# An exploration of perinatal healthcare providers’ perspectives on respectful maternity care in the United States: a scoping review

## TL;DR

This review explores how perinatal healthcare providers in the US view respectful maternity care, especially for Black patients, and identifies key themes and gaps in the literature.

## Contribution

The study provides a comprehensive typology of providers' perspectives on respectful care and highlights a lack of research on providers' accountability for disrespectful practices.

## Key findings

- Providers emphasize avoiding harm and discrimination in perinatal care.
- Health system and macro-level factors influence respectful care practices.
- Few studies address providers' admission of disrespectful care.

## Abstract

Maternal mortality and morbidity rates in the United States (US) among racially minoritized populations have continued to worsen over the past decade. Reviews have examined the perinatal healthcare experiences and outcomes of Black individuals in the US. However, few reviews have examined perinatal healthcare providers’ experiences practicing in the US healthcare system. The purpose of this review was to comprehensively assess the current evidence and knowledge gaps related to perinatal healthcare providers’ perspectives on providing respectful maternity care to Black patients.

A literature search was conducted via PubMed, Embase, Web of Science, and CINAHL using appropriate search terms. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis extension for Scoping Reviews guidelines and by the Joanna Briggs Institute enhanced scoping review framework.

The first and second database searches yielded 764 and 819 articles respectively (2013–2023). An updated search yielded a total of 1,592 articles (2013–2024). Thirty-nine studies met full text review, 14 studies were ultimately included in this review (11 qualitative, two quantitative, and one mix-method). Thematic synthesis of studies in this review yielded a six-component typology of providers’ views and experiences on respectful maternity care in the US. The themes were (1) being free from harm and mistreatment such as physical and verbal abuse; (2) developing rapport between providers and women; (3) meeting professional standards of care such as seeking consent and not performing procedures against patients’ wishes; (4) avoiding discrimination based on age, race/ethnicity, and medical conditions, and low socioeconomic status; (5) health system constraints and facilitators; and (6) macro-level, external constraints, and facilitators.

Findings from this review showed that providers’ descriptive narratives mirrors the body of evidence on individual pregnant women’s accounts of mistreatment while navigating perinatal care. However, none of the fourteen studies focused on providers admitting to their own practices that are or could be deemed disrespectful. Future research on the topic of this scoping review would benefit from looking at perinatal care providers’ willingness to admit to and be accountable for their disrespectful practices. More research is necessary to fully understand and disrupt dehumanizing perinatal care practices.

This review has been registered with the Open Science Framework (10.17605/OSF.IO/DQXG2).

The online version contains supplementary material available at 10.1186/s12884-025-08247-y.