Woman-Centered Care

Woman-centered care is an approach to medicine that empowers women to make decisions and manage their own care, ensuring consideration of their values, cultural traditions, and personal choices in healthcare. Woman-centered care provides ample information on available options and respects the woman’s choices. For example, in maternal healthcare, the mother who wishes to give birth naturally could choose among a home birth with a midwife; a birth center staffed by midwives and nurses, with a doctor on call; or a hospital birth room, where medical care and intervention are readily available, including increasingly common midwife-led units within hospital settings. Even in the hospital setting, the woman would make the final decision after receiving complete information regarding any interventions.

Woman-centered care does not necessarily come naturally to healthcare providers, however. Because they are highly educated and used to being in a position of authority, many doctors find it difficult to allow patients to make decisions regarding care. Hospital routines do not bend easily to patient preferences, either.

Woman-Centered Childbirth

In woman-centered childbirth, the patient has options related to her care. These choices involve not only medical treatment but also values, hopes, and fears. For example, a woman planning the birth of a child might wish to choose who will be with her, whether she will eat or drink during labor, and whether she will stay in bed or walk about. Her decisions on intervention or medical procedures are final, based on complete information regarding the benefits and risks of each choice, typically within a shared decision-making framework with healthcare providers. For example, the couple considering a home birth meets with the doctor and midwife to discuss possible scenarios, including an exceptionally long labor, a medical emergency, or other complications. They opt for the home birth, but they are prepared to make decisions based on the situation.

Poorly informed patients in medical facilities may feel isolated and forced to accept treatment that does not meet their expectations or needs. A possible outcome of such a scenario is that the patient will not comply with treatment or follow-up care. In many cases, the patient may not return to the medical facility, and in cultures where women have been disrespected or mistreated by medical personnel, they may avoid all medical care in the future.

Barriers to Woman-Centered Care

Historically, pregnancy and childbirth were part of the women’s sphere, with midwives attending during labor and deliveries. While midwives still thrive in many places around the world, most high-income countries have adopted hospital-based, physician-directed obstetrical care. Doctors generally believe that their knowledge and experience give them the authority to make decisions for their patients. When a malpractice suit is a potential result of a poor outcome, it is in the physician’s interest to choose a radical intervention such as a Cesarean section, if it reduces risk. Under woman-centered care, the physician’s role is to provide accurate information and an assessment of the conditions, while the final decision is typically made through a shared decision-making process between the patient and the healthcare provider, particularly in situations involving medical risk.

Technology also impacts woman-centered care. A variety of monitors, scanning devices, and medications have made the medical staff comfortable with readouts and a constant supply of information, even if it restricts the laboring mother’s comfort and ability to fully participate in the birth. Such technology potentially moves the focus to the machines and to the baby, rather than on the mother or the combined needs of both mother and child.

Hospital routines also affect the incentive to provide woman-centered care. In some cases, babies may be routinely removed from the mother’s care for bathing, medical evaluations, or treatment with little regard for the mother’s wishes. However, offering individual timetables is difficult and expensive in a large hospital.

Rights-Based Care

In many developing countries, and even in the rural areas of developed countries, access to quality, affordable women’s healthcare is severely limited. Where it is available, medical care is rarely centered on the woman. In some places, the status of women is so low that they are disrespected or even abused by clinical workers. Women, accordingly, may refuse to return to a clinic after they have been mistreated or stigmatized. In most cases, that is the end of the woman’s relationship with not only the clinic but also the entire healthcare system. Women in Nigeria and Ethiopia, for example, often prefer traditional medicine and home care during pregnancy. Even when health services are free, women choose not to use them after being ignored, left alone during labor, lapped for crying out during childbirth, or subjected to mistreatment such as verbal or physical abuse during childbirth. While ideally they would receive follow-up care, women who have been mistreated simply do not return for health services. In rural areas, women can face high costs, transportation issues, limited options, and a lack of comprehensive services.

Beyond Maternal Health Services

Woman-centered care often concentrates on family planning, pregnancy, and childbirth. However, all women need access to appropriate care throughout every stage of their lives. For example, girls and young women need good nutrition to ensure a healthy body, and they benefit from educational materials that help them understand their bodies’ processes and changes. They also need information on sexually transmitted diseases and contraception.

Specialized care should also address the needs of women in prison, victims of domestic abuse, and sex workers. Mental health issues also must be addressed to provide comprehensive care.

Women also need care beyond the childbearing years. Rather than seeing separate doctors at various life stages, it is in the patient’s best interest to stay with a primary doctor to meet her basic health care needs. There, her history and preferences are understood and respected.

Bibliography

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Shields, Sara, and Lucy Candib, editors. “Part Four: Finding Common Ground in the Care of Pregnant, Laboring, and Postpartum Women.” Woman-Centered Care in Pregnancy and Childbirth. Radcliffe Publishing, 2010, pp. 265–85.

“WHO and Partners Launch Global Guide to Advance Respectful Maternal and Newborn Care.” World Health Organization, 7 Aug. 2025, www.who.int/news/item/07-08-2025-who-and-partners-launch-global-guide-to-advance-respectful-maternal-and-newborn-care. Accessed 1 Apr. 2026.