Drivers of Disrespect and Abuse in Obstetric Care: An Integrated Review

Pregnancy and childbirth are pivotal moments in a woman's reproductive journey, demanding compassionate and respectful care to ensure safe motherhood. Respectful Maternity Care (RMC) upholds the dignity and rights of women during labor and childbirth, recommended by the World Health Organization (WHO) to safeguard against mistreatment. Despite global attention, obstetric violence, encompassing mistreatment, disrespect, and abuse, persists worldwide. This integrative review explores the drivers of disrespect and abuse (D&A) within obstetric care, focusing on antenatal, intra-partum, and postnatal settings. The study synthesizes evidence from diverse literature sources, revealing socio-demographic factors as key drivers, particularly affecting women of lower social status. Structural deficiencies, provider biases, and cultural barriers exacerbate mistreatment, underscoring the need for comprehensive reforms. Findings emphasize the urgent need for patient-centered approaches, cultural competence training, and systemic improvements to ensure equitable and respectful maternal care. Recommendations include prioritizing woman-centered care, enhancing healthcare provider training, fostering supportive environments, and empowering communities to report instances of mistreatment. Stakeholders are urged to address workforce challenges, prioritize training, and enhance support for marginalized mothers. This review contributes to the discourse on maternal health and human rights, advocating for dignified maternity care as a fundamental component of comprehensive maternal healthcare services.