A mixed-method exploration of the level of respect provided to women during childbirth at healthcare facilities in the Kingdom of Saudi Arabia

  • Reem Alghamdi

Student thesis: Doctoral ThesisDoctor of Philosophy


Two-phased, sequential, exploratory, mixed-method study has been conducted to explore the level of respect experienced by women during childbirth in Saudi healthcare settings. In the first qualitative phase, an overarching theme pertaining to women’s secure autonomy emerged. The Mother On Respect index (MORi) was culturally adapted, translated into Arabic and tested for validity and reliability in the KSA, and a comparison was made with similar studies in Canada and the USA. By integrating the two phases of the study, dynamic factors were found to have a top-down effect from the health system to the women level. The medicalisation of birth, hospital policies and facilities had a downward effect on women’s autonomy, needs and overall experiences. Mechanisms and recommendations for providing solutions to these issues have been suggested to promote respectful maternity care to ensure that women’s health rights are achieved. The study has provided awareness of those aspects of maternity care service provision which require attention, including better training for healthcare providers, updating policies and developing educational programmes to help to promote respectful maternity care. This will improve communication between women and healthcare providers, enhance practitioners’ knowledge, improve resources to provide high-quality care within maternity care services and ensure that women’s health rights are met during childbirth. This mixed-method study is the first of its kind in this region as the systemic review revealed that no previous research has considered respectful maternity care in the KSA. Furthermore, this study contributes to the body of knowledge concerning respectful maternity care, women’s health care rights, and maternal and foetal healthcare provision. The findings will help healthcare providers including midwives, nurses and physicians, to provide maternity care services which are culturally sensitive and evidence-based to promote respectful maternity care and improve women’s health and access to maternity healthcare facilities in the KSA.

Thesis embargoed until 31 December 2023
Date of AwardDec 2021
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SponsorsKing Saud University
SupervisorOliver Perra (Supervisor), Breidge Boyle (Supervisor) & Janine Stockdale (Supervisor)


  • Respectful maternity care
  • mistreatment
  • childbirth
  • mixed method approach
  • healthcare facilities
  • Saudi Arabia

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