TY - JOUR
T1 - Experiences of disrespect and abuse during childbirth in the World Health Organization European region
T2 - A mixed-method study among 22 countries
AU - Galle, Anna
AU - Berghman, Helga
AU - Mariani, Ilaria
AU - Verdecchia, Maria
AU - Bomben, Arianna
AU - Vik, Eline Skirnisdottir
AU - Drandic, Daniela
AU - Pumpure, Elizabete
AU - Costa, Raquel
AU - Elden, Helen
AU - Miani, Céline
AU - Baranowska, Barbara
AU - Sarantaki, Antigoni
AU - Drglin, Zalka
AU - Radetic, Jelena
AU - Liepinaitienė, Alina
AU - Rozée, Virginie
AU - Abderhalden-Zellweger, Alessia
AU - Cerimagic, Amira
AU - König-Bachmann, Martina
AU - Kolokotroni, Ourania
AU - Chertok, Ilana
AU - Arendt, Maryse
AU - Vedove, Stefano Delle
AU - Nedberg, Ingvild Hersoug
AU - Kurbanovic, Magdalena
AU - Lazdāne, Gunta
AU - Pinto, Tiago Miguel
AU - Lindén, Karolina
AU - Batram-Zantvoort, Stephanie
AU - Tataj-Puzyna, Urszula
AU - Metallinou, Dimitra
AU - Bohinec, Anja
AU - Ružičić, Jovana
AU - Mizgaitienė, Marija
AU - de La Rochebrochard, Elise
AU - Gemperle, Michael
AU - Simon, Imola
AU - Karanikola, Maria
AU - Tasch, Barbara
AU - Fumagalli, Simona
AU - Lazzerini, Marzia
AU - IMAgiNE EURO Study Group
N1 - Publisher Copyright:
© 2025 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
PY - 2026/3
Y1 - 2026/3
N2 - OBJECTIVE: Despite advancements in maternity quality care worldwide, mistreatment of women during childbirth persists. Currently, there is a gap of knowledge on the occurrence of disrespect and abuse during childbirth in the World Health Organization (WHO) European region.METHODS: Within the IMAgiNE EURO (Improving Maternal Newborn Care in the WHO European Region During COVID-19 Pandemic) study, women 18 years and older who gave birth in healthcare facilities in the WHO European region, were invited to complete an online validated questionnaire regarding quality of maternity care. Data were collected between March 2020 and May 2023, declared as the COVID-19 pandemic. A mixed-method analysis was conducted on women's experiences of abuse, involving descriptives and multivariate logistic regression for quantitative data and thematic analysis for qualitative data.RESULTS: Of 50 617 participants among 22 countries, 7683 (15.2%) reported experiences of abuse ranging from 6.4% in Israel to 30.7% in Bosnia-Herzegovina, with significant differences by country, age, and birth mode. Emotional, verbal, and physical abuses were reported by 10.3%, 7.3%, and 2.4%, respectively. The thematic analysis, including 737 responses, identified several shortcomings in care that women perceived as abusive, the experience associated with abuse, and the elicited emotions. Experiences of disrespect and abuse were often linked to a sequence of actions, resulting in women feeling violated and treated as an object.CONCLUSION: Disrespectful maternity care was common during the COVID-19 pandemic in the WHO European region. Efforts are needed to improve communication, implementation of evidence-based practices, and respect for women's rights. Constant monitoring of disrespect and abuse indicators is needed. A paradigm shift must happen, ensuring safe and respectful care for all.
AB - OBJECTIVE: Despite advancements in maternity quality care worldwide, mistreatment of women during childbirth persists. Currently, there is a gap of knowledge on the occurrence of disrespect and abuse during childbirth in the World Health Organization (WHO) European region.METHODS: Within the IMAgiNE EURO (Improving Maternal Newborn Care in the WHO European Region During COVID-19 Pandemic) study, women 18 years and older who gave birth in healthcare facilities in the WHO European region, were invited to complete an online validated questionnaire regarding quality of maternity care. Data were collected between March 2020 and May 2023, declared as the COVID-19 pandemic. A mixed-method analysis was conducted on women's experiences of abuse, involving descriptives and multivariate logistic regression for quantitative data and thematic analysis for qualitative data.RESULTS: Of 50 617 participants among 22 countries, 7683 (15.2%) reported experiences of abuse ranging from 6.4% in Israel to 30.7% in Bosnia-Herzegovina, with significant differences by country, age, and birth mode. Emotional, verbal, and physical abuses were reported by 10.3%, 7.3%, and 2.4%, respectively. The thematic analysis, including 737 responses, identified several shortcomings in care that women perceived as abusive, the experience associated with abuse, and the elicited emotions. Experiences of disrespect and abuse were often linked to a sequence of actions, resulting in women feeling violated and treated as an object.CONCLUSION: Disrespectful maternity care was common during the COVID-19 pandemic in the WHO European region. Efforts are needed to improve communication, implementation of evidence-based practices, and respect for women's rights. Constant monitoring of disrespect and abuse indicators is needed. A paradigm shift must happen, ensuring safe and respectful care for all.
KW - COVID-19
KW - childbirth
KW - maternal and newborn health care
KW - disrespect and abuse
KW - quality of care
UR - https://pubmed.ncbi.nlm.nih.gov/40919727/
UR - https://www-webofscience-com.db.rsu.lv/wos/alldb/summary/4f217a14-ba5d-4804-8a74-3d17f6e904dc-017a1158b2/relevance/1
UR - https://www.scopus.com/pages/publications/105016009517
U2 - 10.1002/ijgo.70516
DO - 10.1002/ijgo.70516
M3 - Article
C2 - 40919727
SN - 0020-7292
VL - 172
SP - 1576
EP - 1590
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 3
ER -
SDG 5 Gender Equality