Respectful maternity care in contemporary obstetric practice: nursing strategies to enhance maternal comfort, safety, communication, and childbirth experience

Respectful maternity care (RMC) is a central component of safe, high-quality obstetric practice. It recognises every woman as a rights-holder and an active participant in decisions about pregnancy, labour, birth and the postnatal period. Respect is demonstrated through dignity, privacy, confidentiality, informed consent, clear communication, freedom from discrimination and abuse, emotional support, and timely evidence-based clinical care. Despite international guidance and national quality initiatives, disrespectful treatment continues to be reported in diverse maternity settings. Its forms include verbal humiliation, physical or sexual abuse, procedures without valid consent, lack of privacy, discrimination, neglect, abandonment, coercion and health-system practices that prevent women from making meaningful choices. Contemporary nursing practice can reduce these risks by embedding respectful behaviours into routine clinical workflows rather than treating kindness as an optional personal quality. This narrative review synthesises major global guidance and selected peer-reviewed evidence on the principles, barriers, measurement and implementation of RMC, with particular attention to nursing strategies across antenatal, intrapartum and postnatal care. It discusses consent and shared decision-making, trauma-informed communication, birth companionship, comfort measures, cultural safety, equity, emergency care, documentation, staff support and facility-level quality improvement. Evidence indicates that multicomponent RMC programmes and provider training can improve reported care experiences, although certainty about downstream maternal and newborn clinical outcomes remains limited. Recent reviews also highlight variation in definitions and measurement tools, reinforcing the need for local adaptation and transparent monitoring. The review concludes that respectful care is both an ethical obligation and a quality-of-care domain. Sustainable improvement requires capable staff, adequate staffing and supplies, supportive leadership, accountability mechanisms, accessible feedback systems and participation of women and communities. Clinical urgency may change the sequence or speed of care, but it does not remove the obligation to communicate, preserve dignity and seek consent whenever possible.