Abuse and Disrespect in Obstetric Care in the United States: A Qualitative Descriptive Study of Nurse Experiences.

Background: This qualitative descriptive study of the experiences of US labor and delivery nurses follows the World Health Organization's call to address abuse and disrespect of women in maternity care. The majority of research about abuse and disrespect for childbearing women has been conducted in Africa, Asia, and Europe, but the US is unique as a high-income country with largely capitalist or privatized health care. The objective of this study was to gain knowledge about abuse and disrespect in hospital-based maternity care in the US from the perspective of labor and delivery nurses.

Methods: Using a qualitative descriptive methodology, online data collection followed by optional interviews, we solicited the experiences of labor and delivery nurses regarding their experiences with patients being treated unethically in obstetric care. Content analysis was used to interpret the data into themes.

Results: One hundred sixty-eight (N = 168) participants provided written examples of unethical treatment they had witnessed in their professional experience, and 7 interviews were conducted. Four major themes were identified: Violation of the Trust that We are Going to Keep You and Your Baby Safe; Assault; Stripping a Patient of Autonomy; and Failure of the Hospital to Provide Safe Conditions for Birth.

Discussion: People within the healthcare system are aware of abuse and disrespect, but it is often hidden by stakeholders who have conflicting interests. Perpetrators of abuse and disrespect are people and systems. More research is necessary to quantify and address the problems from within the healthcare system.