Womens experiences of disrespectful maternity care and its consequences during childbirth in Spain

Disrespectful care during childbirth may adversely affect women's well-being and their relationship with health services. This explanatory sequential mixed-methods study explored women's perceptions and reported consequences of disrespectful treatment during childbirth in Spain. In the quantitative phase, 1,579 women completed the Childbirth Abuse and Respect Evaluation Maternal Questionnaire (CARE-MQ), a validated instrument that assesses self-reported experiences of abuse and/or disrespectful treatment during childbirth. In the qualitative phase, 20 women who reported such experiences participated in semi-structured interviews. Quantitative data were analysed using descriptive and bivariate analyses, and qualitative data were analysed thematically. The mean CARE-MQ score was 6.84 (SD 9.61). Although most women scored 0 on most items, relevant proportions reported negative experiences, particularly lack of support with infant care or breastfeeding (20.4%) and lack of respect for the birth plan when possible or lack of explanation of alternatives (13.8%). Higher CARE-MQ scores were observed in association with induction of labour, neuraxial analgesia, emergency caesarean section, severe perineal trauma, absence of skin-to-skin contact, and longer hospital stay. Qualitative findings described non-consented procedures, poor communication, lack of empathy, feelings of infantilization and helplessness, and subsequent distrust toward healthcare services. These findings highlight the need to strengthen respectful maternity care, informed decision-making, and professional training in woman-centred childbirth care.