Obstetric violence is mistreatment, abuse, or coercion that occurs during pregnancy, labor, delivery, or the postpartum period within healthcare settings. It ranges from performing medical procedures without consent to verbal intimidation, physical force, and discrimination. A 2024 meta-analysis of 25 studies estimated a global prevalence of around 55% to 59%, making it far more common than most people realize.
The term was first formally recognized in 2012 by the Committee of Experts of the Inter-American Belém do Pará Convention, which classified it as a form of gender-based violence that infringes on women’s rights during childbirth. In 2014, the World Health Organization issued a statement calling for the prevention and elimination of disrespect and abuse during facility-based childbirth, framing it as a violation of both rights and trust between women and their healthcare providers.
What Counts as Obstetric Violence
A WHO-supported systematic review of 65 studies across 34 countries identified several core categories of mistreatment: physical abuse, verbal abuse, stigma and discrimination, failure to meet professional standards of care, poor rapport between women and providers, and problems created by health system conditions themselves. These aren’t rare outliers. They represent patterns documented across dozens of countries and healthcare systems.
The most common form, by a wide margin, is non-consented care. The global meta-analysis found that roughly 33% to 37% of women experienced some type of procedure performed without their informed consent. In practice, this looks like an episiotomy (a cut to widen the vaginal opening) done without asking, membranes ruptured against a patient’s wishes, or a vacuum-assisted delivery performed simply because a doctor was in a hurry rather than because it was medically necessary.
Midwives interviewed in a 2025 study published in Frontiers in Global Women’s Health described a culture where consent for certain procedures is treated as optional. One midwife explained that with episiotomies, “the procedure is often performed first and explained afterward. Consent isn’t typically sought, likely because it’s assumed the woman would refuse.” Another described deliveries being instrumented unnecessarily to give gynecology residents practice. Written informed consent is mainly obtained for epidurals and cesarean sections, while other interventions often proceed with only a verbal exchange or no discussion at all.
Verbal Abuse and Intimidation
Verbal mistreatment during labor is well documented in clinical settings, including in the United States. A qualitative study published in the journal Birth collected accounts from nurses who witnessed physicians berating, threatening, and dismissing patients in active labor. One physician told a laboring teenager, “If you don’t stop screaming and actually push that baby out, I’m gonna put these forceps in your vagina with no pain medicine and yank your baby out.” Another doctor responded to a woman screaming during suturing by telling the nurse, “No, she’s just being dramatic. No way she feels that with an epidural.”
Coercion takes subtler forms too. Nurses described providers threatening cesarean sections if patients didn’t comply with a procedure they didn’t want, or pressuring women to accept interventions by framing refusal as dangerous to the baby. A mother in one documented case was berated for the death of her baby because she had missed a prenatal glucose test. These interactions happen in moments of extreme vulnerability, when a person in labor has little ability to advocate for themselves or leave.
Physical Procedures Without Consent
Several specific procedures come up repeatedly in obstetric violence research. Episiotomies performed without consent are among the most commonly reported. The Kristeller maneuver, in which a provider pushes forcefully on the top of the uterus to speed delivery, is banned or discouraged in many countries but still practiced. One midwife described being asked to perform a Kristeller maneuver and refusing, leaving the delivery room rather than participating.
The so-called “husband stitch” is another example that has gained public attention. This refers to an extra suture added during episiotomy repair with the stated or implied purpose of tightening the vaginal opening for a male partner’s sexual pleasure. Research published in 2024 traced how this practice was normalized within twentieth-century American medicine, with physicians, husbands, and laboring women each playing different roles in how knowledge about it circulated. While it is difficult to quantify how often it still occurs, its existence is recognized in medical literature as a form of non-consensual modification to a patient’s body.
Who Is Most Affected
Obstetric violence does not affect everyone equally. Research consistently shows that race, ethnicity, age, and socioeconomic status shape how women are treated during childbirth. A qualitative study of 30 mothers of color in the United States (Black, Latina, and Asian women) found that a majority said their race or ethnicity directly impacted the care they received. Almost two-thirds described feeling stereotyped by their healthcare providers.
One Black mother explained: “I’m Black, and also we were poor at the time. I think that had a huge impact. I think that I just got lumped into a group and assumptions were made of my intellect, of my cognition, and so I feel like I was really dismissed.” This intersection of racial bias and economic disadvantage creates compounding layers of vulnerability. Younger women, those with less formal education, and first-time mothers also report higher rates of mistreatment.
Psychological Consequences
The effects of obstetric violence extend well beyond the delivery room. A systematic review examining the link between obstetric violence and mental health found that it is a significant risk factor for both postpartum depression and post-traumatic stress disorder. Postpartum depression affects an estimated 17% to 47% of women depending on the population studied, and obstetric violence increases that risk substantially.
PTSD after childbirth can involve reliving the traumatic event, nightmares, irritability, difficulty bonding with the newborn, fear of future pregnancies (known as tokophobia), and a persistent feeling of disconnection. Specific experiences tied to higher PTSD risk include multiple perineal tears, the Kristeller maneuver, loss of autonomy during labor, and coercive communication from providers. These symptoms can emerge up to a year after delivery.
Protective factors tell an equally important story. Women whose birth plans were respected, who had clear communication with their care team, who received social support during labor, and who were given immediate skin-to-skin contact with their baby reported significantly lower rates of PTSD. The quality of the relationship between a laboring person and their provider turns out to be one of the strongest predictors of psychological outcomes.
Legal Recognition
Several countries have passed laws specifically criminalizing or regulating obstetric violence. Argentina, Mexico, Venezuela, and certain regions of Spain have implemented protective legislation that names obstetric violence as a distinct legal category. These laws typically define it as any act by healthcare personnel that dehumanizes or objectifies a woman during pregnancy, labor, or postpartum care, including unnecessary medicalization and failure to obtain consent.
In the United States, no federal law specifically addresses obstetric violence by name, though existing legal frameworks around informed consent, medical malpractice, and assault can apply. The American College of Obstetricians and Gynecologists states that meeting the ethical obligations of informed consent requires giving a patient adequate, accurate, and understandable information, and that the patient must be free to ask questions and to make a voluntary choice, including refusal of care. A shared decision-making model, in which treatment options are discussed in the context of a patient’s own values and priorities, is the professional standard. The gap between that standard and what many women actually experience during labor is where obstetric violence lives.