Perspectives of Nurses and Midwives Regarding Factors That Contribute to and Protect Women From Disrespect and Abuse During Labor
J Obstet Gynecol Neonatal Nurs. 2026 Feb 17:S0884-2175(26)00009-2. doi: 10.1016/j.jogn.2026.01.007. Online ahead of print.
ABSTRACT
OBJECTIVE: To explore intrapersonal, interpersonal, and organizational factors that contribute to disrespect and abuse of women in labor by nurses and midwives in the United States.
DESIGN: Qualitative descriptive design.
SETTING: Anonymous online survey.
PARTICIPANTS: Nurses and midwives (N = 124: 90 nurses and 36 midwives) who cared for women in labor during hospital births in the United States for at least 2 years.
METHODS: We used convenience and snowball sampling to recruit participants for an anonymous online survey. This study represents the qualitative strand of a mixed-methods approach guided by Patient Abuse in Healthcare Theory. We analyzed the data using reflexive thematic analysis.
RESULTS: We identified eight themes that represented contributing and protective factors for disrespect and abuse of women in labor by nurses and midwives. Three themes represented factors that contributed to disrespect and abuse: Manifestations of Personal and Ethical Shortcomings in Clinical Conduct; Systemic and Structural Deficiencies as Catalysts for Disrespectful Conduct; and Patient, Family, and Interactional Friction. Five themes represented factors that were protective and deterred disrespect and abuse: Leadership Commitment and Enforced Accountability, Investment in the Work Environment and Resources, Staff Competencies, Well-being, and Self-awareness, Adherence to Professional and Ethical Standards, and Patient Empowerment and Education.
CONCLUSION: Our findings support the Patient Abuse in Healthcare Theory and show how intrapersonal, interpersonal, and organizational factors contribute to and mitigate disrespect and abuse of women during labor by nurses and midwives in the United States from their own perspectives. We recommend future researchers investigate interventions designed to address these factors and foster respectful maternity care.
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