Perceived Competencies and Self-Reported Practices on Respectful Maternity Care (RMC) During Childbirth Among Midwives in Health Facilities. A Descriptive Cross-Sectional Study from Kerala

Abstract

Background

The perceptions of midwives regarding Respectful Maternity Care (RMC) significantly influence the quality of care provided. This research aimed to investigate the level of perceived competencies and self-reported implementation of RMC among Kerala midwives during the childbirth process.

Methods 

A cross-sectional study was conducted between May and June 2025, focusing on perceived competencies and self-reported practice on RMC among 146 midwives selected by convenience sampling from the different units of two hospitals in Kerala. The participants were midwives with at least one year of experience in their roles. To evaluate their perceived competencies and self-reported practice, assessed by the Midwives' Knowledge and Practice Scale, was administered with Cronbach's Alpha reliability of 0.86 and 0.829, respectively, on Respectful Maternity Care. A chi-square was employed to examine the association between the midwives' age, educational background, and work experience with their perceived competencies and self-reported practice on RMC. Result: The findings indicated that midwives in Kerala exhibited strong perceived competencies and self-reported practices of RMC in their care approach. The average scores for overall perceived competencies and self-reported practices of RMC were 110. 4±6.2 and 109.8 ±6.37, respectively. Midwives recorded overall good perceived competencies and self -reported practices on Respectful Maternity Care (RMC) during Childbirth.  The analysis revealed that a positive correlation between the perceived competencies and self-reported practices of RMC among midwives is significant at the 0.01 level (p<0.05; 2-tailed). There is a significant association between research variables and education at the (p<0.05)0.01 level.

Conclusions

The study highlights strong perceived competencies and self-reported practices of RMC among midwives in Kerala, with education playing a significant role in these outcomes. Enhancing respectful maternity care necessitates the development of practical skills with adequate cognitive empowerment among midwives work in the maternal care unit