Obstetric violence in Finland: Analyzing the actions of healthcare staff in birthing narratives

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-06-20 DOI:10.1016/j.midw.2025.104498

Johanna Westergård , Jari Kylmä , Eija Paavilainen

{"title":"Obstetric violence in Finland: Analyzing the actions of healthcare staff in birthing narratives","authors":"Johanna Westergård , Jari Kylmä , Eija Paavilainen","doi":"10.1016/j.midw.2025.104498","DOIUrl":null,"url":null,"abstract":"<div><h3>Problem</h3><div>Obstetric violence is a form of gender-based violence rooted in structural inequality and discrimination. It is a globally prevalent phenomenon, affecting up to 59 % of birthing individuals globally and approximately 45 % in high-income countries. Despite its prevalence, research in Finland remains scarce, and little is known about how birthing individuals describe this phenomenon.</div></div><div><h3>Background</h3><div>Most research on obstetric violence has focused on structural and professional perspectives, with less attention to birthing individuals' experiences. Their accounts are essential for understanding how obstetric violence manifests and impacts maternity care. Studies highlight the role of communication, power dynamics, and institutional practices in shaping birthing experiences. However, research on these perceptions in Finland is limited.</div></div><div><h3>Aim</h3><div>This study aims to describe birthing individuals' experiences of healthcare staff actions in situations perceived as obstetric violence, providing insights to support ethical, patient-centered care.</div></div><div><h3>Methods</h3><div>This study employed a qualitative descriptive design with an inductive approach. Written birth narratives (<em>n</em> = 30) were analyzed using inductive content analysis. Background details such as age, number of births, or time elapsed since birth were unavailable. The narratives were coded and categorized to identify how healthcare staff actions were perceived.</div></div><div><h3>Findings</h3><div>Four categories emerged from the data: (1) ignoring, (2) manipulating, (3) showing aggression, and (4) nurturing.</div></div><div><h3>Discussion</h3><div>The findings demonstrate that obstetric violence in Finland is experienced through being ignored, manipulated, or subjected to aggression by healthcare staff. At the same time, nurturing care, characterized by compassion, professionalism, and responsible communication, was seen to protect birthing individuals' sense of dignity and sense of participation in care. These results support international evidence and underscore the importance of consistent, respectful care practices.</div></div><div><h3>Conclusion</h3><div>Preventing obstetric violence requires ethical decision-making and respect for birthing individuals' autonomy. Clinical expertise alone is insufficient; compassionate, respectful care is essential in matemity healthcare.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104498"},"PeriodicalIF":2.6000,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Midwifery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0266613825002165","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Problem

Obstetric violence is a form of gender-based violence rooted in structural inequality and discrimination. It is a globally prevalent phenomenon, affecting up to 59 % of birthing individuals globally and approximately 45 % in high-income countries. Despite its prevalence, research in Finland remains scarce, and little is known about how birthing individuals describe this phenomenon.

Background

Most research on obstetric violence has focused on structural and professional perspectives, with less attention to birthing individuals' experiences. Their accounts are essential for understanding how obstetric violence manifests and impacts maternity care. Studies highlight the role of communication, power dynamics, and institutional practices in shaping birthing experiences. However, research on these perceptions in Finland is limited.

Aim

This study aims to describe birthing individuals' experiences of healthcare staff actions in situations perceived as obstetric violence, providing insights to support ethical, patient-centered care.

Methods

This study employed a qualitative descriptive design with an inductive approach. Written birth narratives (n = 30) were analyzed using inductive content analysis. Background details such as age, number of births, or time elapsed since birth were unavailable. The narratives were coded and categorized to identify how healthcare staff actions were perceived.

Findings

Four categories emerged from the data: (1) ignoring, (2) manipulating, (3) showing aggression, and (4) nurturing.

Discussion

The findings demonstrate that obstetric violence in Finland is experienced through being ignored, manipulated, or subjected to aggression by healthcare staff. At the same time, nurturing care, characterized by compassion, professionalism, and responsible communication, was seen to protect birthing individuals' sense of dignity and sense of participation in care. These results support international evidence and underscore the importance of consistent, respectful care practices.

Conclusion

Preventing obstetric violence requires ethical decision-making and respect for birthing individuals' autonomy. Clinical expertise alone is insufficient; compassionate, respectful care is essential in matemity healthcare.

查看原文本刊更多论文

芬兰的产科暴力：分析保健人员在分娩叙述中的行为

性别暴力是一种基于性别的暴力，其根源在于结构性不平等和歧视。这是一种全球普遍现象，影响全球高达59%的生育个体，在高收入国家约占45%。尽管这种现象很普遍，但在芬兰的研究仍然很少，而且人们对生育个体如何描述这种现象知之甚少。大多数关于产科暴力的研究都集中在结构和专业角度上，很少关注分娩个体的经历。她们的叙述对于了解产科暴力如何表现和影响产科护理至关重要。研究强调了沟通、权力动态和制度实践在塑造分娩经验中的作用。然而，芬兰对这些观念的研究是有限的。目的本研究旨在描述分娩个体在产科暴力情况下对医护人员行动的经历，为支持道德、以患者为中心的护理提供见解。方法采用定性描述设计和归纳法。采用归纳内容分析法对30例出生记录进行分析。无法获得年龄、出生数量或出生后经过的时间等背景详细信息。对叙述进行编码和分类，以确定如何感知医疗保健人员的行为。从数据中可以得出四种类型：(1)忽视，(2)操纵，(3)表现出攻击性，(4)培养。研究结果表明，芬兰的产科暴力是通过被医护人员忽视、操纵或遭受攻击而经历的。与此同时，以同情、专业和负责任的沟通为特征的养育性护理被视为保护分娩个体的尊严感和参与护理的意识。这些结果支持了国际证据，并强调了始终如一、相互尊重的护理做法的重要性。结论预防产科暴力需要伦理决策和尊重分娩个体的自主权。仅凭临床专业知识是不够的；富有同情心、相互尊重的护理在孕产妇保健中至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.