Prevalence of Mistreatment and Disrespect of Women During Childbirth in the World: A Systematic Review and Meta-Analysis Publisher Pubmed



Mirzania M ; Shakibazedeh E ; Maleki A ; Noorafrooz M ; Karimi N ; Mayra K ; Dashtkoohi M ; Hantoushzadeh S
Source: Reproductive Health Published:2025

Abstract

Background: Mistreatment of women during childbirth is a serious violation of women’s rights, which has become a common experience for many women worldwide and is considered a public health challenge because of the negative outcomes it can cause for both mothers and newborns. This systematic review is aimed to estimate the global prevalence of mistreatment and disrespect of women during childbirth. Methods: The electronic databases PubMed, CINAHL, EMBASE, PsycINFO, Scopus, Web of Science, Google Scholar search engine, and other sources were searched from January 1, 2000, to May 31, 2024, without language restriction, using a pre-specified search strategy. Studies meeting our inclusion criteria were included and assessed for quality using a standardized risk of bias assessment tool. Pooled prevalence was estimated using a random-effects model using Stata software, version 14.0. Heterogeneity was assessed using Cochran’s Q test and I2 statistic, and publication bias was assessed using Begg’s funnel plot and Egger’s test. Results: In total, 117 studies were included, providing 125 datasets and involving 209,175 participants across 37 countries. The prevalence of mistreatment and disrespect during childbirth ranged from 1.9 to 100%, with a pooled estimate of 54.5% (95% CI: 49.1%-59.9%, I2 = 100%). The highest prevalence was observed for “not being allowed a birth companion” (51.5%; 95% CI: 3.7%-99.2%) and “poor rapport between women and providers” (48.1%; 95% CI: 32.2%-64.01%), while the lowest prevalence was related to “sexual abuse” (1.2%; 95% CI: -0.14%-2.6%). Risk of bias assessment was the only significant predictor, suggesting that methodological quality influenced the reported prevalence of mistreatment and disrespect. Conclusion: This study found that more than half (54.5%) of women globally experience mistreatment and disrespect during childbirth- a widespread and alarming issue. The findings highlight an urgent need for targeted interventions, policies, and programs to ensure respectful, safe, and equitable maternity care for all women. © 2025 Elsevier B.V., All rights reserved.