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Cited by 3Global Maternal and Child HealthMaternal and Perinatal Health InterventionsReproductive Health and Contraception

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Respectful maternity care and intersectional identities in low- and middle-income countries: a systematic review.

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Adepoju, Victor Abiola, Odueniyi, Chioma, Abdulrahim, Abdulrakib, Adnani, Qorinah Estiningtyas Sakilah·2025·BMC Pregnancy and Childbirth
DOI 10.1186/s12884-025-08566-0PMC PMC12801694
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Abstract

BACKGROUND: Disrespect and abuse (D&A) during facility-based births remains widespread in low- and middle-income countries (LMICs). This disproportionately impacts women from marginalized social strata. Respectful Maternity Care (RMC), as articulated in the 2014 World Health Organization (WHO) statement, constitutes both a fundamental human right and a quality care imperative. However, women's experiences of RMC are not uniform and are influenced by intersecting social identities such as caste, class, ethnicity, age, disability, marital status, language, literacy, and migrant status. OBJECTIVES: This review aimed to (1) quantify and compare the prevalence of disrespect and abuse (D&A) across social subgroups in LMICs; (2) identify social and systemic determinants such as poverty, education, migration status, and provider bias, that influence women's experiences of respectful or disrespectful maternity care; (3) synthesize qualitative insights to understand how intersecting identities shape women's childbirth experiences; and (4) develop a conceptual model explaining how identity factors and health‑system level drivers interact to produce inequities. METHODS: We conducted a systematic review following PRISMA guidelines. We synthesized literature on intersectional experiences of RMC and D&A in LMICs. Searches spanned five databases and key grey literature sources. The data extraction was finalized in April 2025. Eligible studies were published between 2014 (coinciding with the release of the WHO RMC statement) and 2025. Eligible studies included peer-reviewed primary research and high-quality systematic or scoping reviews that provided identity-disaggregated evidence on respectful or disrespectful maternity care in facility-based childbirth settings in LMICs. A thematic narrative synthesis integrated quantitative and qualitative findings. . RESULTS: Seventeen studies across 15 LMICs were included. Women with intersecting vulnerabilities, especially those who were young, impoverished, unmarried, disabled, lower caste/ethnic minority backgrounds, or migrants, were consistently more susceptible to experience neglect, non-consented care, verbal abuse, or exclusion from decision-making processes. These patterns indicate systemic injustices rather than individual occurrences. Key explanatory mechanisms included social stigma, provider biases about who is "deserving" of care, and communication obstacles. Disability, migration status, socio-economic status, and religion were under-explored in the literature despite being linked to discrimination. CONCLUSION: This review highlights that intersectional inequities substantially influence women's experiences of respectful maternity care in LMICs. However, causal inference is limited by study heterogeneity and uneven representation of identity factors.

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  • Experiences of emotional abuse are not uniform but are shaped by overlapping social identities and structural determinants, including socio-economic status, cultural norms, and social marginalization.

    “An intersectional lens reveals that experiences of emotional abuse are not uniform but are shaped by overlapping social identities and structural determinants, including socio-economic status, cultural norms, and social marginalization (Adepoju et al., 2025).”

    From From use to abuse: psychological, neurobiological, and spiritual pathways in relational harm and recovery (2026) · cites this paper as Adepoju et al., 2025

    The Results (Findings by identity axis; page unavailable) link poverty, caste, and other intersecting identities to stigma, shouting, and more abusive maternity care. The Background also describes moral judgments and structural discrimination. The source supports this pattern for women giving birth in facilities in low- and middle-income countries, but the claim states it for emotional abuse generally, without that setting limitation. (LLM, conf=0.82)

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Metadata

Authors
Adepoju, V. A., Odueniyi, C., Abdulrahim, A., & Adnani, Q. E. S.
Affiliations
  • Johns Hopkins University (US)
  • Universiti Putra Malaysia (MY)
  • Padjadjaran University (ID)
Corresponding author
Adepoju, Victor Abiola
ORCID
Venue
BMC Pregnancy and Childbirth
Publisher
Springer Science and Business Media LLC
Published
2025-12-09
Volume
26
Issue
1
Pages
42-42
ISSN
1471-2393 (ISSN-L)
DOI
10.1186/s12884-025-08566-0
PMC
PMC12801694
OpenAlex
W4417183446
Cited by
3
References
28
Citations by year
2026: 3
FWCI
0.74
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Pregnancy and Childbirth (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Keywords
respectful maternity care, disrespect and abuse in childbirth, intersectionality, social determinants of health, facility-based childbirth, low- and middle-income countries, caste, migration status, disability, poverty, provider bias, health disparities, women's experiences of childbirth, non-consented care, verbal abuse, social stigma
MeSH terms
Respect, Developing Countries, Female, Humans, Maternal Health Services, Poverty, Pregnancy, Professional-Patient Relations, Quality of Health Care, Social Identification, Healthcare Disparities

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