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Respectful Maternity Care

Research and tools designed to help understand how service users experience care.

TOOLS for measuring respectful maternity care include:


The Mothers Autonomy in Decision Making scale (MADM) is a scale developed to assess women’s experiences with maternity care.


It is a reliable and valid instrument, presently MADM version 1.0 is the most recent version and should be used for all new studies.


The Mothers on Respect index (MOR) is a scale developed to assess the nature of respectful patient-provider interactions and their impact on a person’s sense of comfort, behavior, and perceptions of racism or discrimination.


The MOR index is a reliable, patient-informed quality and safety indicator that can be applied across jurisdictions to assess the nature of provider-patient relationships, and access to person-centered care. 

Research and other projects:

RESPCCT: Research Examining the Stories of Pregnant and Childbearing in Canada Today

(Canadian Institutes of Health Research)

Our multidisciplinary team is launching national study of experience of respect, discrimination, and mistreatment in the childbearing year, specifically among disadvantaged communities including First Nations/ Indigenous, LGTBQ2SIA+, recent immigrants and pregnant persons living with disabilities. 

Changing Childbirth in BC

(Michael Smith Foundation for Health Research, Vancouver Foundation)

In Phase 2 of our Changing Childbirth in BC project, we are working with community members to code qualitative data on how model of care and patient-provider communication affect women’s experience of care, and to decide how best to tell these stories, and effect change. Learn more here.

Improving Patient Experience of Respect and Autonomy During Maternity Care: A Pilot Study to Implement Patient-Designed Quality Measures

(American Institute of Research)

Implementation of the MADM and MORi quality measures in 5 US sites across diverse populations, and contexts for pregnancy and birth care.

Undisturbed Labour and Birth Index

(Transforming Birth Fund)

A Delphi study to develop an Undisturbed Labour Birth Index, a quality care measure, based on evidence-based indicators, that can implemented assess care in institutions and at the clinical practice level.

Giving Voice to Mothers US

(Transforming Birth Fund, Groundswell Fund)

This participatory action study in the US used indicators developed and validated by service users to examine how planned place of birth, race and ethnicity affect pregnancy and birth care, experiences with respect, discrimination, or mistreatment, and access to options for care. Learn more here.

Giving Voice to Queer Families

In development via collaboration with multidisciplinary stakeholders and Dr. Molly Altman.