{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:39:41Z","timestamp":1792661981116,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates maternity care providers' knowledge, practice, and perspectives on respectful maternity care (RMC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A global cross\u2010sectional online survey on RMC was conducted by the World Association of Trainees in Obstetrics and Gynecology (WATOG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 458 maternity care providers from 48 countries across six global regions participated in the study. One in five providers (93, 20.3%) had never heard of RMC, and nearly half (223, 48.7%) had received no formal RMC training. Only 74 (16.2%) demonstrated good knowledge of the seven categories of maternal disrespect and abuse. There was no association between RMC knowledge and practice (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.066). Despite 429 (93.7%) of respondents agreeing that RMC could improve feto\u2010maternal outcomes, self\u2010reported practices inconsistent with RMC were common, including verbal abuse (285, 62.2%), detention for unpaid bills and non\u2010confidential care (262, 57.2%), discrimination (203, 44.3%), abandonment\/denial of care (187, 40.8%), and physical abuse (119, 26.0%). The most frequently reported barriers to RMC implementation were time constraints owing to staff and resource shortages (361, 78.8%), inadequate training (356, 77.7%), lack of sanctions for disrespectful care (239, 52.2%), and restrictive cultural and religious norms (203, 44.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There are critical gaps in maternity care providers' knowledge and practice of RMC, despite widespread recognition of its importance for good feto\u2010maternal outcomes. Institutionalized RMC education, adequate staffing and resources, strengthened institutional accountability and reporting mechanisms, and workplace cultures that prioritize patient dignity and autonomy are critical steps toward ensuring RMC for all women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71424","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:50:36Z","timestamp":1792659036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Respectful maternity care: A multinational survey of maternity care providers by the World Association of Trainees in Obstetrics and Gynecology"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7543-0510","authenticated-orcid":false,"given":"Akaninyene Eseme","family":"Ubom","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Sciences PAMO University of Medical Sciences  Port Harcourt Nigeria"},{"name":"Department of Obstetrics and Gynecology PAMO Teaching Hospital  Port Harcourt Nigeria"},{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9321-9412","authenticated-orcid":false,"given":"Mawrah","family":"Mughal","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"ObGyn Unit 1, Allama Iqbal Medical College Jinnah Hospital  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Javier Ruiloba","family":"Portilla","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Fetal Medicine Department Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-5635","authenticated-orcid":false,"given":"Chidinma Peace","family":"Ohachenu","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8900-8057","authenticated-orcid":false,"given":"Munachiso Iheme","family":"Ndukwe","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology University Hospital Hradec Kralove  Hradec Kralove Czechia"},{"name":"Department of Obstetrics and Gynecolgoy Charles University, Faculty of Medicine in Hradec Kralove  Hradec Kralove Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9871-8340","authenticated-orcid":false,"given":"Ayda Linda","family":"Wanjiku","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology University of Nairobi  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6491-7817","authenticated-orcid":false,"given":"Hasmik","family":"Bareghamyan","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology N1 Yerevan State Medical University  Yerevan Armenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5976-2291","authenticated-orcid":false,"given":"Martin","family":"Stepan","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology University Hospital Hradec Kralove  Hradec Kralove Czechia"},{"name":"Department of Obstetrics and Gynecolgoy Charles University, Faculty of Medicine in Hradec Kralove  Hradec Kralove Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0196-7005","authenticated-orcid":false,"given":"Mei Yee","family":"Ng","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology The Coombe Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1362-6224","authenticated-orcid":false,"given":"Elif G\u00f6knur","family":"Top\u00e7u","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology, Reproductive Endocrinology Unit Ulus Liv Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamunokoro Christabel","family":"Kio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Sciences PAMO University of Medical Sciences  Port Harcourt Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Lenu","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Sciences PAMO University of Medical Sciences  Port Harcourt Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8174-7760","authenticated-orcid":false,"given":"Abuchi Chima","family":"Stephen","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics, Gynecology and Perinatology Obafemi Awolowo University Teaching Hospitals Complex  Ile\u2010Ife Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2351-1076","authenticated-orcid":false,"given":"Odigonma","family":"Ikpeze","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics and Gynecology Nnamdi Azikiwe University Teaching Hospital  Nnewi Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8612-9926","authenticated-orcid":false,"given":"Rafal","family":"Zadykowicz","sequence":"additional","affiliation":[{"name":"World Association of Trainees in Obstetrics and Gynecology  Paris France"},{"name":"Department of Obstetrics, Perinatology, Gynecology and Reproduction Medical University of Warsaw  Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9141-8215","authenticated-orcid":false,"given":"Adaeze","family":"Oreh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Clinical Sciences PAMO University of Medical Sciences  Port Harcourt Nigeria"},{"name":"Department of Medicine PAMO Teaching Hospital  Port Harcourt Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0033-7004","authenticated-orcid":false,"given":"Ngozi","family":"Orazulike","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Sciences University of Port Harcourt  Port Harcourt Nigeria"},{"name":"Department of Obstetrics and Gynecology University of Port Harcourt Teaching Hospital  Port Harcourt Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor","family":"Inimgba","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Sciences PAMO University of Medical Sciences  Port Harcourt Nigeria"},{"name":"Department of Obstetrics and Gynecology PAMO Teaching Hospital  Port Harcourt Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Igemo","family":"Ikimalo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Sciences PAMO University of Medical Sciences  Port Harcourt Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Beatrice","family":"Kihara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Nairobi  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Louwen","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Fetomaternal Medicine Goethe University Frankfurt  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience","year":"2018"},{"issue":"6","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001847","article-title":"The mistreatment of women during childbirth in health facilities globally: a mixed\u2010methods systematic review","volume":"12","author":"Bohren MA","year":"2015","journal-title":"PLoS Med"},{"key":"e_1_2_12_4_1","volume-title":"Exploring Evidence for Disrespect and Abuse in Facility\u2010Based Childbirth: Report of a Landscape Analysis","author":"Bowser D","year":"2010"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1016\/S0140-6736(19)31992-0","article-title":"How women are treated during facility\u2010based childbirth in four countries: a cross\u2010sectional study with labour observations and community\u2010based surveys","volume":"394","author":"Bohren M","year":"2019","journal-title":"Lancet"},{"issue":"3","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4103\/jpgm.JPGM_648_19","article-title":"Respectful maternity care during childbirth in India: a systematic review and meta\u2010analysis","volume":"66","author":"Ansari H","year":"2020","journal-title":"J Postgrad Med"},{"issue":"7","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0200318","article-title":"Disrespect and abuse during childbirth in district Gujrat, Pakistan: a quest for respectful maternity care","volume":"13","author":"Azhar Z","year":"2018","journal-title":"PLoS One"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/s12884-016-1019-4","article-title":"The prevalence of disrespect and abuse during facility\u2010based childbirth in urban Tanzania","volume":"16","author":"Sando D","year":"2016","journal-title":"BMC Pregnancy Childbirth"},{"key":"e_1_2_12_9_1","volume-title":"Respectful Maternity Care: Women's Experiences and Outlooks in Eastern Europe and Central Asia","author":"United Nations Population Fund (UNFPA)","year":"2026"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/1742-4755-11-71","article-title":"Facilitators and barriers to facility\u2010based delivery in low\u2010 and middle\u2010income countries: a qualitative evidence synthesis","volume":"11","author":"Bohren MA","year":"2014","journal-title":"Reprod Health"},{"key":"e_1_2_12_11_1","unstructured":"World Health Orgnaisation.The prevention and elimination of disrespect and abuse during facility\u2010based childbirth.2015.https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/a287bfd1\u201097c0\u20104af6\u2010ba57\u2010a4469f1d3ed8\/content"},{"key":"e_1_2_12_12_1","volume-title":"Respectful Maternity Care Charter","author":"White Ribbon Alliance","year":"2011"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1002\/ijgo.70513","article-title":"FIGO statement on respectful care: addressing disrespectful maternity care","volume":"171","author":"Miranda J","year":"2025","journal-title":"Int J Gynecol Obstet"},{"key":"e_1_2_12_14_1","unstructured":"Royal College of Obstetricians & Gynecologists (RCOG).RCOG Maternity Service Standards Framework.2025."},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijans.2022.100449","article-title":"Barriers to the provision of respectful maternity care during childbirth by midwives in south\u2010west, Nigeria: findings from semi\u2010structured interviews with midwives","volume":"17","author":"Ige WB","year":"2022","journal-title":"International Journal of Africa Nursing Sciences"},{"issue":"2","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ijgo.2014.08.015","article-title":"Disrespect and abuse during facility\u2010based childbirth in a low\u2010income country","volume":"128","author":"Okafor II","year":"2015","journal-title":"Int J Gynecol Obstet"},{"key":"e_1_2_12_17_1","volume-title":"An Epidemiological Approach to Reproductive Health","author":"Centers for Disease Control (CDC)","year":"1994"},{"issue":"11","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0277889","article-title":"The prevalence of respectful maternity care during childbirth and its determinants in Ethiopia: a systematic review and meta\u2010analysis","volume":"17","author":"Habte A","year":"2022","journal-title":"PLoS One"},{"issue":"1","key":"e_1_2_12_19_1","first-page":"7","article-title":"Guideline for conducting a knowledge, attitude and practice (KAP) study","volume":"4","author":"Kaliyaperumal KI","year":"2004","journal-title":"AECS Illumination"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1186\/s12884-016-1124-4","article-title":"Women's status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory","volume":"16","author":"Sudhinaraset M","year":"2016","journal-title":"BMC Pregnancy Childbirth"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s13104-019-4118-2","article-title":"Disrespectful and abusive behavior during childbirth and maternity care in Ethiopia: a systematic review and meta\u2010analysis","volume":"12","author":"Kassa ZY","year":"2019","journal-title":"BMC Res Notes"},{"issue":"1","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/aogs.14962","article-title":"Prevalence of obstetric violence in high\u2010income countries: a systematic review of mixed studies and meta\u2010analysis of quantitative studies","volume":"104","author":"Fraser LK","year":"2025","journal-title":"Acta Obstet Gynecol Scand"},{"key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1186\/s12913-023-09561-x","article-title":"Association of workload and practice of respectful maternity care among the healthcare providers, before and during the early phase of COVID\u201019 pandemic in South Western Nepal: a cross\u2010sectional study","volume":"23","author":"Pokharel A","year":"2023","journal-title":"BMC Health Serv Res"},{"issue":"6","key":"e_1_2_12_24_1","first-page":"197","article-title":"Assessment of the level of knowledge of respectful maternity care and sexual and reproductive health and rights in South Sudan","volume":"11","author":"Silver AJ","year":"2023","journal-title":"Am J Public Health Res"},{"key":"e_1_2_12_25_1","first-page":"1","article-title":"From assumptions to outcomes: how unconscious bias shapes obstetric care","volume":"00","author":"Portilla FJR","year":"2026","journal-title":"Int J Gynaecol Obstet"},{"issue":"3","key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"524","DOI":"10.4103\/ijcm.IJCM_1034_20","article-title":"A quality improvement study on improving communication between health\u2010care provider and laboring woman: a step toward respectful maternity care","volume":"46","author":"Sharma B","year":"2021","journal-title":"Indian J Community Med"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71424","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71424","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71424","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:50:41Z","timestamp":1792659041000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71424"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":25,"alternative-id":["10.1002\/ijgo.71424"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71424","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]},"assertion":[{"value":"2026-07-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijgo.71424"}}