Respectful Maternity Care in Colombia

Abstract

Respectful Maternity Care (RMC) is increasingly recognized as a fundamental component of quality maternal healthcare, yet its practical implementation within emergency training remains unclear. Existing training materials often emphasize clinical survival outcomes while providing limited guidance on how respectful care can be enacted in specific situations. This thesis explores how traditional midwifery practices in Colombia can inform emergency maternity care training by identifying locally grounded manifestations of respectful care and translating them into actionable educational material.

The project was conducted in collaboration with Laerdal Global Health and focused on the Colombian region of Chocó, where traditional midwifery remains a culturally significant and widely practiced form of care. Rather than framing the project as a problem-solving intervention, the investigation sought to learn from existing care systems that already sustain respectful, mother-centered practices. A participatory and decolonizing design approach guided the research, positioning traditional midwives and community actors as knowledge holders and collaborators throughout the process.

Fieldwork included engagement with the Kilombo Yumma collective in Bogotá and participation in a regional traditional midwife convention in Chocó, attended by over 450 midwives. Through interviews, observation, and participatory sessions, the project identified how respectful care is locally defined and practiced. Analytical methods including actor mapping, constellation mapping, manifestation categorization, and journey mapping were used to interpret qualitative fieldwork data and identify opportunities for training interventions.

A key finding was that respectful maternity care in this context is primarily enacted through communication. Traditional midwives described respect as the building of trust through listening, explaining, reassuring, and recognizing the mother’s perspective. Communication emerged as a horizontal manifestation influencing multiple aspects of care, shaping both emotional wellbeing and clinical effectiveness. This insight provided a strategic entry point for intervention, as communication practices can be integrated into existing care interactions without requiring additional infrastructure or resources.


Based on these findings, the project developed a training proposal consisting of a workshop format facilitated by traditional midwives and a set of circular role-play tools called Respectful Maternity Communication Volvelles. These tools present emergency care scenarios from the perspectives of the mother, traditional midwife, and doctor, enabling participants to engage with relational care dynamics through experiential learning. The workshop structure reflects the community’s knowledge transmission practices, particularly horizontal dialogue formats such as Uramba, aligning both content and learning format with local epistemologies.

Prototype testing with medical students and healthcare actors demonstrated the potential of role-play to support perspective-taking, empathy, and reflection on respectful communication practices. Participants engaged actively with the material and expressed interest in integrating such training into their formal education.

This thesis contributes both a design proposal and a methodological framework for identifying and translating respectful care practices into training material. It demonstrates how design can function as a mediator between traditional and biomedical knowledge systems, supporting the integration of locally grounded respectful care practices into healthcare education. By positioning respectful communication as an operational component of clinical care, this project offers a scalable and context-sensitive approach to strengthening respectful maternity care training.