Evidence map›Paper›PMID 40919727›Full record

ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026

Experiences of disrespect and abuse during childbirth in the World Health Organization European region: A mixed-method study among 22 countries.

Anna Galle, Helga Berghman, Ilaria Mariani, Maria Verdecchia, Arianna Bomben, Eline Skirnisdottir Vik, Daniela Drandic, Elizabete Pumpure, Raquel Costa, Helen Elden and 33 more

Abstract read
In one paragraph

Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Experiences of disrespect and abuse during childbirth in the World Health Organization European region: A mixed-method study among 22 countries.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

43 authors.

Anna GalleInternational Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University Gent, Ghent, Belgium.ORCID https://orcid.org/0000-0003-1427-5067
Helga BerghmanInternational Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University Gent, Ghent, Belgium.ORCID https://orcid.org/0009-0009-3950-1519
Ilaria MarianiWHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.ORCID https://orcid.org/0000-0001-8260-4788
Maria VerdecchiaWHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
Arianna BombenWHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.ORCID https://orcid.org/0000-0002-7384-287X
Eline Skirnisdottir VikDepartment of Health and Caring Science, Western Norway University of Applied Sciences, Bergen, Norway.ORCID https://orcid.org/0000-0002-9472-5947
Daniela DrandicRoda-Parents in Action, Zagreb, Croatia.ORCID https://orcid.org/0000-0003-3119-7734
Elizabete PumpureRiga Maternity Hospital, Riga, Latvia.
Raquel CostaEPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0003-1614-540X
Helen EldenInstitute of Health and Caring Sciences, Sahlgrenska Academy, Gothenburg, Gothenburg University, Gothenburg, Sweden.ORCID https://orcid.org/0000-0003-0000-0476
Céline MianiDepartment of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.ORCID https://orcid.org/0000-0003-3835-0287
Barbara BaranowskaDepartment of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland.ORCID https://orcid.org/0000-0003-2723-9604
Antigoni SarantakiDepartment of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Athens, Greece.ORCID https://orcid.org/0000-0003-3316-8566
Zalka DrglinNational Institute of Public Health, Ljubljana, Slovenia.ORCID https://orcid.org/0009-0001-1805-7668
Jelena RadeticCenter for Moms, Belgrade, Serbia.
Alina LiepinaitienėDepartment of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania.ORCID https://orcid.org/0000-0003-3268-8797
Virginie RozéeSexual and Reproductive Health and Rights Research Unit, Institut National d'Études Démographiques (INED), Paris, France.ORCID https://orcid.org/0000-0003-0288-982X
Alessia Abderhalden-ZellwegerSchool of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.ORCID https://orcid.org/0000-0003-1984-6105
Amira CerimagicNGO Baby Steps, Sarajevo, Bosnia and Herzegovina.
Martina König-BachmannHealth University of Applied Sciences Tyrol, Innsbruck, Austria.ORCID https://orcid.org/0000-0003-1659-1282
Ourania KolokotroniSchool of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.ORCID https://orcid.org/0000-0002-7653-002X
Ilana ChertokSchool of Nursing, Ohio University, Athens, Ohio, USA.
Maryse ArendtBeruffsverband Vun de Laktatiounsberoderinnen zu Lëtzebuerg Asbl (Professional Association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg.ORCID https://orcid.org/0000-0002-0523-3837
Stefano Delle VedoveWHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
Ingvild Hersoug NedbergUiT the Arctic University of Norway, Tromso, Norway.ORCID https://orcid.org/0000-0002-5202-195X
Magdalena KurbanovicUniversity of Rijeka Faculty of Health Studies, Rijeka, Croatia.
Gunta LazdaneInstitute of Public Health, Rīga Stradiņš University, Riga, Latvia.
Tiago Miguel PintoHEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal.
Karolina LindenUniversity of Gothenburg, Goteborg, Sweden.ORCID https://orcid.org/0000-0002-2792-3142
Stephanie Batram-ZantvoortDepartment of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.ORCID https://orcid.org/0000-0002-3948-9777
Urszula Tataj-PuzynaDepartment of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland.ORCID https://orcid.org/0000-0001-9800-3434
Dimitra MetallinouDepartment of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece.ORCID https://orcid.org/0000-0003-1788-3818
Anja BohinecNational Institute of Public Health, Ljubljana, Slovenia.ORCID https://orcid.org/0009-0007-2051-5166
Jovana RužičićCentar Za Mame, Belgrade, Serbia.
Marija MizgaitienėKaunas Hospital of the Lithuanian University of Health Sciences, Kaunas, Lithuania.
Elise de La RochebrochardSexual and Reproductive Health and Rights Research Unit, Institut National d'Études Démographiques (INED), Paris, France.ORCID https://orcid.org/0000-0002-1639-7335
Michael GemperleInstitute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Wädenswil, Switzerland.ORCID https://orcid.org/0000-0002-0683-9734
Imola SimonUniversity of Applied Sciences Burgenland, Pinkafeld, Austria.
Maria KaranikolaCyprus University of Technology School of Health Sciences, Cyprus.
Barbara TaschBeruffsverband Vun de Laktatiounsberoderinnen zu Lëtzebuerg Asbl (Professional Association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg.
Simona FumagalliUniversity of Milano Bicocca, Milan, Italy.ORCID https://orcid.org/0000-0002-0156-8429
Marzia LazzeriniWHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.ORCID https://orcid.org/0000-0001-8608-2198
IMagiNE EURO study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDespite advancements in maternity quality care worldwide, mistreatment of women during childbirth persists. Currently, there is a gap of knowledge on the occurrence of disrespect and abuse during childbirth in the World Health Organization (WHO) European region.

methodsWithin the IMAgiNE EURO (Improving Maternal Newborn Care in the WHO European Region During COVID-19 Pandemic) study, women 18 years and older who gave birth in healthcare facilities in the WHO European region, were invited to complete an online validated questionnaire regarding quality of maternity care. Data were collected between March 2020 and May 2023, declared as the COVID-19 pandemic. A mixed-method analysis was conducted on women's experiences of abuse, involving descriptives and multivariate logistic regression for quantitative data and thematic analysis for qualitative data.

resultsOf 50 617 participants among 22 countries, 7683 (15.2%) reported experiences of abuse ranging from 6.4% in Israel to 30.7% in Bosnia-Herzegovina, with significant differences by country, age, and birth mode. Emotional, verbal, and physical abuses were reported by 10.3%, 7.3%, and 2.4%, respectively. The thematic analysis, including 737 responses, identified several shortcomings in care that women perceived as abusive, the experience associated with abuse, and the elicited emotions. Experiences of disrespect and abuse were often linked to a sequence of actions, resulting in women feeling violated and treated as an object.

conclusionDisrespectful maternity care was common during the COVID-19 pandemic in the WHO European region. Efforts are needed to improve communication, implementation of evidence-based practices, and respect for women's rights. Constant monitoring of disrespect and abuse indicators is needed. A paradigm shift must happen, ensuring safe and respectful care for all.

Indexed as

COVID-19Delivery, ObstetricMaternal Health ServicesParturitionProfessional-Patient RelationsAdultEuropeFemaleHumansPhysical AbusePregnancyQuality of Health CareRespectSARS-CoV-2Surveys and QuestionnairesWorld Health OrganizationchildbirthCOVID‐19disrespect and abusematernal and newborn health carequality of care

Identifiers

PMID40919727
PMCPMC12936641

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.