Although the global healthcare system is paying increasing attention to obstetric violence, this form of gender-based violence during childbirth remains a serious issue. The primary objective of this comprehensive study is to explore the experiences and needs of women subjected to obstetric violence on a global scale. A systematic search was conducted in December 2024 across the Web of Science, Embase, PubMed, and CINAHL databases to identify eligible studies. Data synthesis was performed using the three-stage thematic and content analysis method. A total of 39 eligible qualitative studies were included in this review. Thematic synthesis identified 6 themes and 17 sub-themes: (1) Obstetric Violence Types; (2) Gaslighting Effect: The Authoritative Position of Healthcare Providers; (3) Stigmatization and Discrimination Experienced by Women; (4) Who is Normalizing Obstetric Violence? (5) Substandard Medical Institutions; (6) Trauma Induced by Obstetric Violence. Obstetric violence continues to persist in various countries and regions. Women have endured various forms of obstetric violence, with their autonomy and rights to informed consent being severely compromised. They have experienced neglect and abandonment by healthcare providers, and face discrimination and differential treatment due to factors such as race, socioeconomic status, age, and culture. The primary cause of obstetric violence is the unequal power dynamics between healthcare providers and women, with the authoritative position of healthcare providers leading to a lack of communication and recognition between both parties.
ChadwickR. Breaking the frame: obstetric violence and epistemic rupture. Agenda2021; 35: 104–115.
2.
ChurchAC. “Don’t push!” experiences of obstetric violence in US hospital settings. Soc Sci Med2024; 363: 117497.
3.
VullikantiMYaminAE. Obstetric violence is not a misnomer. Am J Obstet Gynecol2024.
4.
ChervenakFAMcLeod-SordjanRPolletSL, et al.Obstetric violence is a misnomer. Am J Obstet Gynecol2024; 230: S1138–s1145.
5.
OrganizationWH. The prevention and elimination of disrespect and abuse during facility-based childbirth: WHO statement. 2014.
6.
GarciaLM. Theory analysis of social justice in nursing: applications to obstetric violence research. Nurs Ethics2021; 28: 1375–1388.
7.
GarciaLM. Obstetric violence in the United States and other high-income countries: an integrative review. Sex Reprod Health Matters2023; 31: 2322194.
8.
ShrivastavaSSivakamiM. Evidence of 'obstetric violence' in India: an integrative review. J Biosoc Sci2020; 52: 610–628.
9.
SimenehGTTesemaGWSeifuBA, et al.Obstetric violence and associated factors among women who gave birth at public hospitals in Addis Ababa city administration, Ethiopia. Front Glob Womens Health2024; 5: 1417676.
10.
FraserLKCano-IbáñezNAmezcua-PrietoC, et al. Prevalence of obstetric violence in high-income countries: a systematic review of mixed studies and meta-analysis of quantitative studies. Acta Obstet Gynecol Scand2024.
11.
MadeiroARufinoACAcaquiRF, et al.Disrespect and abuse during childbirth in maternity hospitals in Piauí, Brazil: a cross-sectional study. Int J Gynaecol Obstet2022; 159: 961–967.
12.
LimmerCMStollKVedamS, et al.Measuring disrespect and abuse during childbirth in a high-resource country: development and validation of a German self-report tool. Midwifery2023; 126: 103809.
13.
LeiteTHPereiraAPELealMDC, et al.Disrespect and abuse towards women during childbirth and postpartum depression: findings from Birth in Brazil Study. J Affect Disord2020; 273: 391–401.
14.
SilveiraMFMesenburgMABertoldiAD, et al.The association between disrespect and abuse of women during childbirth and postpartum depression: findings from the 2015 Pelotas birth cohort study. J Affect Disord2019; 256: 441–447.
15.
PathakPGhimireB. Perception of women regarding respectful maternity care during facility-based childbirth. Obstet Gynecol Int2020; 2020: 5142398.
16.
GalleAManaharlalHCumbaneE, et al.Disrespect and abuse during facility-based childbirth in southern Mozambique: a cross-sectional study. BMC Pregnancy Childbirth2019; 19: 369.
17.
GarciaLMJonesJScandlynJ, et al.The meaning of obstetric violence experiences: a qualitative content analysis of the Break the Silence Campaign. Int J Nurs Stud2024; 160: 104911.
18.
YildirimSMert-KaradasM. The invisible wounds of women: ethical aspects of obstetric violence. Nurs Ethics2024.
19.
SweetPL. The sociology of gaslighting. Am Sociol Rev2019; 84: 851–875.
20.
BohrenMAVogelJPHunterEC, et al.The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med2015; 12: e1001847.
21.
YalleyAAJarašiūnaitė-FedosejevaGKömürcü-AkikB, et al.Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality. Front Public Health2024; 12: 1388858.
22.
WhiffinCJGraceyFEllis-HillC. The experience of families following traumatic brain injury in adult populations: a meta-synthesis of narrative structures. Int J Nurs Stud2021; 123: 104043.
23.
Dixon-WoodsMShawRLAgarwalS, et al.The problem of appraising qualitative research. Qual Saf Health Care2004; 13: 223–225.
24.
ThomasJHardenA. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol2008; 8: 45.
25.
MayaETAdu-BonsaffohKDako-GyekeP, et al.Women's perspectives of mistreatment during childbirth at health facilities in Ghana: findings from a qualitative study. Reprod Health Matters2018; 26: 70–87.
26.
AvciNKaydirakMM. A qualitative study of women's experiences with obstetric violence during childbirth in Turkey. Midwifery2023; 121.
27.
PereraDLundRSwahnbergK, et al.When helpers hurt': women's and midwives' stories of obstetric violence in state health institutions, Colombo district, Sri Lanka. BMC Pregnancy Childbirth2018; 18: 211.
28.
SantanaATCoutoTMLimaKTRDS, et al.Obstetric racism, a debate under construction in Brazil: perceptions of black women on obstetric violence. Ciência Saúde Coletiva2024; 29: e09952023.
29.
WudnehACherinetAAbebeM, et al.Obstetric violence and disability overlaps: obstetric violence during child birth among womens with disabilities: a qualitative study. BMC Womens Health2022; 22: 299.
30.
YalleyAA. Layers of inequality: gender, medicalisation and obstetric violence in Ghana. Int J Equity Health2024; 23: 243.
31.
AlnabilsyRSharonD. The experience of pregnancy and childbirth overshadowed by obstetric violence and structural barriers of the Israeli health system from the perspective of Arab and Jewish women. Qual Health Res2023; 33: 647–659.
32.
EsanOTMaswimeSBlaauwD. A qualitative inquiry into pregnant women's perceptions of respectful maternity care during childbirth in Ibadan Metropolis, Nigeria. Sex Reprod Health Matters2022; 30: 2056977.
33.
Fielding-SinghPDmowskaA. Obstetric gaslighting and the denial of mothers' realities. Soc Sci Med2022; 301, 114938.
34.
Martin-BadiaJObregon-GutierrezNGoberna-TricasJ. Obstetric violence as an infringement on basic bioethical principles. reflections inspired by focus groups with midwives. Int J Environ Res Publ Health2021; 18.
35.
de KokBCUnyIImmamuraM, et al.From global rights to local relationships: exploring disconnects in respectful maternity care in Malawi. Qual Health Res2020; 30: 341–355.
36.
UnutkanAElemE. “Normal in all the rush”: a phenomenological study analyzing midwifery students’ views on obstetric violence. Nurse Educ Today2024; 132: 106014.
37.
Briceno MoralesXEnciso ChavesLVYepes DelgadoCE. Neither medicine nor health care staff members are violent by nature: obstetric violence from an interactionist perspective. Qual Health Res2018; 28: 1308–1319.
38.
GleasonEGMolina BerrioDPLopez RiosJM, et al.“Giving birth is not a matter of ethnicity, it is a matter of humanity”: experiences of obstetric violence during childbirth among indigenous women. Salud Colectiva2021; 17.
39.
DevAKivlandCFaustinM, et al.Perceptions of isolation during facility births in Haiti-a qualitative study. Reprod Health2019; 16: 185.
40.
JiruHDSendoEG. Promoting compassionate and respectful maternity care during facility-based delivery in Ethiopia: perspectives of clients and midwives. BMJ Open2021; 11: e051220.
41.
ShimodaKHoriuchiSLeshabariS, et al.Midwives' respect and disrespect of women during facility-based childbirth in urban Tanzania: a qualitative study. Reprod Health2018; 15: 8.
42.
Solnes MiltenburgAvan PeltSMeguidT, et al.Disrespect and abuse in maternity care: individual consequences of structural violence. Reprod Health Matters2018; 26: 88–106.
43.
MettaEUnkelsRMselleLT, et al.Exploring women's experiences of care during hospital childbirth in rural Tanzania: a qualitative study. BMC Pregnancy Childbirth2024; 24: 290.
44.
MayraKMatthewsZSandallJ, et al.“I have to listen to them or they might harm me” and other narratives of why women endure obstetric violence in Bihar, India. Birth Issues Perinat Care2024.
45.
AnyiamSWooJSpencerB. Listening to black women's perspectives of birth centers and midwifery care: advocacy, protection, and empowerment. J Midwifery Womens Health2024; 69: 653–662.
46.
WeberAZJensenDDiClemente-BoscoK, et al.“I managed to stand on my own. I saved my baby's life.”: qualitative analysis of birth experiences from women living with HIV in Cape Town, South Africa. Reprod Health2024; 21: 142.
47.
DmowskaAFielding-SinghPHalpernJ, et al.The intersection of traumatic childbirth and obstetric racism: a qualitative study. Birth Issues Perinat Care2024; 51: 209–217.
48.
SharonDAlnabilsyR. Obstetric violence (OV) consequences and coping strategies: insights through the voices of Arab and Jewish women in Israel. Violence Against Women2024.
49.
MalatjiRMadibaS. Disrespect and abuse experienced by women during childbirth in midwife-led obstetric units in Tshwane District, South Africa: a qualitative study. Int J Environ Res Publ Health2020; 17: 3667.
50.
van der WaalRvan NistelrooijI. Shroud waving self-determination: a qualitative analysis of the moral and epistemic dimensions of obstetric violence in The Netherlands. PLoS One2024; 19: e0297968.
51.
AfulaniPAKellyAMBubackL, et al.Providers' perceptions of disrespect and abuse during childbirth: a mixed-methods study in Kenya. Health Pol Plann2020; 35: 577–586.
52.
Brazy-NancyEMatternCRakotonandrasanaBI, et al.A qualitative analysis of obstetric violence in rural Madagascar. Heliyon2023; 9: e13905.
53.
Mena-TudelaDRomanPGonzález-ChordáVM, et al.Experiences with obstetric violence among healthcare professionals and students in Spain: a constructivist grounded theory study. Women Birth2023; 36: e219–e226.
54.
KrollCMurphyJPostonL, et al.Cultivating the ideal obstetrical patient: how physicians-in-training describe pain associated with childbirth. Soc Sci Med2022; 312: 115365.
55.
MaungTMShowKLMonNO, et al.A qualitative study on acceptability of the mistreatment of women during childbirth in Myanmar. Reprod Health2020; 17: 56.
56.
DwekatIMMTengku IsmailTAIbrahimMI, et al.Exploring factors contributing to mistreatment of women during childbirth in West Bank, Palestine. Women Birth2021; 34: 344–351.
57.
NdirimaZNeuhannFBeiersmannC. Listening to their voices: understanding rural women's perceptions of good delivery care at the Mibilizi District Hospital in Rwanda. BMC Womens Health2018; 18: 38.
58.
LusambiliAWisofschiSShumbaC, et al.Health care workers' perspectives of the influences of disrespectful maternity care in rural Kenya. Int J Environ Res Publ Health2020; 17: 8218.
59.
AmroussiaNHernandezAVives-CasesC, et al.“Is the doctor God to punish me?!” An intersectional examination of disrespectful and abusive care during childbirth against single mothers in Tunisia. Reprod Health2017; 14: 32.
60.
D-zomekuVMMensahBABNakuaEK, et al.Exploring midwives' understanding of respectful maternal care in Kumasi, Ghana: qualitative inquiry. PLoS One2020; 15: e0220538.
61.
JaffreY. What midwives have to say about their lives, their jobs and their healthcare practices. Sante Publique2018; 30: 151–166.
62.
LoganRGMcLemoreMRJulianZ, et al.Coercion and non-consent during birth and newborn care in the United States. Birth (Berkeley, Calif.)2022; 49: 749–762.
63.
BoakyePNPeterESimmondsA, et al.An examination of the moral habitability of resource-constrained obstetrical settings. Nurs Ethics2021; 28: 1026–1040.
64.
Martínez-GalianoJMMartinez-VazquezSRodríguez-AlmagroJ, et al.The magnitude of the problem of obstetric violence and its associated factors: a cross-sectional study. Women Birth2021; 34: e526–e536.
65.
VedamSStollKTaiwoTK, et al.The giving voice to mothers study: inequity and mistreatment during pregnancy and childbirth in the United States. Reprod Health2019; 16: 77.
66.
KukuraE. Obstetric violence. Georgetown Law J2018; 106: 721–801.
67.
Montanari VergalloGDe PaolaLNapoletanoG, et al.Obstetric violence: if you can recognize it, you can prevent it. Arch Gynecol Obstet2024; 310: 2745–2747.
68.
SebringJCH. Towards a sociological understanding of medical gaslighting in western health care. Sociol Health Illness2021; 43: 1951–1964.
69.
CorreaMKleinKVasquezP, et al.Observations and reports of incidents of how birthing persons are treated during childbirth in two public facilities in Argentina. Int J Gynaecol Obstet2022; 158: 35–43.
70.
VillarmeaSKellyB. Barriers to establishing shared decision-making in childbirth: unveiling epistemic stereotypes about women in labour. J Eval Clin Pract2020; 26: 515–519.
71.
MorganJM BreauG. Access to maternal health services for Indigenous women in low- and middle-income countries: an updated integrative review of the literature from 2018 to 2023. Rural Remote Health2024; 24: 8520.
72.
Adu-BonsaffohKTammaEMayaE, et al.Health workers' and hospital administrators' perspectives on mistreatment of women during facility-based childbirth: a multicenter qualitative study in Ghana. Reprod Health2022; 19: 82.
73.
LeiteTHMarquesESCorrêaRG, et al.Epidemiology of obstetric violence: a narrative review of the Brazilian context. Ciência Saúde Coletiva2024; 29: e12222023.
74.
AnnbornAFinnbogadóttirHR. Obstetric violence a qualitative interview study. Midwifery2022; 105: 103212.
75.
BohrenMAMehrtashHFawoleB, et al.How women are treated during facility-based childbirth in four countries: a cross-sectional study with labour observations and community-based surveys. Lancet2019; 394: 1750–1763.
76.
FreedmanLPKrukME. Disrespect and abuse of women in childbirth: challenging the global quality and accountability agendas. Lancet2014; 384: e42–44.
77.
NoveAFribergIKde BernisL, et al.Potential impact of midwives in preventing and reducing maternal and neonatal mortality and stillbirths: a Lives Saved Tool modelling study. Lancet Global Health2021; 9: e24–e32.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
