“There is no occasion for woman to consider themselves subordinate or inferior to men.” Mind of Mahatma Gandhi, 3RD Edn., 1968:297.Dear Editor,Raval et al.[1] assess provision of respectful maternal care in public health facilities in Gujarat state by conducting a direct observational study in Apr 2021 issue of the Journal. They visited a few healthcare facilities in this western Indian state, observed various events and prepared a report highlighting compliance with standard practices. Their effort is laudable and is need of the hour as UN has dedicated its fifth Sustained Development Goal after much deliberation specifically for this purpose. It aspires to ‘achieve gender neutrality and empower all women and girls’ by 2030.[2]Having conducted the study and reporting their results, the authors recommend various measures to enhance compliance with respectful maternity care performance standards across facilities. What we need to realize is that perhaps nobody wants to consciously violate these good practices but accumulation of several factors beforehand leads to it. And one of them is lagging behind of female workforce participation in service sector in India. And one of the reasons for that is that less women than men opt for science stream courses in Colleges and Universities.[3]When at the base of pyramid, a smaller number of women is there, at the apex their number – and ratio – is likely to be reduced further. It is observed that when female patients lack access to women physicians in rural areas, there is concurrent reduction in access to maternal health services too.[4] It is a common knowledge that abortion is legal in most of the cases but due to illiteracy, misinformation and various social taboos, a large number of girls undergo illegal – and frequently unsafe – procedures; many a times resulting in sepsis and even death.[5] Hence what we need to realize is that when women are present everywhere in public spaces, everywhere women feel safe and we need to work on this principle, rather than simply provide tutorials to existing workforce – although that has its own value.Challenges in front of women are not restricted to obtaining respectful care during vaginal delivery although that is one of the most important ones. Present-day women face second-grade recognition practically in all the aspects of life – not restricted to healthcare sector alone. Hence while sensitizing our workforce to lack of dignified care to expectant care is important, awareness of lack of dignity elsewhere, rather everywhere is equally important. Only when we realize the scale and scope of the uphill challenge, we can search for better solutions. And that begins with providing women with equal footing in all the aspects of lived experience – not just related to reproductive health. We propose that what when a woman faces disrespect during childbirth; is a reflection of a larger malaise ailing our society and its solution too should not be restricted to enhancing capacity of primary care staff but be widened to empower them with equal franchise and agency at all the times.
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