Relationship – The Foundation of Safe and Respectful Maternity Care

When we think about safe maternity care, our minds often turn to clinical expertise, technology, and managing risk. These are essential. But they are only part of the story.

Safety is also created through human relationships. A woman who feels listened to, respected, and genuinely cared for is more likely to feel safe, ask questions, share concerns, and actively participate in decisions about her care. In maternity care, the quality of relationships is not separate from safety; it is one of its foundations.

Two simple but powerful approaches can help strengthen both safety and respect in maternity care.

First, communication matters. Women need clear, consistent, and timely information to understand what to expect and to participate meaningfully in decisions about their care. Effective communication extends beyond simply providing information; it involves creating shared understanding, reducing uncertainty, and building trust. When women feel informed, listened to, and actively involved in decision-making, they are more likely to feel safe, respected, and confident throughout pregnancy, birth, and the postnatal period. Providing timely, accurate, and understandable information supports informed decision-making, reduces uncertainty, promotes a sense of safety and trust and creates partnership.

Second, maternity care should build on wellness and recognise normal variation, rather than focusing solely on what could go wrong. Pregnancy and birth are major life events, not simply clinical conditions to be managed. While identifying and responding to risk is an essential component of safe care, an overly risk-focused approach can unintentionally undermine women’s confidence and reinforce the idea that pregnancy and birth are inherently problematic. A strengths-based approach recognises women’s capabilities, supports informed choice, and acknowledges that variation is often a normal part of childbearing.

Underlying both strategies is the importance of warm, respectful, and trusting relationships between women and maternity care professionals. Evidence consistently shows that positive relationships are central to women’s experiences of care and are associated with greater satisfaction, trust, engagement, and emotional wellbeing. When women feel known, respected, and supported by their healthcare professionals, they are better able to participate actively in a therapeutic partnership and to engage in decisions about their care.

Research also suggests that every interaction matters. Regardless of role or discipline, maternity care professionals can positively influence women’s experiences through the relationships they build and the way they communicate and provide care. Creating conditions where every woman has the opportunity to develop genuine, positive connections with healthcare professionals is therefore essential. This involves getting to know women as individuals, showing interest in their lives beyond the pregnancy, listening to what matters to them, and providing care that is personalised, responsive, and engaging.

Positive relationships do not happen by accident. They require maternity services to create environments where meaningful connections are possible. This means giving healthcare professionals enough time to get to know women as people, not just patients. It means encouraging curiosity about women’s lives, values, hopes, and concerns. It means providing care that feels personal, responsive, and compassionate.

Respectful maternity care is often discussed as a matter of rights, and it is. But it is also about human connection. Women are more likely to feel safe when they are cared for by professionals who see them as people first and patients second. Clear communication, a focus on wellness, and genuine relationships may seem simple, but they are some of the most powerful tools we have for creating maternity care that is both safe and respectful.

Safe maternity care is not achieved through clinical expertise alone. It is built through communication, trust, and relationships that help women feel informed, respected, and genuinely cared for. When maternity services invest in these foundations, both women and healthcare professionals benefit.

References

Australian College of Midwives. (2026). National Midwifery Guidelines for Consultation and Referral (5th ed.).

Australian College of Midwives. (2021). Philosophy for Midwifery.

Australian Commission on Safety and Quality in Health Care. (2021). National Safety and Quality Health Service Standards (2nd ed.). Sydney: ACSQHC.

Australian Government Department of Health. Woman-centred Care: Strategic Directions for Australian Maternity Services (2019).

Australian Institute of Health and Welfare (2026) Australia’s mothers and babies

Bohren, M. A., & Bradfield, Z. (2024). We urgently need humanised, respectful maternity care for all. BMJ, 386, q1594.

Bohren, Meghan A., et al. (2015). “The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review.” PLoS Medicine, 12(6), e1001847.

International Confederation of Midwives, White Ribbon Alliance, & World Health Organization. (2019). Universal Rights of Childbearing Women.

Leap, N., Dahlen, H., Brodie, P., Tracy, S., & Thorpe, J. (2010). Relationships – the glue that holds it all together: Midwifery continuity of care. In L. Davies, R. Daellenbach & M. Kensington (Eds.), Sustainability, Midwifery and Birth (pp. 61–74). Routledge.

Sandall, Jane, et al. (2024). Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews.

The World Health Organization (WHO); (2025); Compendium on respectful maternal and newborn care.

World Health Organization. (2014). The prevention and elimination of disrespect and abuse during facility-based childbirth. Geneva: World Health Organization.

World Health Organization. (2016). Standards for improving quality of maternal and newborn care in health facilities. Geneva: World Health Organization.

World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva: World Health Organization.