Midwives' lived experiences of obstetric violence: a hermeneutic phenomenological study.

Abstract

Background: Obstetric violence encompasses harmful practices and care dynamics during pregnancy, childbirth, and postpartum that undermine women's dignity, autonomy, and rights, and is associated with structural, gender, and organisational factors in maternity care.

Objectives: To explore how midwives understand, experience, and interpret obstetric violence in delivery room settings, including its perceived causes and contextual conditions.

Methods: A qualitative study based on Gadamerian hermeneutic phenomenology was conducted with ten hospital midwives from two public hospitals in Andalusia and Catalonia. Semi-structured interviews (November 2024-April 2025) were audio-recorded, transcribed verbatim, and analysed iteratively using ATLAS.ti, with researcher triangulation and participant validation.

Results: Midwives described obstetric violence as a multifactorial phenomenon influenced by women's vulnerability, communication, professional practices, and healthcare system conditions. Woman-centred care, communication, and professional autonomy were identified as protective factors, while workload and institutional constraints hindered individualised care. This study contributes an underexplored midwifery perspective to a field mainly focused on women's experiences.

Conclusions: Preventing obstetric violence requires strengthening communication, informed consent, women's participation, professional education, and organisational conditions that support respectful, woman-centred maternity care. Obstetric violence should be interpreted not only in relation to individual intent, but also in relation to its relational, structural, and experiential dimensions.