# Effectiveness of a respectful maternity care program in a Guatemalan indigenous region rural hospital: a quasi-experimental study

## TL;DR

A respectful maternity care program improved childbirth experiences for Indigenous women in a rural Guatemalan hospital.

## Contribution

This study evaluates an educational RMC program for nurses in Guatemala, a region with limited RMC research.

## Key findings

- RMC scores increased by 68% after the educational program for nurses.
- The rate of physical, verbal abuse, or discrimination during childbirth dropped from 71.6% to 33%.
- The program improved women's childbirth experiences in a rural Guatemalan hospital.

## Abstract

Mistreatment of women during childbirth in healthcare facilities can serve as a barrier to utilizing healthcare services. Respectful maternity care (RMC) has been recommended to address this issue, and interventions to promote RMC have been implemented globally. For Indigenous women in particular, such care is closely related to childbirth satisfaction and is considered crucial. However, research on RMC in Guatemala is limited, with no reports focusing on educational interventions. Therefore, this study aimed to implement an educational program to promote RMC for nurses and evaluate its effectiveness.

This study employed a quasi-experimental design and was conducted at a hospital in the Quiché Department, Guatemala. For nurses in the hospital, a two-day educational program on RMC, which included lectures and group work, was implemented. The effectiveness of the program was assessed by comparing women's experiences of RMC and mistreatment during childbirth before and after the intervention. Data was analyzed using chi-square tests, independent t-tests, and ANCOVA.

This study included 176 postpartum women, with 88 in each pre- and post-intervention group. The average RMC scores significantly increased from 33.74 pre-intervention to 56.70 post-intervention (p < .001), representing a 68% relative increase. In the pre-intervention group, 71.6% of women experienced physical abuse, verbal abuse, or stigma or discrimination, which significantly decreased to 33.0% in the post-intervention group (p < .001).

This educational program suggested improvements in women's childbirth experiences in the facility. Implementing this program in other facilities and regions could contribute to the widespread promotion of RMC practices in healthcare settings.