Maternity care devoid of respect manifested in ways such as abuse discrimination negligence abandonment or ineffective communication is widespread in the United States and disproportionately affects Black Hispanic and multiracial birthing people. Respectful maternity care RMC prioritizes the dignity autonomy and rights of individuals throughout their childbirth journey. RMC philosophies have evolved to be guided by rights and reproductive justice-based frameworks and encompass shared themes of autonomy and choice communication and shared-decision making SDM safety and support dignity and respect and freedom from abuse. This quality improvement project introduces a respectful maternity care-based birth preference sheet to a Pacific Northwest midwifery practice aiming to enhance patient-centered communication and shared decision-making in prenatal care.