Bihar remains above the national average maternal mortality at 274 per 100,000 live births, or about 6500 maternal deaths per year. With only 63.8% of births facility-based, the maternal mortality rate stagnates at high levels. Respectful maternal care (RMC) represents an additional component to consider in humane health care practice and maternal mortality outcomes related to childbirth. Through a collaboration with PRONTO International, an organization dedicated to improving the quality of maternal and newborn healthcare at Primary Health Care facilities (PHCs) in Bihar, a mixed method analysis of i. Quantitative analysis of birth simulation videos coded for RMC related indicators and ii., Qualitative analysis of nurse-midwife mentor interviews was conducted. The aim of this analysis was to better understand the factors around RMC affecting quality of maternal care in Bihar, India.