Search Results (52)

Introduction: This study explores obstetric providers’ perceptions of intimate partner violence (IPV) screening in the Chinese clinical setting, guided by the social–ecological model. Methods: Purposive sampling was employed to recruit eight obstetricians and 12 obstetric nurses from a tertiary general hospital in Suzhou, Jiangsu Province, China. Individual semi-structured interviews were conducted between December 2024 and September 2025. Results: Guided by the social–ecological model, this study examines factors influencing healthcare professionals’ engagement in intimate partner violence screening across four levels. A multilevel framework was distilled; four key themes were identified, including the intrapersonal level, interpersonal level, institutional level and community and policy level. (1) The intrapersonal level—healthcare professionals’ competence (knowledge base, communication skills, role identity, screening attitudes, and diagnostic ability); (2) the interpersonal level—interdisciplinary collaboration (internal referrals and external support); (3) the institutional level—hospital screening efficacy (screening resources and management systems); and (4) the community and policy level—social environment (policy support, educational resources, and cultural context). Conclusions: Multilevel factors impact IPV screening in China. These results indicate that a multidimensional model of intervention should be designed to promote IPV screening in China, including integrating IPV curricula into mandatory medical student training, enhancing interdisciplinary collaboration, conducting public education on IPV, implementing socio-cultural adjustments, challenging authoritative attitudes, and providing comprehensive social support. Full article

Background: Perinatal deaths remain a major public health concern and present unique medico-legal challenges. Forensic autopsy plays a crucial role in determining the cause of death, distinguishing live birth from stillbirth, assessing fetal viability, and identifying traumatic or non-natural causes of death. Methods: This retrospective study included all perinatal cases referred to the Gaziantep Forensic Medicine Group Presidency between 2021 and 2024. Demographic characteristics, gestational age, autopsy findings, histopathological and toxicological examinations, hydrostatic lung test results, and final forensic diagnoses were evaluated. Results: Seventeen of 339 infant forensic cases met the inclusion criteria. Fourteen underwent complete forensic autopsy, whereas three were evaluated by external postmortem examination and medical records. Despite a multidisciplinary forensic investigation that included external examination, complete forensic autopsy, systematic macroscopic organ evaluation, routine histopathological examination, hydrostatic lung flotation testing, toxicological analysis when indicated, review of maternal medical and obstetric records, judicial investigation records, and placental and umbilical cord histopathology whenever available, no definitive cause of death could be established in six cases. Advanced decomposition prevented determination in two cases. One case was classified as an undiagnosed natural death, whereas no specific cause of death could be assigned in the remaining three cases. Placental examination was available in only a minority of cases, whereas umbilical cord histopathology was performed in nearly all autopsied cases. Causes of death included traumatic injury, pulmonary immaturity, intrauterine infection, congenital anomalies, maternal drug exposure, placental abruption, maternal disease, and umbilical cord pathology. Conclusions: Perinatal death investigations require a multidisciplinary forensic approach integrating autopsy, histopathology, toxicology, placental examination, and clinical information. Beyond determining the cause of death, forensic evaluation is essential for assessing live birth, fetal viability, suspected abuse, maternal violence, medical malpractice, and criminal investigations. Full article

Background/Objectives: Fear of childbirth may begin before pregnancy and may be shaped by earlier traumatic and relational experiences. This study examined the association between intimate partner violence (IPV) and prior-to-pregnancy fear of childbirth among non-pregnant women and considered its implications for preconception and obstetric care. Methods: This descriptive, correlational, cross-sectional study was conducted online in Türkiye between 1 January and 31 May 2025 after approval from the Non-Interventional Scientific Research Ethics Committee of Istanbul Atlas University (23 December 2024; No. 10/07). The sample comprised 125 nulligravid women, defined as women who had never previously been pregnant, who were aged 18 years or older, were not currently pregnant, were living with an intimate partner, were literate in Turkish, and reported no psychiatric disorder. Data were collected using a Personal Information Form, the Husband Violence Against Women Scale (HVWAS), and the Fear of Childbirth Prior to Pregnancy Scale (FCPPS). Descriptive statistics, Spearman correlation analysis, Mann–Whitney U tests, and Kruskal–Wallis tests were performed. Results: The mean age of participants was 28.84 ± 5.47 years. The mean HVWAS score was 46.11 ± 12.51, and the mean FCPPS score was 36.05 ± 13.56. HVWAS scores were weakly positively correlated with prior-to-pregnancy fear of childbirth (rho = 0.207, p = 0.020). An exploratory association was observed between educational level and HVWAS scores (p = 0.019); however, the educational subgroups were highly unequal in size. No significant association was found between educational level and FCPPS scores (p = 0.219). Conclusions: Higher HVWAS scores were weakly associated with greater prior-to-pregnancy fear of childbirth. Because of the cross-sectional design, the direction and causality of this association cannot be determined. Confidential assessment of IPV and childbirth-related fear during preconception counseling and women’s health encounters may assist in identifying women who could benefit from further psychosocial evaluation and support. Full article

Background: Maternity care for vulnerable pregnant women presents a particular challenge within midwifery practice. In Germany, maternity services lack standardized frameworks to adequately address the specific needs of individuals who have experienced, among other factors, sexualized violence, poverty, female genital mutilation/cutting (FGM/C), or discrimination. Limited access to healthcare among these populations contributes to increased maternal and neonatal morbidity and mortality. Emerging evidence indicates that comprehensive medical and psychosocial support provided by midwives can substantially improve obstetric outcomes for marginalized pregnant women. Methods: An elective course, Antenatal Care for Vulnerable Women, was offered in the sixth semester of the Bachelor’s program in Midwifery Science at the University of Tübingen in 2025. The course provided insights into the psychosocial challenges faced by vulnerable pregnant women and prepared students for these specific aspects of midwifery practice. The curriculum incorporated foundational lectures and innovative teaching formats aimed at cultivating constructivist approaches to problem-solving. All sixth-semester midwifery students were asked to assess their knowledge and skills across five vulnerability categories: asylum-seeking, FGM/C, intimate partner violence, trauma, and racism. A pilot pre–posttest analysis using a 6-point Likert scale (1 = very good, 6 = poor) was conducted as hypothesis-generating and curriculum-guiding. The pretest included 38 respondents. The posttest included 11 respondents who attended the course. Results: Students who attended the course demonstrated observable gains in knowledge and skills across all categories, with the greatest improvements in asylum-seeking, median of 5 (IQR 4–5) vs. 2 (2–3); FGM/C, 5 (4–5) vs. 2 (2–3); and racism, 5 (3–5) vs. 2 (2–3). Conclusions: Innovative teaching methods may contribute to preparing midwifery students for targeted care of vulnerable pregnant women. Findings from the pre- and posttests provide preliminary insight into the potential value of experiential learning and may inform the further development of practice-oriented teaching methods. Full article

Indigenous Kichwa women in the Ecuadorian Amazon experience disproportionately high levels of obstetric violence, yet their experiences remain largely absent from national demographic data. This study aims to measure the prevalence and forms of obstetric violence among Kichwa women while demonstrating the utility of community-designed demographic tools for documenting marginalized reproductive health experiences. We developed a participatory survey in collaboration with Kichwa midwives and women, several of whom are co-authors, and administered 139 structured surveys and 69 ethnographic interviews across 43 Indigenous communities in the Napo province to women who had given birth in a public hospital within the past five years. Quantitative data were analyzed using descriptive statistics to estimate prevalence across domains of obstetric violence, and interviews were thematically analyzed to contextualize these patterns. Findings indicate pervasive obstetric violence, including non-consensual procedures, verbal and psychological abuse, structural barriers to care, and suppression of traditional practices such as midwifery and plant medicine. Over 80% of participants reported at least one non-consensual procedure and at least one form of cultural or epistemic suppression, with most experiencing violence across multiple domains. These results position obstetric violence in the Amazon as a compounded, population-level exposure shaped by structural, environmental, and cultural determinants, underscoring the need for intercultural health reforms and Indigenous-led models of health governance. Full article

This systematic review aimed to identify psychosocial risk factors associated with the development of complicated perinatal grief in adult women who experienced pregnancy loss. Following PRISMA guidelines, comprehensive searches were conducted in Web of Science, PubMed, Scopus, and PsycINFO databases, covering 1990–2024. A total of 34 quantitative studies comprising 7872 participants were included, mainly using cross-sectional and longitudinal designs. Findings indicate that complicated perinatal grief is a multifactorial condition influenced by personal variables (absence of living children, history of depression or PTSD, advanced maternal age, low education and income), obstetric factors (later gestational loss, multiple pregnancies, stillbirth, or neonatal death), and psychosocial factors (low social support, relationship conflict, violence, ostracism, and limited psychological care). Negative cognitions, rumination, and maladaptive coping strategies were also linked to prolonged symptoms of depression, anxiety, and post-traumatic stress. The review concludes that complicated perinatal grief is a multidimensional phenomenon determined by psychological, social, cultural, and medical factors and highlights the need to understand perinatal loss as a profoundly significant experience that affects women’s identity, relationships, and mental health. This evidence highlights the importance of emphasizing the identified risk factors that can lead to complicated grief. Full article

Background/Objectives: Obstetric violence (OV) is a violation of women’s human rights during reproductive processes. Despite being the subject of debate among healthcare professionals, increasingly recognized, and legislated against in some countries, OV continues to be reproduced and normalized during training. The objective of this study was to determine the perception of OV among health sciences students and gynaecology and obstetrics residents. Methods: A cross-sectional observational study was conducted with 304 health sciences students and gynaecology and obstetrics residents in Spain. An online questionnaire was distributed that gathered information on sociodemographic variables and clinical experience and included the validated PercOV-S instrument. Descriptive and bivariate analyses were performed to explore associations between variables. Results: The overall perception of OV was moderately high (mean 3.93/5), with higher scores for visible or protocolized forms (4.27/5) than for invisible or subtle forms (2.87/5). Being a woman, being a midwifery resident, or having had personal experiences with pregnancy or childbirth increased sensitivity to OV. Clinical exposure in obstetrics and gynaecology services increased both awareness and the likelihood of witnessing OV. Twenty-eight percent of students reported having observed OV, and twenty percent reported emotional distress, even considering dropping out. Conclusions: Despite the recognition of OV, repeated exposure during training can promote its normalization. The results of this study highlight the need for safe, reflective training environments that mainstream feminist perspectives, sexual rights, and the detection of subtle forms of OV. Full article

Motherhood regret still constitutes a major taboo that limits the possibility of processing the negative exposure to being a mother. This qualitative study involved Italian women living both in Italy and abroad, where traditional patriarchal thinking remains influential. Sixteen women defining themselves as ‘regretful were interviewed to explore their experiences of regret, the changes following the birth of children, family and social support, and employment. The thematic analysis highlighted several recurring themes: the idealisation of motherhood and the hidden struggles it conceals; the guilt associated with feeling inadequate and the indifference of some fathers; the social pressure that compels women to conform to maternal expectations; the perception of being trapped in a predefined role; and the conflict between personal identity and the ideal of the “perfect mother.”. The findings reveal that maternal regret is deeply intertwined with internalised patriarchal norms, the myth of the “good mother,” and the social expectation of women’s self-sacrifice. Despite recognising these as cultural constructs, participants expressed feelings of guilt, anger, and inadequacy, intensified by the unequal division of domestic and parental responsibilities. This issue and the need for a revival of women’s consciousness-raising groups to open a space for dialogue on the topic in countries where patriarchy is still strong, such as Italy, are discussed. Full article

(1) Background: Intrapartum obstetric violence has become increasingly visible and is portrayed as a cross-cutting and complex phenomenon. Despite numerous international debates and extensive reports in the literature, there is limited consensus on its definition, emphasizing the need to clarify the concept. The aim of this article is to analyze the concept of obstetric violence in the care of women in labor in health institutions; (2) Methods: Search and selection of studies using the scoping review methodology, based on the Joanna Briggs Institute guidelines and Rodgers’ conceptual review method for data extraction and analysis; (3) Results: A sample of 49 studies provided a comprehensive understanding of the concept, revealing in its conceptualization attributes of physical, verbal, psychological, sexual, institutional and structural violence. Identification of antecedents of gender inequality and failure of relational, technical and structural standards at the level of health institutions and their professionals, as the main triggers of obstetric violence. Reporting of consequences with a negative impact on maternal and child health; (4) Conclusions: Conceptual analysis with important contributions to the paradigm shift in the work of health professionals. Multiple dimensions, cultural differences and variations in the concept should continue to be examined to improve its research and application. Full article

Objectives: To identify the factors influencing the job satisfaction of midwives working in birthing rooms with a medium to high level of obstetric intervention. Methods: A qualitative phenomenological–hermeneutic design based on Heideggerian philosophy was implemented. A study involving 25 participants, midwives, and resident nurses (RINs) was conducted. Residents were included to enrich the analysis with their critical perspectives with regard to interventional procedures and exposure to acts of obstetric violence. Convenience sampling was used. Data were collected from four focus groups in three hospitals in the region and one in-depth interview between 30 September 2022 and 23 June 2023. The testimonies were recorded and transcribed verbatim, and data analysis was carried out using an inductive–deductive approach. The triangulation of data and researchers was used to minimise potential bias. Results: The participants highlighted the following key dimensions or areas that contribute to midwives’ job satisfaction in the labour and birthing room: maternal satisfaction, professional competencies, multidisciplinary team, working conditions, and interventions during childbirth. Conclusions: These findings may inform healthcare management strategies to reduce burnout and improve working conditions in maternity care settings. Full article

Obstetric violence (OV) is a form of gender-based violence (GBV) that arises from the medicalisation of childbirth and the systematic devaluation of women’s bodies during pregnancy, childbirth, and the postpartum period. Recognised as a violation of sexual and reproductive rights, OV reflects historically constructed power relations and highlights the need for public authorities to provide guarantees. In Portugal, OV has historical roots and continues to be an obstacle to the realisation of constitutional principles such as human dignity. Based in an intersectional feminist epistemology and the social constructionist approach, this study was conducted using an exploratory qualitative approach. Ten r7495/2006 acialised Brazilian women were interviewed to examine their experiences of OV during pregnancy, childbirth, and the postpartum period in the Portuguese NHS, through the lens of reproductive and sexual rights. The interviews revealed dehumanising and discriminatory treatment, highlighting the lack of respect for these women’s autonomy, dignity, and rights. These experiences of OV during pregnancy, childbirth, and the postpartum period affected the participants, leading to trauma and significant negative impacts on their mental, sexual, and reproductive health. This research on OV is crucial to advancing global reproductive justice, as it challenges structural inequalities and places racialised Brazilian women at the heart of the struggle for universal human rights and equality in sexual and reproductive healthcare. Full article

Obstetric violence during pregnancy and childbirth is unfortunately a major problem throughout the world. Neuroleptanalgesia is a classic form of analgesia which consists in administering analgesics and neuroleptics, such as haloperidol, simultaneously. Haloperidol is still occasionally used during childbirth and, in most cases, without informed consent in Spain. It is used with the excuse of being an antiemetic, but the reality is that it is a form of obstetric violence called chemical submission. The combination of haloperidol with opioids leads to a potentiation of the sedative effects of both drugs, which may lead to multiplied risks for both mother and baby. At present, the use of haloperidol during childbirth is a practice exclusive to Spain. In fact, the association El Parto es Nuestro (Birth Is Ours) launched an awareness campaign in February 2021 aimed at eradicating the use of haloperidol during childbirth without informed consent. The present essay aims to bring awareness about the ongoing practice of using haloperidol. It is of great importance to eradicate this practice that is so harmful to mothers and their babies, as well as educate health personnel regarding this situation. Full article

As gender-based violence, obstetric violence is a complex phenomenon that represents a matter for debate worldwide. The main objective of this exploratory study is to understand the experiences of obstetric violence during pregnancy, childbirth, and the postpartum period of racialised Brazilian women in the Portuguese National Health System. Using a qualitative case study research approach, semi-structured individual interviews were conducted with ten racialised Brazilian women who gave birth in Portugal. A thematic qualitative analysis was used. The findings reveal significant cases of obstetric violence, which include the complexities and lack of support, assistance and monitoring networks, structural inequalities, neglect, and intersectional discriminatory practices based on racial and cultural prejudices, as well as reflection. These experiences not only affect the physical health of mothers but also have profound psychological and emotional consequences. This study highlights the urgent need for culturally sensitive care and the implementation of policies to prevent obstetric violence, ensuring that the rights and dignity of migrant mothers are upheld. By highlighting these critical issues, this study aims to contribute to the broader discourse on maternal health care and promote social justice for these historically marginalised groups. Full article

Background/Objectives: Childbirth is a profoundly personal experience that often does not align with expectations. The World Health Organization has established guidelines for best practises; in this sense, it is crucial to understand the childbirth experiences of Portuguese women in comparison with these guidelines. Methods: A quantitative, descriptive, correlational, and cross-sectional study was conducted to achieve this. In total, 615 women completed a sociodemographic questionnaire and the Labour and Childbirth Experience questionnaire, which comprised 39 statements based on the WHO’s recommendations. Additionally, the study utilized the Life Satisfaction Scale and gathered insights into participants’ overall perception of care during this phase. Results: The results were categorized as follows: (1) practises influencing the labour experience; (2) practises influencing the experience of vaginal birth; (3) practises affecting the experience of caesarean birth; and (4) emotional experience during labour and birth. Conclusions: Notably, the study found that practises discouraged by the WHO are still prevalent, potentially enabling obstetric violence. However, a robust and statistically significant correlation was observed between the childbirth experience and the overall perception of care. Full article

This pilot cross-sectional study was designed to determine the profile of obstetric violence in Ecuador in recent years. An online survey was conducted between March 2022 and April 2022, including women over 18 years who granted their informed consent to participate (n = 1598). We used non-probabilistic sampling to obtain our sample. Fisher’s exact test was performed to assess the association between violence and type of birth, healthcare facility, and education level. Out of the women who participated in the study, 89.2% (n = 1426) identified themselves as Mestiza. Additionally, 88.3% (n = 1411) had completed university-level education. The majority of the participants, specifically 63.6% (n = 1017), received their care in public institutions, and 98.2% (n = 1569) reported structural negligence, while 74.5% (n = 1190) reported violation of their right to information. The entire sample affirmed to have experienced violation of the right of presence. This report shows that obstetric violence is present in Ecuador in different ways and that women experience negligence and violation of their right to receive ethical healthcare during childbirth. Full article