Sociodemographic factors associated with obstetric violence: A systematic review

This systematic review aimed to identify sociodemographic and obstetric factors associated with obstetric violence and to synthesize the available evidence on its manifestations, prevalence, and institutional contexts. A systematic review with narrative synthesis was conducted following PRISMA 2020 guidelines and SWiM recommendations for synthesis without meta-analysis. Electronic searches were performed in PubMed/MEDLINE, the Cochrane Library, SciELO, and Google Scholar between June and July 2025. Studies published in the last 10 years addressing obstetric violence in institutional or public healthcare settings were considered. Observational, qualitative, mixed-methods, quasi-experimental studies, integrative reviews, and legal analyses were included. Data extraction was performed independently by two reviewers using pre-piloted forms, and methodological quality was assessed using JBI, MMAT, and ROBINS-I tools according to study design. A total of 5,405 records were identified, and 13 studies met the inclusion criteria. The evidence consistently showed that women in socially vulnerable situations—particularly Indigenous women, women with disabilities, adolescents, women with low educational attainment, and users of public healthcare services—were more exposed to obstetric violence. The most frequent manifestations included lack of informed consent, unnecessary medicalization, disrespectful verbal treatment, repetitive invasive procedures, exclusion from clinical decision-making, denial of support during childbirth, and disregard for cultural practices. Qualitative studies highlighted emotional neglect, discriminatory attitudes, and hierarchical relationships between patients and healthcare staff that limited women’s autonomy during obstetric care. Quantitative studies reported heterogeneous prevalences, including high frequencies of disrespectful treatment and lack of informed consent in institutional settings. A quasi-experimental study conducted in Ethiopia showed significant improvements in women’s knowledge and attitudes regarding respectful obstetric care following an educational intervention. Obstetric violence remains a structural and multifactorial problem within health systems, influenced by social, cultural, and institutional inequalities. The findings support the need to strengthen respectful maternal care through rights-based, intercultural, disability-inclusive, and person-centered approaches, including informed consent, language mediation, and reasonable accommodations.