Obstetric Violence from a Midwife Perspective

Abstract

This study examines and determines the prevalence of obstetric violence (OV) as perceived by midwives, as well as their knowledge of it and the professional factors that could be associated with the perception of OV. A cross-sectional study was conducted of 325 midwives in 2021 in Spain. Almost all (92.6%, 301) the midwives knew the term OV, but 74.8% (214) did not believe OV to be the same as malpractice. Moreover, 56.9% (185) stated they had rarely observed OV, and 26.5% (86) regularly observed OV. Most midwives consider physical aggression to be OV, in comparison, not providing information to women was only considered unacceptable treatment. The clinical practice considered the most grave within the context of OV was an instrumental birth or cesarean section without clinical justification. In addition, 97.5% (317) believed that raising awareness on the subject is one of the fundamental points to reducing this problem. Certain factors, such as less work experience, female gender, attendance at home births, and previous training in OV, were associated with an increased perception of situations as OV (p < 0.005). A high percentage of midwives perceived specific clinical practices (e.g., indicate cesarean section without clinical justification or perform the Kristeller maneuver) as OV, and certain characteristics of the professional profile, such as the professional experience or the sex of the midwife, were associated with an increased perception of OV. Most midwives knew the term OV but did not consider that it could pertain to some behaviors included in the international definitions of OV, such as the lack of information provided to a woman or the non-identification of the midwife, among others.