Status and influencing factors of obstetric violence: a mixed study

Few researches have focused on obstetric violence in the Asia-Pacific region, necessitating an understanding of the current situation of obstetric violence and exploration of factors influencing its occurrence. This study aimed to investigate the current status and influencing factors of obstetric violence.

We used a modified obstetric violence questionnaire to understand the status of obstetric violence in women and the objective sampling method to select qualified interviewees for face-to-face semi-structured in-depth interviews.

Seven hundred twenty-one women completed the online questionnaire, among whom 10 women participated in the in-depth interview. The current prevalence of obstetric violence was 51.6% (n = 372), with verbal violence being the most common type (82.0%, n = 305). In binary logistic regression analysis, living in countryside [OR (95% CI) = 0.592 (0.402-0.872)], private hospitals [OR (95% CI) = 0.422 (0.233-0.765)], multiparas [OR (95% CI) = 0.405 (0.273-0.601)], and having a family member accompaniment during delivery in the labor room [OR (95% CI) = 0.324 (0.177-0.59], having prenatal maternal education [OR (95% CI) = 0.583 (0.393-0.865)], and active expression of needs during childbirth [OR (95% CI) = 0.415 (0.252-0.685)] were protective factors for obstetric violence. Maternal or family members having workplace violence against medical staff during childbirth [OR (95% CI) = 5.642 (2.148-14.818)], and familiarity with obstetric violence [OR (95% CI) = 2.138 (1.360-3.360)] were risk factors for obstetric violence. Based on family support during adolescence, the risk of obstetric violence in the "Strongly supportive" group was only 0.029 times that of the "Very unsupportive" control group. Women in other age groups are at higher risk of obstetric violence than women aged ≥ 45 years. The qualitative research has analyzed five themes: needs to be strengthened humanistic care, process that needs optimization, culture of obstetric violence, needs to be strengthened human resources, and needs to be strengthened medical facilities.

The current incidence of obstetric violence is moderately common level, multilevel measures are urgently needed. Efforts should focus on promoting the coverage of the "Internet + Prenatal Education" program in rural areas to raise maternal awareness. Concurrently, training for medical staff should be enhanced, and preventive measures should be incorporated into healthcare quality assessment systems.