The first month of life is the most vulnerable time for a child’s survival. In 2015, 2.7 million children died in the first 28 days of life and 1.3 million were stillborn. Addressing access to quality, equitable, and respectful care around the time of birth and during the neonatal period is critically important for maternal and newborn survival.

On September 26, 2017, Every Preemie—SCALE convened a group of technical experts in Washington, DC to explore issues around providing respectful care to newborns. While much work has been done to address respectful care for women during childbirth, more attention is needed to define respectful care for newborns during birth and beyond. Dr. Jim Litch (Every Preemie – SCALE / GAPPS) opened the meeting by stating, “While some components of respectful care may overlap for both mother and newborn, such as making sure that the family and baby are not separated unless medically necessary after birth, newborns have unique needs and are especially vulnerable because of their lack of ability to express their own needs and interests.”

The concept of respectful care originates with the human rights movement; however, the rights of children were not legally defined until 1990 when the United Nations enacted the Convention on the Rights of the Child.  “The general principles of the Convention all form the backbone of the right to health and healthcare,” explained Marcus Stahlhofer of the World Health Organization (WHO), and this document is a key building block to the discussion around providing respectful care for newborns.

Childbirth straddles the period between pregnancy and the newborn, touching both the needs of the mother and the baby. In 2011, the White Ribbon Alliance produced a groundbreaking consensus document, the Respectful Maternity Care Charter, and convened a Global Council on Respectful Maternity Care (RMC) to tackle the problem of disrespect and abuse during childbirth. The council is a multi-sectoral group of over 300 members around the world. As Betsy McCallon, Executive Director of the White Ribbon Alliance explained, “the goal is to make sure that RMC is integrated everywhere at every level. Much can be learned from the work of the Council on Respectful Maternity Care and we support this effort to bring attention to the wellbeing and respectful care for the newborn.”

In 2016, the WHO released a new framework for quality of care in health facilities throughout pregnancy, during childbirth, and the postnatal period for pregnant women and newborns.  Dr. Smita Kumar from the U.S. Agency for International Development stressed that this framework provides a key opportunity to leverage global efforts around quality of care to improve neonatal outcomes by ensuring newborns receive respectful care during birth and beyond. 

Given the foundation that has been laid to provide respectful maternity care and the current global focus on improving quality of care for mothers and newborns, this is a critical time to address the care of the newborn. The Preterm Birth/Low Birth Weight Global Technical Working Group meets twice a year to explore implementation challenges and solutions around preterm birth and low birth weight. Last week’s meeting brought together the maternal, newborn health, and human rights communities to work together on this important issue. Presentations, materials, and more information on the technical working group and outcomes of this meeting are available on the Every Preemie website.

By Maria Stepanchak and Jim Litch

Every Preemie—SCALE is a 5-year USAID-funded program designed to catalyze the global and national conversation around preterm birth and low birth weight in 25 priority maternal and child health countries, primarily in Africa and South Asia. The program is implemented by PCI, the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), and the American College of Nurse-Midwives (ACNM).