Status and influencing factors of obstetric violence in Shanghai, China: a multicenter cross-sectional survey

BACKGROUND: A substantial body of evidence indicates that obstetric violence can cause profound and lasting physical and psychological damage to pregnant women. However, there is notable lack of research examining the incidence of obstetric violence specifically within the Asia-Pacific region, highlighting an urgent need to elucidate its prevalence and delineate the multifactorial contributors to its occurrence. Therefore, the present study aimed to explore the prevalence and determinants of obstetric violence in secondary and tertiary healthcare facilities in Shanghai, China. METHODS: This hospital-based, cross-sectional study employed a convenience sample of 895 postpartum women recruited from four specialized maternal and child health hospitals for a questionnaire-based survey conducted between June and September 2025. Data analysis included univariate analyses, correlation assessments, and multivariate logistic regression modeling. RESULTS: The overall self-reported prevalence of obstetric violence was 17.1% (153 of 895 participants). Verbal abuse emerged as the most prevalent form of obstetric violence (8.3%). Notably, both incidence and perceived severity of obstetric violence were significantly higher in secondary institutions compared to those in tertiary institutions (p < 0.05). Higher educational attainment, presence of pregnancy complications, and greater autonomy in maternal decision-making were associated with lower odds of experiencing obstetric violence (p < 0.05). Receiving care at a secondary-level institution was independently associated with obstetric violence (p < 0.05). CONCLUSIONS: Obstetric violence was prevalent in both secondary and tertiary maternity specialty hospitals. This study advocates implementing multilevel interventions targeting individual mothers, healthcare providers, hospital systems, and broader societal structures for improving the quality of maternity care throughout the perinatal continuum and promoting the principles of respectful maternity care.