Document Type : Review Article
Authors
1
PhD Student in Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Full Professor, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Assistant Professor, Department of Medical Ethics, School of Medicine, Shahed University, Tehran, Iran
4
a) Full Professor, Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran b) Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5
Associate Professor, Department of General Surgery, School of Medicine, Urmia University of Medical Sciences , Urmia , Iran
Abstract
Background & aim: Despite efforts to improve respectful maternal care during childbirth in Iran, its advancement remained limited. This study aimed to synthesize barriers and facilitators of respectful maternal care within the Iranian context.
Methods: This review was conducted following Arksey and O’Malley’s framework and JBI guidelines. Two independent researchers searched English databases ofCINAHL, EMBASE, MEDLINE, PsycINFO, ProQuest, Scopus, as well as Persian databases of Irandoc, SID, ISC, and Medlib—using keywords related to respectful maternity care, childbirth, mistreatment, dignity, autonomy, and Iran. Original qualitative and quantitative studies conducted in Iran and published between 2010 and 2024 were included. Quantitative data were extracted and integrated with qualitative findings through narrative synthesis, while qualitative data underwent content and thematic analysis.
Results: Of 833 records identified, 24 studies met the inclusion criteria. Most commonly reported disrespectful behaviors were verbal and physical abuse and violations of maternal privacy. Findings were grouped into four main themes: instances of disrespectful care (e.g., neglect, verbal abuse), barriers (e.g., staff shortages, inadequate infrastructure), facilitators (e.g., staff training, family support), and proposed interventions (e.g., educational programs, policy reforms). From healthcare providers’ perspectives, barriers included individual and organizational factors, whereas recipients highlighted individual, health-related, and social issues. Facilitators included interpersonal communication, providers’ characteristics, involvement of recipients and companions, and governance. Interventions were classified as management-oriented and educational strategies.
Conclusion: This review highlights major disrespectful behaviors and key barriers and facilitators influencing respectful maternal care in Iran. Addressing staff shortages and improving healthcare settings are essential for sustainable quality improvements.
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