy (mean: 4.60 ± 0.49), and created a shy-free environment (mean: 4.52 ± 0.53) in labor rooms. MSPs, when paired with a shirt, were seen to prevent overexposure (mean: 4.33 ± 0.69), although their resemblance to traditional dress had more regional variance (mean: 4.21 ± 0.88). PW also felt MSPs provided comfort when with family and friends (mean: 4.39 ± 0.67) and during conversations with healthcare teams (mean: 4.39 ± 0.54), enhancing overall comfort (mean: 4.41 ± 0.57). Birth companion perspectives showed the importance of respecting cultural norms (mean: 4.43 ± 0.50). MSPs maintained privacy (mean: 4.52 ± 0.50) and created a shy-free environment (mean: 4.48 ± 0.50). MSPs with a shirt prevented overexposure (mean: 4.30 ± 0.65), resembled traditional dress (mean: 4.60 ± 0.56), and offered comfort (mean: 4.38 ± 0.59) and privacy (mean: 4.38 ± 0.67).
Table 4. Mean acceptability of pregnant women and birth companions after using Maathru Samman Pants during labor at the primary healthcare level.
Table 5 represents a strong demand for Maathru Samman Pants (MSPs) and their positive impact on respectful maternity care. The vast majority of PW agree or strongly agree that the introduction of MSPs is a positive initiative, 76 (95%), with many feeling awkward in the labor room due to the presence of other personnel, 69 (86.2%). Regarding hygiene and cleanliness, most participants rated the labor room as good or very good, 58 (72.5%). MSPs were viewed favorably for future use, with most PW indicating they would very often or always use MSPs for privacy in future deliveries, 74 (92.5%). There was a strong inclination to recommend MSPs along with shirts to other pregnant women for maintaining privacy, with most either agreeing or strongly agreeing to doing so, 77 (96.2%). Overall, the findings indicate a strong demand for MSPs within maternity care, as well as their positive impact.
Table 5. Demands of pregnant women using Maathru Samman Pants during labor at the primary healthcare level.
Table 6 represents data from 80 pregnant women (PW) demonstrating a positive demand for Maathru Samman Pants (MSPs). No PW changed their MSPs during delivery. Only one PW was asked about their MSPs by another PW, 1 (1.2%). Most PW previously labored in their own clothes 45 (56.2%), but most experienced improved comfort and privacy with MSPs, 60 (68.75%). Few PW experienced discomfort, 6 (7.5%), or suggested changes, 5 (6.2%). Overall labor experience with MSPs was rated highly for Acceptability, 66 (82.5%) by PW. Among the 60 birth companions (BCs), the majority agreed that MSPs are a positive initiative, 49 (81.7%), and would always recommend them, 54 (90%). Few BCs reported PW discomfort, 3 (5%), or desired changes, 8 (13.3%). Most female BCs previously labored in their own clothes, 44 (73.3%), and showed a preference for MSPs.
Table 6. Demands of pregnant women and birth companions using Maathru Samman Pants during labor at the primary healthcare level.
Table 7 represents a qualitative analysis presented in themes and sub-themes, supported by verbatim quotations from pregnant women and birth companions.
Table 7. Qualitative results of studied pregnant women and birth companion.

4. Discussion

The introduction of Maathru Samman Pants (MSPs) at the primary health care (PHC) level represents a practical, culturally sensitive, and patient-centered advancement in promoting respectful maternity care (RMC). Globally, RMC has been recognized as a fundamental right of every woman during pregnancy and childbirth, with emphasis on privacy, dignity, autonomy, and freedom from harm and mistreatment [8]. In India, despite improvements in institutional delivery rates through programs such as Janani Suraksha Yojana (JSY), challenges remain in delivering care that respects the woman’s bodily autonomy, particularly in low-resource PHC settings [9].
Visual privacy and dignity are often compromised in these facilities, where open labor wards, inadequate partitions, and the absence of gender-sensitive delivery protocols prevail [10]. Maathru Samman Pants (MSPs), a modest and functional garment with strategically placed flaps for procedural access, directly addresses these gaps. In the present multicentric study across four geographic regions of India, 100% of women surveyed reported feeling that MSPs helped cover their bodies during childbirth, which is an often-neglected yet important factor affecting physical comfort during labor.
The respect for cultural norms and avoidance of overexposure—especially in conservative rural communities—are critical for patient acceptability and trust in maternal health systems [11]. The MSPs’ design, which resembles traditional attire such as salwar suits, enhances their cultural appropriateness and facilitates community acceptance, as observed by both women and their birth companions in the study. Cultural congruence in medical apparel has previously been shown to enhance maternal satisfaction and care-seeking behavior [12].
Evidence from global and Indian settings has consistently shown that disrespect and abuse during childbirth can lead to trauma, delayed postnatal care, and avoidance of health facilities in subsequent pregnancies [13,14]. By offering coverage and modesty, MSPs address a significant contributor to obstetric violence—unwanted exposure of the woman’s body—thus fostering a psychologically safer birthing environment. This aligns with the WHO’s quality-of-care framework, which places “experience of care” on a par with clinical effectiveness and safety [15].
Furthermore, high levels of satisfaction with MSPs reported by birth companions suggest that the intervention is well-received, not just by patients but also by supportive family members, enhancing the overall labor room experience. Involving birth companions is a key WHO recommendation, now promoted in India’s LaQshya initiative for improving the quality of intrapartum care [16]. The positive impact of MSPs on both pregnant women and their companions underscores the intervention’s alignment with these guidelines.
An important aspect of the success of MSPs lies in their practicality: the majority of women found them easy or very easy to use during delivery, and felt they reduced dressing-related hassles. Previous research has highlighted the functional limitations of traditional hospital gowns, which often expose women during critical procedures or do not accommodate mobility and comfort [17]. MSPs thus bridge a functional gap by maintaining modesty while supporting movement, toileting, and per vaginal examinations, without compromising clinical access.
The study also revealed strong future demand for MSPs, with over a majority of women stating they would use them again and 96.25% recommending them to others. Such figures reflect deep acceptability and the potential for policy-level adoption. With the Government of India expanding Health and Wellness Centers under Ayushman Bharat to ensure comprehensive PHC delivery, innovations such as MSPs could be integrated as part of standard childbirth kits [18]. This also aligns with India’s National Health Policy 2017, which prioritizes people-centered care, quality, and dignity [19].
Qualitative narratives from both women and birth companions further reinforced the themes of respect, comfort, tradition, and empowerment. Women expressed emotional satisfaction, less embarrassment, and increased ease during procedures, which are direct outcomes of improved design and privacy. These observations are consistent with findings from Bohren et al. and the White Ribbon Alliance that show when women feel safe and respected, their childbirth outcomes improve not only physically but also emotionally [13,20]. Women highlighted the garment’s comfort and practicality, particularly its facilitation of movement and toileting during labor, which aligns with prior research emphasizing the importance of functional maternity wear for patient dignity and ease [20]. The MSPs’ design, which mirrors traditional attire such as salwar suits, was praised for preserving cultural values and privacy—key components in respectful maternity care that influence women’s willingness to seek facility-based deliveries [12].
Birth companions noted the creation of a “shy-free” environment, reducing embarrassment and enhancing psychological safety, a factor linked to improved birth experiences and maternal outcomes [21]. The acceptance and positive feedback from both groups indicate strong potential for the integration of MSPs into maternity care protocols. Minor suggestions, such as adding feeding zippers, reflect user engagement and opportunities for refinement. These findings contribute to evidence that culturally sensitive, practical interventions can empower women and improve respectful maternity care, echoing WHO recommendations on dignity and privacy in childbirth [7].
Limitations: This study has a few limitations. Selection bias may be present, as women willing to participate might have had more positive views of Maathru Samman Pants, which may affect satisfaction reports. Self-reported data also risk social desirability bias, especially in culturally sensitive settings where participants might overstate positive experiences. Variations in implementing MSPs and the facility conditions across the four regions could have influenced outcomes, limiting consistency.

5. Conclusions

In conclusion, Maathru Samman Pants are more than just a garment—they are a low-cost, culturally appropriate, and respectful solution to long-standing issues in maternity care. By addressing key barriers of privacy, exposure, and discomfort during labor, MSPs have demonstrated their potential to enhance the quality of childbirth experiences in PHCs. Scaling up its implementation, coupled with provider training and policy support, can contribute significantly to India’s goals of respectful and dignified maternity care for all.

Author Contributions

V.R.B. has contributed to the conception, study design, and writing the first draft. Data analysis and synthesis were contributed by P.S. All the authors made a significant contribution to the work reported, in the execution, acquisition, and interpretation of the data, or all these areas; took part in revising or critically reviewing the article; gave final approval for the version to be published; agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work. A.P., D.T., M.V., P.G., R.K., S.P., W.K.S., and A.G. form an MSPs group and have equally contributed to this manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

Indian Council of Medical Research, Extramural Adhoc project 13078-2021.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of four participatory sites. The participatory sites were the All India Institute of Medical Sciences, Mangalagiri, Guntur, Andhra Pradesh, with IEC approval number AIIMS/MG/IEC/2023-24/11 dated 16 April 2022; the All India Institute of Medical Sciences, Bathinda, Punjab, with IEC approval number IEC/AIIMS/BTI/401 dated 7 August 2023; the North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, with IEC approval number NEIGR/IEC/M3/F5/2022 dated 9 April 2022; and the ICMR-National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), with IEC approval number D/ICEC/Sci-07/08/2024 dated 7 August 2024.

Data Availability Statement

The data presented in this study are available on request from the corresponding author, due to ethical restrictions prevent revealing the identities of the participants.

Acknowledgments

We thank the Executive Director, AIIMS Mangalagiri, for his immense support. We also thank the Directors and Heads of all the participatory sites. We are grateful to Sravan Babu, District Medical & Health Officer, Guntur. We also acknowledge the Office of the Civil Surgeon, Bathinda, Director of Health Services, Meghalaya, Shillong. We thank Pradeep Aggarwal, Community and Family Medicine, AIIMS Rishikesh, for supporting and reviewing the project protocol, and Lajya Devi Goyal, Department of Obstetrics & Gynaecology, AIIMS Bathinda, Priyanka, Department of Obstetrics & Gynecology, AIIMS Bathinda, for her support in initiating data collection at the north site. We thank Noorin Bhimani, and Archana Bhosale, Department of Obstetrics & Gynecology, Lokmanya Tilak, Municipal Medical College and General Hospital, for supporting tertiary care data collection at the West site. We thank Nandeti Asha, Vaka Siva Naga Lakshmi, Rutuja Anil Yadhav, Neha Sharma, Indu Prabha, Riakor Kharkongor, Derek Lyngdoh, Saphilahan Sisha Chye, and the project staff of ICMR 13078 for their effective role in data collection, and P. Siva Santosh Kumar, former Senior Resident, AIIMS Mangalagiri, for staff training. We thank all the pregnant women, birth companions, doctors, nurses, and supporting staff for their supportive and active participation in the study. We thank the Department of Obstetrics and Gynecology, AIIMS Mangalagiri, for its support in piloting the study tools.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Smitha, M.; Yadav, P.; Jacob, J.; Begum, J. Intrapartum respectful maternity care practices and its barriers in Eastern India. J. Fam. Med. Prim. Care 2022, 11, 7657. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  2. Reddy, B.V.; Sirisha, P.; Patil, A.; Tandon, D.; Verma, M.; Gupta, P.; Kakkar, R.; Pala, S.; Shullai, W.K. Assessing the Feasibility of Introducing Maathru Samman Pants in Labor Rooms to Improve Comfort and Satisfaction in Pregnant Women and Their Birth Companions in India: A Multicentric, Cross-Sectional Study. Cureus 2025, 17, e80513. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  3. Reddy, B.V. Maathru Samman Pants: An initiative towards “Respectful Maternity Care”. J. Fam. Med. Prim. Care 2019, 8, 1821. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  4. World Health Organization. Primary Health Care. 2025. Available online: https://www.who.int/news-room/fact-sheets/detail/primary-health-care (accessed on 25 March 2026).
  5. Gage, A.D.; Carnes, F.; Blossom, J.; Aluvaala, J.; Amatya, A.; Mahat, K.; Malata, A.; Roder-DeWan, S.; Twum-Danso, N.; Yahya, T.; et al. In Low- And Middle-Income Countries, Is Delivery In High-Quality Obstetric Facilities Geographically Feasible? Health Aff. 2019, 38, 1576–1584. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  6. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Implementing High-Quality Primary Care; Robinson, S.K.; Meisnere, M.; Phillips, R.L., Jr.; McCauley, L. (Eds.) Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care; National Academies Press: Washington, DC, USA; Committee on Implementing High-Quality Primary Care: Washington, DC, USA, 2021. Available online: https://www.ncbi.nlm.nih.gov/books/NBK571807/ (accessed on 25 March 2026).
  7. World Health Organization. WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience; WHO: Geneva, Switzerland, 2018. [Google Scholar]
  8. Ministry of Health and Family Welfare. Janani Suraksha Yojana: Guidelines for Implementation; Government of India: New Delhi, India, 2006.
  9. Sharma, G.; Penn-Kekana, L.; Halder, K.; Filippi, V. An investigation into mistreatment of women during labour and childbirth in maternity care facilities in Uttar Pradesh, India: A mixed methods study. Reprod. Health 2019, 16, 7. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  10. Bowser, D.; Hill, K. Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth: Report of a Landscape Analysis; USAID: Washington, DC, USA, 2010.
  11. Montagu, D.; Sudhinaraset, M.; Diamond-Smith, N.; Campbell, O.M.R.; Gabrysch, S. Where women go to deliver: Understanding the changing landscape of childbirth in Africa and Asia. Health Policy Plan. 2017, 32, 1146–1152. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  12. Bohren, M.A.; Vogel, J.P.; Hunter, E.C.; Lutsiv, O.; Makh, S.K.; Souza, J.P.; Aguiar, C.; Coneglian, F.S.; Diniz, A.L.A.; Tunçalp, Ö.; et al. The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review. PLoS Med. 2015, 12, e1001847. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  13. George, A.; Iyer, A.; Sen, G. Gendered health systems biased against maternal survival: Preliminary findings from Koppal, Karnataka. Econ. Political Wkly. 2005, 40, 1869–1878. [Google Scholar]
  14. World Health Organization. Standards for Improving Quality of Maternal and Newborn Care in Health Facilities; WHO: Geneva, Switzerland, 2016. [Google Scholar]
  15. Ministry of Health and Family Welfare. LaQshya—Labour Room Quality Improvement Initiative: Operational Guidelines; Government of India: New Delhi, India, 2017.
  16. Rosen, H.E.; Lynam, P.F.; Carr, C.; Reis, V.; Ricca, J.; Bazant, E.S.; Bartlett, L.A.; Quality of Maternal and Newborn Care Study Group of the Maternal and Child Health Integrated Program. Direct observation of respectful maternity care in five countries: A cross-sectional study of health facilities in East and Southern Africa. BMC Pregnancy Childbirth 2015, 15, 306. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  17. Ministry of Health and Family Welfare. Comprehensive Primary Health Care Through Health and Wellness Centres—Operational Guidelines; Government of India: New Delhi, India, 2018.
  18. Ministry of Health and Family Welfare. National Health Policy 2017; Government of India: New Delhi, India, 2017. Available online: https://nhsrcindia.org/sites/default/files/2021-07/1%20National%20Health%20Policy%202017%20%28English%29%20.pdf (accessed on 23 December 2025).
  19. White Ribbon Alliance. Respectful Maternity Care: The Universal Rights of Childbearing Women; White Ribbon Alliance: Washington, DC, USA, 2011; Available online: https://maternalhealthmatters.org.au/wp-content/uploads/2020/09/Position-Statement-Respectful-Maternity-Care.pdf (accessed on 6 January 2026).
  20. Kawish, A.B.; Umer, M.F.; Arshed, M.; Khan, S.A.; Hafeez, A.; Waqar, S. Respectful Maternal Care Experience in Low- and Middle-Income Countries: A systematic Review. Medicina 2023, 59, 1842. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  21. Vedam, S.; Stoll, K.; Taiwo, T.K.; Rubashkin, N.; Cheyney, M.; Strauss, N.; McLemore, M.; Cadena, M.; Nethery, E.; Rushton, E.; et al. The Giving Voice to Mothers Study: Inequity and mistreatment during pregnancy and childbirth in the United States. Reprod. Health 2019, 16, 77. [Google Scholar] [CrossRef] [Scilit] [PubMed]
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