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Mothers on Respect (MOR) Index

The Mothers on Respect (MOR) Index is a 14-item self-report measure on individual experiences of respectful or disrespectful care from maternity care providers. Different aspects of respectful care captured by the scale include ease of communication with provider, patient autonomy, and perception of discriminatory practices.

Categories

Geographies Tested: Canada

Populations Included: Female

Age Range: Adults

Items:

Overall while making decisions during my pregnancy I felt:

1. Comfortable asking questions
2. Comfortable declining care that was offered
3. Comfortable accepting the options for care that my (midwife, doctor) recommended
4. Coerced into accepting the options my (midwife, doctor) suggested (reverse scored)*
5. I chose the care options that I received
6. My personal preferences were respected
7. My cultural preferences were respected

Response Options:
Yes
No
Not applicable

During a prenatal visit I held back from asking questions or discussing my concerns:

8. Because my (midwife, doctor) seemed rushed (reverse scored)
9. Because I wanted maternity care that differed from what my (midwife, doctor) recommended (reverse scored)
10. Because I thought my (midwife, doctor) might think I was being difficult (reverse scored)

Response Options:
Yes, once
Yes, more than once
No
Never

When I had my baby I felt that I was treated poorly by my (midwife, doctor):

11. Because of my race, ethnicity, cultural background or language (reverse scored)
12. Because of my sexual orientation andor gender identity (reverse scored)
13. Because of my health insurance (reverse scored)
14. Because of a difference in opinion with my caregivers about the right care for myself or my baby (reverse scored)

Response Options:
Never
Sometimes
Usually
Always

*This item was re-phrased when administered to the United States sample. The word “coerced” was replaced with “pushed”.

Note: For the United States sample, the 14-item MORi scale with harmonized Likert-scale response options was used:
6-point Likert scale
Strongly disagree - 1
Strongly agree - 6

Scoring Procedures

Items are scored such that higher scores reflect more respectful interactions with maternity care providers. For items 8-10, “Yes, once” or “Yes, more than once” are recoded as “Yes”, and “No” and “Never’ recoded as “No”. For items 11-14, “Never” is recoded as “No”, and “Sometimes”, “Usually”, or “Always” recoded as “Yes”.

Original Citation

Vedam, S., Stoll, K., Rubashkin, N., Martin, K., Miller-Vedam, Z., Hayes-Klein, H., & Jolicoeur, G. (2017). The mothers on respect (MOR) index: measuring quality, safety, and human rights in childbirth. SSM-population health, 3, 201-210. https://doi.org/10.1016/j.ssmph.2017.01.005

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