{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:58:45Z","timestamp":1789804725746,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To improve the quality of intrapartum care at Princess Marina Hospital, Gaborone, Botswana, through a champion\u2010led educational intervention, introduction of the World Health Organization's Labor Care Guide (LCG), which highlights four key measures to promote respectful maternal care (RMC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In August 2022, we engaged medical and nursing staff in interactive training on the WHO LCG and implemented a mnemonic\u2010based checklist\u2014\u201cCOPE\u201d (Companions, Oral fluids, Pain relief, Eliminate the supine position). Motivational posters were displayed in the labor ward. Surveys to assess client labor experiences were conducted in November 2022 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009204) and October 2024 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009211). An anonymous staff survey assessed personal practice changes before and after the training.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over 2\u2009years, significant improvements in reported maternal experience were observed. Reports of a \u201cvery bad\u201d experience decreased from 116\/204 (56.9%) to 13\/211 (6.2%) and dissatisfaction with care reduced from 22\/204 (10.8%) to 3\/211 (1.4%). Adequate fluid provision increased from 108\/204 (52.9%) to 159\/211 (75.4%) and pain relief from 41\/204 (20.1%) to 108\/211 (51.2%). The reported presence of a labor companion increased from 14\/204 (6.9%) to 133\/211 (63.0%). Patient reports of exclusive supine positioning during the second stage of labor decreased from 106\/204 (52.0%) to 11\/211(5.2%). Staff questionnaires showed a consistent improvement in reported adoption of \u201cCOPE\u201d practices compared with recollected practices before the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Deeply entrenched labor care practices are difficult to change; however, sustained, champion\u2010led quality improvement interventions using the LCG and with sustained supportive supervision can yield meaningful improvement in women's birth experiences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70238","type":"journal-article","created":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T05:54:49Z","timestamp":1748066089000},"page":"798-804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Promoting respectful maternity care with the\n                    <scp>WHO<\/scp>\n                    labor care guide and the checklist mnemonic \u201c\n                    <scp>COPE<\/scp>\n                    \u201d: A quality improvement project"],"prefix":"10.1002","volume":"171","author":[{"given":"Mercy Nkuba","family":"Nassali","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Botswana  Gaborone Botswana"},{"name":"Department of Obstetrics and Gynecology Princess Marina Hospital  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8642-0526","authenticated-orcid":false,"given":"Jodie C.","family":"Russell","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maipelo","family":"Tsuaneng","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone 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Botswana"},{"name":"Department of OBGYN Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franciose D.","family":"Rubgega","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Botswana  Gaborone Botswana"},{"name":"Department of Obstetrics and Gynecology Princess Marina Hospital  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leatile","family":"Sedabadi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Botswana  Gaborone Botswana"},{"name":"Department of Obstetrics and Gynecology Princess Marina Hospital  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Modimowame","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Princess Marina Hospital  Gaborone Botswana"},{"name":"Ministry of 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Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Luckett","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Botswana  Gaborone Botswana"},{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Department of OBGYN Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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