Dignity and respect
Treat every woman, newborn and family with courtesy, compassion and respect throughout care.
Pregnancy • Labour • Birth • Postnatal Care
Respectful Maternity Care
Person-centred maternity care that protects dignity, privacy and confidentiality, supports informed choice and communication, provides continuous support and helps keep women and newborns free from mistreatment.
WHO-aligned
Dignity & privacy
Informed choice
Continuous support
Positive childbirth experience
WHO core principles
What respectful maternity care means in practice
WHO's quality-of-care framework includes both the provision of care and the experience of care. Respectful care is a core part of the experience of care.
Privacy
Protect privacy during examinations, procedures, labour, birth and postnatal care.
Confidentiality
Handle personal, clinical and reproductive health information confidentially and appropriately.
Informed choice
Explain relevant options, benefits, risks and alternatives in understandable language and support informed decisions.
Freedom from mistreatment
Care should protect women and newborns from physical, verbal and sexual abuse, neglect, discrimination and other mistreatment.
Effective communication
Listen, explain, invite questions and provide clear information that responds to the woman’s needs and preferences.
Continuous support
Support should be individualized and may include a companion of choice where appropriate and permitted.
Emotional support
Recognize emotional needs, reduce avoidable anxiety and strengthen the woman’s sense of capability and control.
Every interaction matters
Practical actions for maternity staff
Respectful care is not a single intervention. It is the way communication, clinical care, examinations, procedures, support and decisions are delivered throughout the woman's care journey.
1
Introduce yourself and your role
Tell the woman who you are and what your role is in her care.
2
Ask before touching or examining
Explain what you need to do, why it is needed and obtain appropriate consent before an examination or procedure.
3
Use clear, non-judgemental language
Avoid shouting, humiliation, blame, threats, ridicule or language that undermines confidence.
4
Protect privacy
Use screens, curtains, appropriate draping and a private space whenever feasible. Limit unnecessary observers.
5
Keep her informed
Explain progress, findings, interventions and changes in the plan in language she can understand.
6
Invite questions
Pause when practical and allow the woman to ask questions or express concerns.
7
Support choice
Discuss available options and respect informed preferences while providing clinically appropriate care.
8
Support a companion
Facilitate a companion of choice when appropriate, according to the woman’s preference and facility arrangements.
9
Support comfort and pain relief
Discuss pharmacological and non-pharmacological comfort and pain-relief options appropriate to the woman and clinical situation.
10
Support mobility and birth position
For women in labour who are clinically appropriate, support mobility and position choices consistent with WHO recommendations and local clinical circumstances.
11
Explain interventions
Before non-emergency interventions, explain the indication, expected benefit, important risks and available alternatives as appropriate.
12
Communicate changes and referrals
When referral or escalation is required, explain why, what will happen next and what information will accompany the woman.
Consent & informed choice
- Explain before actingExplain the proposed examination, procedure or intervention and why it is being considered.
- Use understandable languageAdapt information to the woman's language, health literacy and communication needs.
- Invite questionsGive the woman an opportunity to ask questions and express concerns whenever circumstances permit.
- Support informed decisionsWhere options exist, communicate relevant benefits, risks and alternatives and support informed choice.
Privacy & confidentiality
- Protect physical privacyUse curtains, screens, doors and appropriate draping during examinations and procedures.
- Limit unnecessary observersOnly people who are necessary or welcomed should be present, consistent with teaching and facility policies.
- Protect informationKeep clinical and personal information confidential and share it appropriately for continuity and safety.
- Respect sensitive concernsCreate a safe environment for women to discuss reproductive, sexual, mental health and safeguarding concerns.
Preventing mistreatment
What respectful maternity care must protect women from
WHO identifies mistreatment during childbirth as a quality-of-care and rights concern. Prevention requires systems, staff behaviour, accountability and an environment that protects dignity and informed choice.
Physical abuse
Hitting, slapping, unnecessary physical force, harmful restraint or other physical mistreatment.
Verbal abuse or humiliation
Shouting, insults, threats, mocking, blaming or degrading language.
Non-consensual care
Performing examinations or procedures without appropriate consent, except where lawful emergency provisions apply.
Loss of privacy
Unnecessary exposure, lack of privacy during examination or allowing avoidable observers.
Discrimination
Unequal or degrading treatment based on personal, social, demographic or health-related characteristics.
Neglect or abandonment
Failure to provide appropriate attention, assessment, monitoring, communication or timely escalation when care is needed.
Denial or inappropriate restriction of care
Withholding appropriate services or treating a woman unfairly because of inability to pay or other discriminatory reasons, subject to applicable law and policy.
Coercion or intimidation
Using fear, pressure, threats or humiliation to force a woman into a decision when informed communication and consent are appropriate.
Important: Respectful care does not mean that clinically necessary treatment should be withheld. It means that care should be safe, evidence-based and person-centred, with communication and informed participation whenever the clinical situation permits.
Communication
A simple communication cycle for respectful care
Effective communication is one of WHO's maternal and newborn quality-of-care standards.
1
Listen
Start by asking what the woman knows, wants, fears or needs.
2
Explain
Use simple language and explain what is happening and why.
3
Check
Ask whether the explanation is clear and invite questions.
4
Decide together
Where clinically appropriate, support shared decision-making and informed choice.
5
Document
Record relevant assessments, decisions, consent and communication according to professional and facility requirements.
6
Follow up
Revisit decisions when the clinical situation changes and explain any new recommendations.
Positive childbirth experience
Respectful choices during labour and birth
WHO's intrapartum care recommendations support a positive childbirth experience through woman-centred care, including respectful communication, a companion of choice, pain-relief strategies, mobility and birth-position choice when appropriate.
Companion of choice
Ask who the woman would like to support her, consistent with facility arrangements and clinical safety.
Communication preferences
Ask how she would like information explained and ensure important information is understood.
Mobility
For appropriate women in labour, support movement and comfortable positions according to clinical circumstances.
Birth position
Discuss and support an appropriate birth position according to the woman’s preference, clinical situation and available care.
Pain relief
Discuss available pharmacological and non-pharmacological pain-relief options and support informed choice.
Privacy and dignity
Plan practical measures that preserve privacy, dignity and confidentiality during labour and birth.
Clinical context matters: preferences should be discussed and supported whenever appropriate, but the woman's and baby's clinical condition may require changes to the plan, additional monitoring, referral or intervention.
Companion and emotional support
- Ask the woman's preferenceFind out whether she wants a companion and who she would prefer.
- Communicate expectationsExplain relevant facility arrangements so the companion can provide safe and supportive assistance.
- Provide emotional supportOffer reassurance, listen to concerns and avoid language that increases fear or shame.
- Strengthen capabilitySupport the woman to understand what is happening and participate in her care.
Pain relief and comfort
Pain is individual. Respectful care means listening to the woman's experience and discussing available options rather than dismissing pain or assuming what she should tolerate.
- Ask about pain and comfortAssess the woman's needs and preferences in the context of the clinical situation.
- Discuss optionsExplain available non-pharmacological and pharmacological approaches appropriate to the setting.
- ReassessPain and support needs can change during labour; revisit the plan when appropriate.
Facility quality improvement
How facilities can embed respectful care into routine systems
WHO's quality-of-care framework includes effective communication, respect and preservation of dignity, emotional support, competent personnel, functioning referral systems and essential resources.
Leadership commitment
Make respectful care a visible quality and safety priority with clear accountability.
Staff orientation and training
Train all relevant staff in communication, consent, dignity, privacy, supportive care and prevention of mistreatment.
Clear policies
Maintain policies and procedures addressing informed consent, confidentiality, companion support, complaints and safeguarding.
Supportive environment
Provide appropriate space, privacy, essential resources and staffing that enable respectful care.
Referral readiness
Maintain a functioning referral system with clear communication and timely escalation.
Feedback and accountability
Provide safe mechanisms for women and families to give feedback and raise concerns, and use information for quality improvement.
For midwives, nurses and educators
Respectful care as a professional practice
Use respectful maternity care principles consistently during antenatal, intrapartum, postnatal and newborn interactions.
- Use person-centred languageAddress the woman respectfully and avoid labels that reduce her to a diagnosis, procedure or bed number.
- Maintain professional boundariesProtect confidentiality, consent and appropriate professional conduct in all interactions.
- Teach students respectfullyClinical education should preserve dignity, obtain appropriate permission and avoid unnecessary exposure or observation.
- Document important decisionsRecord clinically relevant assessments, consent, interventions, referrals and communication according to local standards.
- Escalate safety concernsUse established safeguarding, clinical escalation and incident-reporting processes when harm, abuse or unsafe care is suspected.
Frequently asked questions
Respectful maternity care FAQs
What is respectful maternity care?
Respectful maternity care is person-centred care that maintains dignity, privacy and confidentiality, protects women and newborns from harm and mistreatment, supports informed choice and provides continuous, appropriate support. WHO places respectful care within the broader quality-of-care framework for maternal and newborn health.
Does respectful care mean avoiding all medical interventions?
No. Respectful care does not mean refusing clinically indicated interventions. It means that care should be evidence-based and that women should be appropriately informed and involved in decisions whenever possible. Emergency care may require immediate action, with communication and explanation provided as soon as feasible.
Can a woman choose a companion during labour?
WHO recommends a companion of choice during labour and childbirth for women who want one, subject to the clinical setting and applicable facility arrangements. The woman’s preferences should be respected and communicated to the care team.
Why is consent important during maternity care?
Consent supports autonomy and informed choice. Before examinations or procedures, the woman should receive understandable information about what is proposed and why, with an opportunity to ask questions and make an informed decision, except where applicable emergency or legal provisions require otherwise.
What does privacy include during childbirth?
Privacy includes appropriate draping, curtains or private spaces, limiting unnecessary observers, protecting confidential information and avoiding unnecessary exposure during examinations and procedures.
How should staff communicate during labour?
Staff should listen, explain what is happening, avoid judgemental or humiliating language, invite questions, communicate changes in the care plan and support the woman’s participation in decisions whenever clinically appropriate.
What if an emergency happens?
Clinical safety takes priority. The team should provide necessary emergency care promptly, while communicating with the woman and family as far as the situation allows. Once the immediate emergency is controlled, the team should explain what happened, what was done and the next steps.
Guideline references
Evidence base
Key WHO resources used to develop this educational page.
WHO recommendations: Intrapartum care for a positive childbirth experience (2018)
WHO's comprehensive intrapartum guideline emphasizes woman-centred care, respectful communication, privacy, informed choice, continuous support and a positive childbirth experience.
WHO guideline
WHO: Respectful care
WHO's quality-of-care framework describes respectful care as maintaining dignity, privacy and confidentiality, respecting rights, ensuring freedom from harm and mistreatment, and enabling informed choice and continuous support.
WHO respectful care resource
WHO Standards for improving quality of maternal and newborn care in health facilities (2016)
The standards include effective communication, respect and preservation of dignity, emotional support, competent personnel, functioning referral systems and essential resources.
WHO standards
WHO Labour Care Guide: User's Manual (2021)
A tool designed to support good-quality, evidence-based and respectful care during labour and childbirth.
WHO Labour Care Guide
Compendium on Respectful Maternal and Newborn Care (2025)
A practical WHO-led resource consolidating evidence and tools for implementing and monitoring respectful maternal and newborn care and preventing mistreatment.
WHO 2025 compendium
Educational information: This page provides general information based on WHO guidance and is not a substitute for individualized clinical care, professional standards, local law or facility policy. Clinical decisions should consider the woman’s and newborn’s condition, informed preferences, available resources and applicable professional and legal requirements. In an emergency, seek urgent medical care.