The Spanish version of the Student Perceptions of Respectful Maternity Care scale: Cultural adaptation and psychometric validation

The Spanish version of the Student Perceptions of Respectful Maternity Care scale: Cultural adaptation and psychometric validation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Spanish version of the Student Perceptions of Respectful Maternity Care scale: Cultural adaptation and psychometric validation Marisol MEJUTO-PREGO, Desirée MENA-TUDELA This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7939702/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 18 You are reading this latest preprint version Abstract Background The quality of care provided during pregnancy, childbirth, and postpartum has a direct impact on maternal health and women's experiences. Aim To culturally adapt and translate the "Student Perceptions of Respectful Maternity Care (SPRMC)" instrument into the Spanish context. Methods Cultural adaptation was conducted through a translation-back-translation process and review by an expert panel. Subsequently, construct validity and internal consistency of the scale were evaluated. A study was performed with a sample of 209 students. Results Factor analysis identified a five-factor structure: Respectful Care, Safety and Comfort, Supportive Care, Safe Space, and Disrespect and Autonomy, explaining 41.1% of total variance. The instrument's internal consistency was 0.812 measured through McDonald’s ω. Conclusions Results support the validity and reliability of the Spanish version of SPRMC. This tool may be useful in practice as a resource for training in ethical, communicative, and woman-centred care competencies. Health sciences/Health care Health sciences/Medical research Biological sciences/Psychology Social science/Psychology Respectful Maternity Care Abuse and Disrespect Obstetric Violence Nursing Students Figures Figure 1 INTRODUCTION The World Health Organization (WHO) stated that many women suffer disrespectful and abusive treatment during childbirth in healthcare facilities worldwide. This treatment not only violates women's right to respectful care but may also threaten their rights to life, health, physical integrity, and non-discrimination 1 . Mounting evidence reveals a concerning global pattern of disrespectful, abusive, or neglectful intrapartum care 1 , making Respectful Maternity Care (RMC) the primary strategy for improving reproductive health services 2 . RMC is defined as a perinatal care approach grounded in human rights and reproductive justice, promoting women's dignity, autonomy, individuality, and preferences. This model actively seeks to prevent mistreatment and provides a practical paradigm for maternity care 3 , encompassing core elements such as autonomy, informed consent, privacy, person-centred communication, shared decision-making, dignity, safety, and justice 3 , 4 However, despite its relevance, RMC remains a relatively unexplored area in the Spanish healthcare literature and context, particularly in relation to professional training. In spite of the clear deficiencies among nursing and midwifery professionals who provide obstetric care in our country 5 . Nevertheless, promising interventions exist where such training stands out as the most effective strategy 6 , highlighting the need for rigorous evaluation of these programs. The training and education of healthcare professionals and future healthcare practitioners appear to play a fundamental role in facilitating the much-needed paradigm shift in obstetric care, directly influencing Respectful Maternity Care (RMC) 7 . Similarly, the World Health Organization (WHO) emphasizes the necessity for interventions to drive behavioural changes among healthcare professionals, transform clinical environments, and reform health systems. These actions are essential to ensure all women have access to respectful, competent, and person-centred care services 1 . Therefore, the availability of validated tools to measure the effectiveness of training programs is crucial. Thus, the Student Perceptions of Respectful Maternity Care (SPRMC) tool was developed to assess nursing students’ perceptions of respectful maternity care 4 . It has also been widely used across various countries 8 – 12 . The SPRMC is an 18-item instrument measured on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), and is structured around three factors explaining 37.44% of the variance: Factor 1 – Respectful Care (10 items), Factor 2 – Safety and Comfort (5 items), and Factor 3 – Supportive Care (3 items). The internal consistency showed a good Cronbach’s alpha of 0.81 for the total scale, 0.81 for the Respectful Care subscale, 0.69 for Safety and Comfort, and 0.62 for Supportive Care. Test-retest reliability after one week was confirmed by a Pearson correlation coefficient (r = 0.91, p < 0.001). The total score is calculated by summing the raw scores of all items, taking into account that items 1 to 10 are reverse-worded. The total score ranges from 18 to 90 points, with higher scores indicating greater perceived respectful care 4 . Based on the above, the aim of the present study was to culturally adapt and translate the Student Perceptions of Respectful Maternity Care (SPRMC) instrument 4 for the Spanish context. MATERIAL AND METHODS Design For this study, a cultural adaptation and translation of the Student Perceptions of Respectful Maternity Care (SPRMC) instrument into the Spanish context was conducted. Key steps for cultural and linguistic adaptation followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework 13 , a specific methodological standard for evaluating measurement instruments in health and psychological research. Translation and scale adaptation First, we contacted the original questionnaire author to request permission for translation and adaptation. Subsequently, the SPRMC scale was translated into Spanish using guidelines for healthcare translation and cross-cultural adaptation to achieve equivalence between original and translated versions 14 . In the translation and cultural adaptation phase of the instrument, a professional bilingual translator with experience in health and gender terminology was responsible for performing the direct translation from English to Spanish. Subsequently, the research team—composed of experts in maternal health, sexual and reproductive rights, and research methodology—conducted a thorough review of the translated items, ensuring the semantic, conceptual, and cultural equivalence of the items with respect to the original version. Although the classic procedure of double translation and back-translation suggested by Sousa and Rojjanasrirat 14 was not followed, rigorous internal review controls were implemented, which allowed maintaining the fidelity of the content of the original instrument in the new linguistic and cultural context. Thus, the process included a critical evaluation by experts in reproductive health and psychometry, aimed at identifying and correcting possible linguistic ambiguities or cultural inadequacies. These strategies allowed for the implementation of rigorous quality controls. The original English and preliminary Spanish versions are available as Supplementary Note 1 and 2. Validation A focus group of 5 experts (3 scale-validation researchers and 2 mothers close to the research team) evaluated item relevance for respectful maternity care 15 . The experts scored each item as "Not at all adequate" (1), "Somewhat adequate" (2); "Adequate" (3) and "Very adequate" (4) as well as the names of the factors of the SPRMC scale. Items reaching consensus were retained; others were revised per expert suggestions and re-evaluated. Content Validity Index (CVI) was calculated per Polit and Beck 15 , 16 for items and overall scale. Inter-expert agreement was measured using modified Kappa; values > 0.74 were considered excellent 15 , 17 . The questionnaire was modified per expert suggestions. Sample size All study participants were enrolled in a university course on sexual and reproductive rights, offered by the Universitat Jaume I as part of their academic and/or continuing education in health sciences. While part of the group was made up of undergraduate university students, other participants were already working as health professionals and were taking the program as part of their continuing education. Since they were all actively involved in the same educational environment and participated in the course as students, they were considered a relevant and homogeneous population for the purposes of the study, which focused on analysing perceptions generated in an academic training context on respectful care in maternity. The sample size was determined following the methodological recommendations of Anthoine et al 18 . According to Anthoine et al. 18 , for instrument validation studies, a sample size of between 5 and 10 participants per item is suggested. Since the instrument has 18 items, a target range of 90 to 180 participants was established. The final sample of 209 participants exceeded this threshold, thus meeting the minimum criteria used to perform an exploratory factor analysis (EFA) 19 . Non-probabilistic convenience sampling was used, administering questionnaires (sociodemographic/obstetric variables and SPRMC-Spanish) to students enrolled in a sexual/reproductive rights course at a Spanish public university (September–December 2024). Questionnaires with > 10% missing items were excluded. Data analysis Descriptive analysis included means, SDs, and 95% CIs for quantitative variables, and absolute frequencies/percentages for qualitative variables. Construct validity was assessed via Exploratory Factor Analysis (EFA) 20 . Kaiser-Meyer-Olkin (KMO) index and Bartlett’s sphericity test confirmed factor analysis applicability. EFA used Minimum Residual extraction with Oblimin rotation. Factor loadings > 0.4 retained items in a given factor, based on parallel analysis 21 . Internal consistency of subscales and total scale was evaluated using McDonald’s ω, as the measurement scale was ordinal. Values between 0.7–0.9 indicate adequate internal consistency 22 . In order to make the results of this study comparable with preliminary studies, Cronbach's α was also calculated. Relationships between total scale and its factors were examined using Spearman’s correlation coefficient to assess structural coherence. Correlations of 0.50–0.70 were considered good, and > 0.7 were regarded as strong 23 . Bivariate analyses assessed effects of sociodemographic/control variables on scale scores. Mann-Whitney U tests were used when Kolmogorov-Smirnov normality assumptions were violated. Statistical analysis was performed using Excel and Jamovi v.2.3.28, with significance at p < 0.05. Ethical considerations This study was conducted in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 7 April 2016 on the protection of natural persons, the Spanish Organic Law 3/2018 of 5 December on Personal Data Protection and Digital Rights Guarantee, and the principles of the Declaration of Helsinki. The study was approved by the Human Research Ethics Committee of the Universitat Jaume I (code: CEISH/127/2023). Students provided written informed consent after being informed of the research purpose. Participation was voluntary, and ethical standards were upheld throughout. RESULTS Sample description For the analysis of these results, a total of 219 questionnaires were obtained. Of these, 4.56% (n = 10) were excluded for being incomplete by more than 10%. The final sample consisted of 209 questionnaires. The mean age was 30.7 (SD ± 9.63; Minimum = 18; Maximum = 55) years, and 95.2% (n = 199) were women. A total of 71.4% (n = 142) were healthcare professionals and 28.6% (n = 57) were university students. Table 1 shows the descriptive characteristics of the sample. Table 1 Descriptive results of the study (n = 209). n % Sex Men 10 7.8 Woman 199 95.2 Have you ever been pregnant? (n = 199) No 147 70.3 Yes 62 29.7 Have you ever give birth? (n = 62) No 5 8.1 Yes 57 91.9 Have you personally experienced obstetric violence? No 146 69.9 yes 63 30.1 Have you ever witnessed a woman giving birth? No 48 23.0 Yes 161 77.0 Clinical experience in gynaecology and obstetrics No 44 21.1 Yes 165 78.9 During your clinical experience, have you seen a woman suffer obstetric violence? (n = 165) No 22 10.5 Yes 134 64.1 Maybe 21 10.0 Were all the women you encountered during your clinical experience treated in the same way? (n = 165) No 133 68.9 Yes 60 31.1 During your academic training, have you received education with a gender perspective? No 61 29.2 Yes 148 70.8 Do you consider your training with a gender perspective to be sufficient? No 139 69.2 Yes 62 30.8 During obstetric care, are women judged for their feelings No 16 8.1 Yes 157 79.3 Maybe 25 12.6 Have you heard of the concept “obstetric violence”? No 15 7.2 Yes 194 92.8 Do you consider yourself sufficiently trained in obstetric violence? No 170 82.5 Yes 36 17.5 The term "obstetric violence" criminalize healthcare professionals No 146 69.9 Yes 63 30.1 During your training, were you taught to practice or be complicit in obstetric violence? No 124 59.3 Yes 85 40.7 Have you ever felt forced or pressured to carry out practices you perceived as violent? No 101 48.3 Yes 108 51.7 Have you witnessed obstetric violence during your training? No 65 31.1 Yes 144 65.6 Validation The expert group evaluated each item and minor changes were introduced to 15 of the 18 items, resulting in the final version as comparatively shown in Table 2 ; achieving an overall content validity index greater than 0.74. Table 2 Content validity results of the “Student Perceptions of Respectful Maternity Care (SPRMC)” scale after consensus with native translators. Adapted version Final version I-CVI* Pc** K*** 1.Es necesario regañar a una mujer si no coopera con el personal sanitario. (R) Unchanged 1 0.03 1 2.Estoy de acuerdo en que las mujeres deberían "dejar su dignidad en la puerta", ya que, dar a luz no tiene nada de privado. (R) 2. Estoy de acuerdo en que las mujeres deberían "dejar su dignidad fuera", ya que, el parto no tiene nada de privado. (R) 0.8 0.16 0.76 3.La confidencialidad es difícil de mantener en la atención a la maternidad. (R) 3. Es difícil mantener la confidencialidad en la atención a la maternidad. (R) 0.8 0.16 0.76 4.Estoy demasiado ocupado para saludar a todas las mujeres con una sonrisa. (R) 4. Tengo tanto trabajo que no puedo saludar a cada mujer con una sonrisa. (R) 0.8 0.16 0.76 5.Procedimientos rutinarios como el tacto vaginal y la palpación abdominal no requieren permiso. (R) 5. Procedimientos rutinarios como el examen vaginal y la exploración abdominal no requieren permiso. (R) 0.8 0.16 0.76 6.Las creencias culturales de las mujeres son tan variadas que no se puede esperar que el personal las tenga todas en cuenta. (R) Unchanged 1 0.03 1 7.No tiene sentido dar todos los detalles sobre los procedimientos de parto porque algunas mujeres no lo entenderán. (R) 7. Dar todos los detalles sobre los procedimientos de parto no tiene sentido porque algunas mujeres no los entenderán. (R) 0.8 0.16 0.76 8.A menudo estoy demasiado ocupado para ofrecer opciones de parto a las mujeres. (R) 8. A menudo tengo tanto trabajo durante el parto que no puedo ofrecer opciones a las mujeres. (R) 0.8 0.16 0.76 9.A menudo es difícil mantener un entorno tranquilo para las mujeres durante el parto. (R) 9. Frecuentemente, es difícil mantener un ambiente tranquilo para las mujeres durante el parto. (R) 0.8 0.16 0.76 10.Si las mujeres no cuidan de su propia salud, no deben esperar el mismo trato que las demás. (R) 10. Si las mujeres no cuidan de su propia salud, no deben esperar el mismo cuidado que a las demás. (R) 0.8 0.16 0.76 11.Las mujeres de parto necesitan un espacio libre de molestias innecesarias. 11. Las mujeres durante el parto necesitan un espacio libre de interrupciones innecesarias. 0.8 0.16 0.76 12.Tengo la responsabilidad de ayudar a las mujeres a sentirse seguras durante el parto. Unchanged 0.8 0.16 0.76 13.Intento limitar la exposición del cuerpo de la mujer cuando la atiendo. 13. Intento preservar la intimidad del cuerpo de la mujer mientras la cuido. 1 0.03 1 14.Escuchar activamente las historias de las mujeres valora sus experiencias. 14. Al escuchar activamente las historias de las mujeres valoras sus experiencias. 0.8 0.16 0.76 15.Explico a la mujer los beneficios y los riesgos antes de cualquier intervención. 15. Explico a la mujer los beneficios y los riesgos antes de cualquier procedimiento. 0.8 0.16 0.76 16.Debe animarse a las mujeres a participar activamente en su atención. 16. Se debe animar a las mujeres a participar activamente en sus cuidados. 0.8 0.16 0.76 17.Todas las mujeres deben recibir el apoyo que necesitan para la lactancia. 17. Cada mujer debería recibir el apoyo que necesita con la lactancia materna. 0.8 0.16 0.76 18.Hay que animar a las mujeres a hablar con otras mujeres puérperas sobre sus experiencias. 18. Hay que animar a las mujeres a hablar con otras mujeres sobre sus experiencias de maternidad. 0.8 0.16 0.76 *I-CVI: Item-level Content Validity Index **Pc: Probability of chance agreement ***K: Modified Kappa Index KMO (0.768) and Bartlett (χ² = 890; p ≤ 0.001) confirmed the feasibility of factor analysis. Thus, exploratory factor analysis yielded a total of 41.1% of the explained variance in 5 factors for the SPRMC scale, as observed in the scree plot (Fig. 1 ). The distribution of total variance explained by each factor was relatively equitable: Factor 1 = 10.73%, Factor 2 = 9.08%; Factor 3 = 7.75%; Factor 4 = 6.91% and Factor 5 = 6.59% of the explained variance. Table 3 shows the factor matrix for each item, presenting factor loadings and item distribution across the factors suggested by exploratory factor analysis. Additional analyses indicated that the obtained model had good overall fit (RMSEA = 0.0399; 90% CI of RMSEA = 0.0137–0.0599; TLI = 0.929; BIC = -292; χ² = 97.6; df = 73; p = 0.029). Table 3 Factor matrix of each item a , showing the factor loadings and the distribution of items within each factor suggested by the exploratory factor analysis. Items Factors 1 2 3 4 5 Scolding a woman is necessary if she does not cooperate with health care providers. 0.607 I agree that women should “leave their dignity at the door” as there is nothing private about giving birth. 0.627 Confidentiality is hard to maintain in maternity care. 0.337 I am too busy to greet every woman with a smile. 0.290* Routine procedures like vaginal examination and abdominal palpation do not require permission. 0.571 Women’s cultural beliefs are so varied that staff cannot be expected to accommodate them all. 0.707 There is no point providing all the details about birth procedures because some women will not understand. 0.615 I am often too busy to provide birth options to women. 0.663 It is often hard to keep a calm environment for women during labour. 0.633 If women do not look after their own health, they should not expect the same treatment as others. 0.503 Labouring women need a birth space free from unnecessary disturbance by others. 0.229* I have a responsibility to help women feel safe during labour and birth. 0.731 I try to limit exposing a woman’s body when providing care. 0.835 Actively listening to women’s stories values their experiences. 0.447 I explain benefits and risks to a woman before any procedure. 0.408 Women should be encouraged to actively participate in their care. 0.711 Every woman should receive support she needs with breastfeeding. 0.443 Women should be encouraged to talk to other postpartum women about their experiences. 0.343 a factor loadings above 0.3 *The weighting of this item was calculated to determine which factor had the greatest influence. The internal consistency of the total scale measured by McDonald's ω showed an overall value of 0.812, indicating adequate internal consistency, which did not increase significantly when removing any item (Supplementary Table S1 ). For each factor, internal consistency was: Respectful Care = 0.736; Safety and Comfort = 0.740; Supportive Care = 0.632; Safe Space = 0.548; Disrespect and Autonomy = 0.617. Cronbach's α yielded an overall result of 0.761, indicating a good level of reliability; it will not improve if any item is removed. Regarding the correlation between the total scale and its factors, all correlations were statistically significant, with a strong relationship observed between "Respectful Care" and "Safe Space" with the total scale. A good correlation was also observed between the total scale and the factors "Safety and Comfort", "Supportive Care" and "Disrespect and Autonomy". These results suggest that all highlighted correlations are positive with "Respectful Care" and "Safe Space" being the strongest, while although "Safety and Comfort" is weaker, it remains significant (Table 4 ). Table 4 Correlation matrix between the total scale score and its factors Total scale Respectful care Safety and comfort Supportive care Safe space Lack of respect and autonomy Total scale - Respectful care 0.801*** - Safety and comfort 0.544*** 0.399*** - Supportive care 0.565*** 0.406*** 0.371*** - Safe space 0.755*** 0.397*** 0.246*** 0.285*** - Lack of respect and autonomy 0.652*** 0.483*** 0.292*** 0.245*** 0.334*** - Spearman’s Rho *** p < 0,001 Final scale and interpretation Once the factors and item distribution were calculated, the total scale had a maximum score of 90 points and a minimum score of 18 points. The item and factor distribution is presented in Supplementary Note 3. For the "Respectful Care" factor, a maximum score of 25 points and a minimum of 5 points were established. For the "Safety and Comfort" factor, the maximum score was 15 points and the minimum 3. For "Supportive Care", a maximum score of 20 points and a minimum of 4 were set. For "Safe Space", a maximum score of 15 points and a minimum of 3 were determined. And for the "Disrespect and Autonomy" factor, a maximum score of 15 points and a minimum of 3 were established. Thus, a higher score for the total scale, as well as for each factor, indicates a greater perception of respectful maternity care. Finally, the name given to this scale was: Perception of Respectful Maternity Care (CUMARE). CUMARE scale results For the CUMARE scale, a mean of 82.8 points (SD ± 5.64; Maximum: 90; Minimum: 65) was obtained for the total. Results for each factor were: Respectful Care = 23.2 (SD ± 2.14; Maximum: 25; Minimum: 13) points; Safety and Comfort = 14.3 (SD ± 1.43; Maximum: 15; Minimum: 3) points; Supportive Care = 19 (SD ± 1.33; Maximum: 20; Minimum: 12) points; Safe Space = 12.5 (SD ± 2.01; Maximum: 15; Minimum: 7) points; Disrespect and Autonomy = 13.8 (SD ± 1.44; Maximum: 15; Minimum: 9) points. Table 5 shows statistically significant differences between the total CUMARE scale and its factors with the previously described sociodemographic and control variables. Participants who had a previous pregnancy showed significantly higher scores for the total CUMARE scale (p = 0.011) and for the "Supportive Care" factor (p = 0.036). Statistically significant differences were also found for the "Disrespect and Autonomy" factor (p < 0.001), with women who had experienced a pregnancy obtaining the highest scores. Having experienced obstetric violence personally showed higher scores for the total CUMARE scale (p = 0.015) and the "Disrespect and Autonomy" factor (p < 0.001). Participants who felt sufficiently trained about obstetric violence obtained statistically significantly higher scores for the total CUMARE scale (p = 0.002), the "Safety and Comfort" factor (p = 0.030), "Supportive Care" (p = 0.010), "Safe Space" (p = 0.021), and "Disrespect and Autonomy" (p = 0.005). It is noteworthy that no statistically significant differences were found in the total scale score or its factors, except for the "Disrespect and Autonomy" factor (p < 0.001), based on whether feminist topics had been addressed in academic training. Table 5 Inferential analysis between the Percepción sobre los cuidados respetuosos a la maternidad (CUMARE) scale, its factors, and sociodemographic and control variables. CUMARE scale Respectful care Safety and comfort Supportive care Safe space Lack of respect and autonomy Mean SD p a Mean SD p a Mean SD p a Mean SD p a Mean SD p a Mean SD p a Sex Men 82.4 6.06 0.776 22.9 2.23 0.608 14.1 1.45 0.518 19.1 1.60 0.495 12.5 2.46 0.818 13.8 1.40 0.798 Woman 82.9 5.63 23.2 2.14 14.3 1.43 19.0 1.32 12.5 1.99 13.8 1.45 You are Student 82.6 5.78 0.556 23.2 2.17 0.902 14.4 1.01 0.624 19.0 1.29 0.775 12.8 1.77 0.370 13.2 1.59 < 0.001 Professional 83.2 5.44 23.2 2.13 14.3 1.53 19.0 1.30 12.5 2.09 14.1 1.27 Have you ever been pregnant? (n = 199) No 82.2 5.75 0.011 23.1 1.98 0.239 14.3 1.33 0.138 18.8 1.46 0.036 12.4 1.95 0.145 13.6 1.53 < 0.001 Yes 84.3 5.12 23.2 2.50 14.5 1.64 19.4 0.85 12.7 2.14 14.5 0.92 Have you ever give birth? (n = 62) No 86.4 3.91 0.350 24.8 0.45 0.087 14.4 0.89 0.437 19.8 0.45 0.196 13.2 2.05 0.702 14.2 1.30 0.528 Yes 84.1 5.20 23.1 2.56 14.5 1.69 19.3 0.87 12.7 2.16 14.5 0.88 Obstetric violence in personal level No 82.2 5.77 0.015 23.0 2.25 0.071 14.4 1.16 0.719 18.9 1.43 0.148 12.4 2.01 0.219 13.6 1.49 < 0.001 Yes 84.2 5.09 23.6 1.82 14.3 1.91 19.2 1.04 12.7 2.00 14.4 1.14 Have you ever witnessed a woman giving birth? No 81.5 6.67 0.178 22.8 2.29 0.231 14.0 1.53 0.039 18.7 1.54 0.386 12.7 1.86 0.492 13.3 1.55 < 0.001 Yes 83.2 5.25 23.3 2.09 14.4 1.38 19.1 1.26 12.4 2.06 14.0 1.36 Clinical experience in gynaecology and obstetrics No 81.7 6.64 0.278 22.8 2.32 0.257 14.1 1.52 0.181 18.9 1.42 0.882 12.7 1.82 0.483 13.1 1.59 < 0.001 Yes 83.1 5.32 23.3 2.09 14.4 1.40 19.0 1.31 12.4 2.06 14.0 1.34 During your academic training, have you received education with a gender perspective? No 83.7 5.10 0.192 23.5 2.00 0.197 14.5 1.19 0.141 19.2 1.20 0.191 12.3 2.21 0.393 14.3 1.18 < 0.001 Yes 82.5 5.82 23.1 2.19 14.3 1.51 18.9 1.38 12.6 1.92 13.6 1.49 Have you heard of the concept “obstetric violence”? No 79.7 7.01 0.065 22.3 2.99 0.260 13.6 1.80 0.028 18.8 1.61 0.818 11.9 1.58 0.169 13.1 1.33 0.010 Yes 83.1 5.47 23.2 2.06 14.4 1.38 19.0 1.31 12.5 2.04 13.9 1.43 Do you consider yourself sufficiently trained in obstetric violence? No 82.3 5.76 0.002 23.1 2.22 0.236 14.3 1.49 0.030 18.9 1.39 0.010 12.3 2.03 0.021 13.7 1.50 0.005 Yes 85.4 4.45 23.6 1.75 14.7 1.07 19.4 0.97 13.2 1.80 14.4 0.97 Do you believe that the term “obstetric violence” criminalize health professionals? No 82.7 5.69 0.677 23.3 1.98 0.774 0.809 1.64 0.809 19.0 1.37 0.734 12.4 2.01 0.284 13.9 1.47 0.484 Yes 83.1 5.55 23.0 2.48 14.6 0.69 19.0 1.24 12.7 2.02 13.8 1.39 During your training. were you taught to practice or be complicit in obstetric violence? No 83.0 5.45 0.887 23.3 2.00 0.785 14.4 1.07 0.925 19.1 1.31 0.281 12.6 1.94 0.587 13.7 1.57 0.041 Yes 82.7 5.93 23.1 2.34 14.2 1.83 18.9 1.36 12.4 2.12 14.1 1.19 Have you witnessed obstetric violence during your training? No 82.1 5.96 0.243 23.0 2.21 0.615 14.3 1.22 0.244 19.0 1.39 0.608 12.6 1.78 0.850 13.2 1.53 < 0.001 Yes 83.2 5.48 23.2 2.12 14.4 1.51 19.0 1.31 12.5 2.11 14.1 1.32 Have you ever felt forced or pressured to carry out practices you perceived as violent? No 82.7 5.53 0.517 23.2 2.11 0.856 14.3 1.14 0.283 19.0 1.44 0.641 12.5 1.85 0.911 13.6 1.48 0.028 Yes 83.0 5.76 23.2 2.18 14.3 1.65 19.0 1.23 12.4 2.16 14.0 1.38 a U Mann-Whitney test DISCUSSION According to the reviewed literature, no Spanish version of the SPRMC scale currently exists. Therefore, this study conducted a translation and cultural adaptation of the SPRMC scale to the Spanish context and evaluated its psychometric properties. The results indicated that the Spanish version of the SPRMC scale 4 , named CUMARE, is a valid and reliable instrument for assessing the perceptions of respectful maternal care among Spanish nursing students. The reliability analysis showed adequate internal consistency, with no significant increased observed when any item was removed. The items considered for removal were the same as those excluded in previous local adaptation of the scale 9 . Therefore, the items: “I have so much work that I cannot greet each woman kindly” and “Women during childbirth need a space free from unnecessary interruptions” were retained out of respect for the original version. The original SPRMC scale obtained a total of 3 factors: Respectful care, Safety & Comfort and Supportive care. However, the Spanish adaptation obtained 5 factors through exploratory factor analysis. This difference may be associated with sociocultural, contextual and healthcare system differences between countries in which each study was conducted (Nepal and Spain). The first three factors in the Spanish version align with those of the original and account for the highest variance. On the other hand, the emergence of two new factors labelled as “Safe space” and “lack of respect and autonomy” may reflect unique aspects of maternity care experiences in the Spanish healthcare system. Despite these differences, all identified dimensions are consistent with frameworks highlighted in the RCM literature 3 , 24 , 25 . It seems like in spite of the availability of existing tools, analysis reveals significant methodological and psychometric discrepancies among instruments measuring respectful maternity care 26 . This disparity may hinder the ability to measure and compare research findings across different contexts. Therefore, adapting already established tools may offer advantages over developing new ones from scratch 27 . On this matter, further work on confirmatory factor analysis of the CUMARE tool appears beneficial. Although multicomponent interventions; those involving structural changes, staff training, and community engagement, appear most effective in implementing RMC frameworks, the training, attitudes, behaviours, and motivation of healthcare professionals continue to play a crucial role in achieving steady change 28 . Future studies in the Spanish context could evaluate the outcome of educational interventions CUMARE, as has been done in other settings 7 , 29 . Regarding comparative results, having personal experience through pregnancy and/or childbirth plays a key role in shaping perceptions related to obstetric care—an observation also made in previous studies on obstetric violence 30 , 31 . On the other hand, some authors state that disrespect and abuse during childbirth is equivalent to obstetric violence 7 . From our perspective, although there is some overlap between the two concepts, there are also important distinctions that must be acknowledged. Both concepts highlight harmful practices in obstetric care and can have negative consequences for women’s health, violating fundamental human rights. Nevertheless, obstetric violence is a concept rooted in feminist and human rights movements, with political and legal implications, whereas disrespect and abuse stems from a more academic perspective. Additionally, obstetric violence is framed as a form of gender-based violence, involving systemic oppression and structural inequality perpetuated by the medical-patriarchal system. It is closely linked to reproductive rights, feminism, and women’s autonomy. In contrast, disrespect and abuse is a more neutral term lacking legal recognition, though it can still inform health policy design 32 . Therefore, while the concepts share some elements, they are not equivalent from conceptual, feminist, or political perspectives. They can coexist and both require measurement and accountability through validated tools. In this sense, the use of tools that assess perceptions of RMC, as CUMARE, and the perception of obstetric violence like PercOV-S 33 in a supplementary way may offer a deeper and nuanced vision of obstetric care. Providing reflexion on both positive aspects related to respectful practices as the negative experienced related to violence. Furthermore, this dual approach may ease a better comprehension of the contextual, structural, and relational factors that influence the quality of maternity care, thereby supporting the design of more holistic interventions aimed at transforming the care model from a human rights and equity perspective, as suggested by other authors 34 . Some of the findings in this study point in that direction; however, future research should address this issue in greater depth. This study presents several limitations that should be considered when interpreting its findings. First, the sample was selected though non-probability convenience sampling, which may limit the generalizability of the results. Although an adequate sample size was achieved for psychometric analyses, most participants were women with prior training in health-related fields, which may have contributed to greater sensitivity toward respectful maternity care. Second, although established methodological guidelines for cross-cultural adaptation of instruments were followed, a confirmatory factor analysis was not conducted to validate the resulting factorial structure. This represents an opportunity for future research. Additionally, as the tool measures perceptions, the potential presence of social desirability or response bias cannot be ruled out. A potential limitation of the study is the heterogeneity of the participants' academic and professional profiles. However, all individuals were exposed to the same training on sexual and reproductive rights in a controlled academic setting, justifying their joint inclusion in the analysis. One potential methodological limitation is that the sample size criterion used was based on the traditional rule of participants per item, which has been questioned in recent years. However, the sample size achieved exceeds the minimum suggested by various previous guidelines and allows for exploratory analyses with a reasonable basis of confidence. Despite these limitations, the study successfully achieved the cultural and psychometric adaptation of a tool for measuring perceptions of respectful maternity care in the Spanish academic context. Finally, the CUMARE scale is a valid and reliable tool. In educational settings, CUMARE can be used as a resource for training in ethical, communication, and person-centred care competencies in health-related degree programs such as Nursing, Medicine, or Midwifery. Its application as a pedagogical tool would encourage students to critically reflect on the care provided and facilitate a structured analysis of the elements that define respectful maternity care. From a clinical perspective, its systematic use can help identify areas for improvement in maternity care, particularly regarding respect, safety, support, and women’s autonomy. Furthermore, the scale could be integrated into continuing professional development programs for healthcare providers, promoting an institutional culture oriented toward respect and the protection of sexual and reproductive rights. CONCLUSIONS The cultural adaptation and Spanish translation of the Student Perceptions of Respectful Maternity Care (SPRMC) instrument has resulted in the CUMARE scale. A valid and reliable tool for assessing perceptions of respectful maternity care within Spanish academic settings. The resulting factorial structure, comprising 5 dimensions, reflects both elements shared with the original version and new categories relevant to de Spanish healthcare system, such as “Safe space” and “Lack of respect and autonomy”. Thus, CUMARE serves a useful instrument for evaluating the impact of educational programs aimed at promoting a maternity care model grounded in human rights and respect for women. Its implementation in training environments may contribute to raising student awareness and strengthening the paradigm of Respectful Maternity Care. Future research should include confirmatory factor analyses and explore the application of CUMARE in other educational and clinical contexts. In addition, its combined use with specific instruments on obstetric violence is recommended to provide a more holistic and critical vision of obstetric care, making easier the design of transformative interventions from a feminist, equity-based and human-rights oriented approach. Declarations Acknowledgements: We would like to express our deepest gratitude to all the nursing students who voluntarily participated in this study and generously shared their knowledge. Their contributions are invaluable for training future nurses in respectful, compassionate, and woman-centred maternity care. Funding sources: This study is part of a research project funded by the Women’s Institute (Ministry of Equality, Government of Spain) under the 2023 Call for Grants for Feminist Research (Grant Code: 07-2-ID23). Additional financial support was provided by the Universitat Jaume I (Grant Code: GACUJIMB-2024-02). Author contributions: Marisol MEJUTO-PREGO: Conceptualization; investigation; writing – original draft; methodology; validation; visualization; writing – review and editing; data curation. Desirée MENA-TUDELA (corresponding author): Conceptualization; Methodology; investigation; methodology; writing – original draft; formal analysis; visualization; writing – review and editing; supervision; validation; project administration; resources. Data availability statement: Dataset available on request from the authors. Additional Information (including a Competing Interests Statement): The authors declare that there are no conflicts of interest related to this manuscript. References World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth . World Health Organization (2015). doi:WHO/RHR/14.23. White Ribbon Alliance. The Universal Rights of Childbearing Women. Washington, DC. (2011). Cantor, A. G. et al. Respectful Maternity Care: A Systematic Review. Ann Intern. Med 177 , (2024). Dhakal, P., Gamble, J., Creedy, D. K. & Newnham, E. Development of a tool to assess students’ perceptions of respectful maternity care. Midwifery 105 , 103228 (2022). Martínez-García, E. et al. Good practices in perinatal bereavement care in public maternity hospitals in Southern Spain. Midwifery 124 , (2023). Mira-Catalá, P., Hernández-Aguado, I. & Chilet-Rosell, E. Respectful maternity care interventions to address women mistreatment in childbirth: What has been done? BMC Pregnancy Childbirth . 24 , 1–11 (2024). Dhakal, P., Creedy, D. K., Gamble, J., Newnham, E. & McInnes, R. Educational interventions to promote respectful maternity care: A mixed-methods systematic review. Nurse Educ. Pract. 60 , 103317 (2022). Chen, L. L. et al. Development and psychometric testing of the Perception of Childbirth Environment Scale in Taiwan. Midwifery 140 , 104215 (2025). Çamlibel, M. & Uludağ, E. The Turkish version of the students’ perceptions of respectful maternity care scale: An assessment of psychometric properties. Nurse Educ. Pract 70 , (2023). Huang, J. et al. Exposure to disrespectful maternity care and perceptions of respectful maternity care among nursing and midwifery pre-registration students in China: A national cross-sectional study. Nurse Educ. Pract 78 , (2024). AbdElAziz ElShora, S. N., Osman, A., Abd Elnabi, H., Dwedar, L. M. & M. M. E. & Effect of Respectful Maternity Care Educational Program on the Perception of Internship Nursing Students. Tanta Sci. Nurs. J. 31 , 34–50 (2023). Dhakal, P. et al. Midwifery and nursing students’ perceptions of respectful maternity care and witnessing of disrespect and abuse: A comparative study from Nepal and Jordan. Midwifery 112 , 103426 (2022). Mokkink, L. B., Prinsen, C. A. C., Bouter, L. M., de Vet, H. C. W. & Terwee, C. B. The COnsensus-based standards for the selection of health measurement INstruments (COSMIN) and how to select an outcome measurement instrument. Brazilian J. Phys. Ther. 20 , 105–113 (2016). Sousa, V. D. & Rojjanasrirat, W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. J. Eval Clin. Pract. 17 , 268–274 (2011). Polit, D. F., Beck, C. T. & Owen, S. V. Is the CVI an Acceptable Indicator of Content Validity? Res. Nurs. Health . 30 , 459–467 (2007). 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Psychometric properties of a scale: internal consistency. Rev. Salud pública . 10 , 831–839 (2008). Hazra, A. & Gogtay, N. Biostatistics Series Module 6: Correlation and Linear Regression. Indian J. Dermatol. 61 , 593–601 (2016). Miller, S. et al. Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. Lancet 388 , 2176–2192 (2016). Moridi, M., Pazandeh, F., Hajian, S. & Potrata, B. Midwives’ perspectives of respectful maternity care during childbirth: A qualitative study. PLoS One . 15 , 1–12 (2020). Dhakal, P., Gamble, J., Creedy, D. K. & Newnham, E. Quality of measures on respectful and disrespectful maternity care: A systematic review. Nurs. Heal Sci. 23 , 29–39 (2021). Beaton, D. E., Bombardier, C., Guillemin, F. & Ferraz, M. B. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine (Phila. Pa. ). 25, 3186–3191 (2000).). 25, 3186–3191 (2000). (1976). Kasaye, H., Sheehy, A., Scarf, V. & Baird, K. The roles of multi-component interventions in reducing mistreatment of women and enhancing respectful maternity care: a systematic review. BMC Pregnancy Childbirth . 23 , 1–19 (2023). Dhakal, P., Creedy, D. K., Gamble, J., Newnham, E. & McInnes, R. Effectiveness of an online education intervention to enhance student perceptions of Respectful Maternity Care: A quasi-experimental study. Nurse Educ. Today . 114 , 105405 (2022). Mena-Tudela, D. et al. Changes in health sciences students’ perception of obstetric violence after an educational intervention. Nurse Educ. Today . 88 , 104364 (2020). Mena-Tudela, D. et al. Perception of obstetric violence in a sample of Spanish health sciences students: A cross-sectional study. Nurse Educ. Today 110 , (2022). Williams, C. R. & Meier, B. M. Ending the abuse: the human rights implications of obstetric violence and the promise of rights-based policy to realise respectful maternity care. Sex Reprod. Heal Matters 27 , (2019). Mena-Tudela, D., Cervera-Gasch, Á., Alemany-Anchel, M. J., Andreu-Pejó, L. & González-Chordá, V. M. Design and Validation of the PercOV-S Questionnaire for Measuring Perceived Obstetric Violence in Nursing, Midwifery and Medical Students. Int. J. Environ. Res. Public. Health . 17 , E8022 (2020). Hajizadeh, K. et al. The psychometric properties of the respectful maternity care (RMC) for an Iranian population. BMC Health Serv. Res. 20 , 1–7 (2020). Additional Declarations No competing interests reported. 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This treatment not only violates women's right to respectful care but may also threaten their rights to life, health, physical integrity, and non-discrimination\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Mounting evidence reveals a concerning global pattern of disrespectful, abusive, or neglectful intrapartum care\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e, making Respectful Maternity Care (RMC) the primary strategy for improving reproductive health services\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eRMC is defined as a perinatal care approach grounded in human rights and reproductive justice, promoting women's dignity, autonomy, individuality, and preferences. This model actively seeks to prevent mistreatment and provides a practical paradigm for maternity care\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e, encompassing core elements such as autonomy, informed consent, privacy, person-centred communication, shared decision-making, dignity, safety, and justice\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eHowever, despite its relevance, RMC remains a relatively unexplored area in the Spanish healthcare literature and context, particularly in relation to professional training. In spite of the clear deficiencies among nursing and midwifery professionals who provide obstetric care in our country\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Nevertheless, promising interventions exist where such training stands out as the most effective strategy\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e, highlighting the need for rigorous evaluation of these programs.\u003c/p\u003e\u003cp\u003eThe training and education of healthcare professionals and future healthcare practitioners appear to play a fundamental role in facilitating the much-needed paradigm shift in obstetric care, directly influencing Respectful Maternity Care (RMC)\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Similarly, the World Health Organization (WHO) emphasizes the necessity for interventions to drive behavioural changes among healthcare professionals, transform clinical environments, and reform health systems. These actions are essential to ensure all women have access to respectful, competent, and person-centred care services\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Therefore, the availability of validated tools to measure the effectiveness of training programs is crucial.\u003c/p\u003e\u003cp\u003eThus, the Student Perceptions of Respectful Maternity Care (SPRMC) tool was developed to assess nursing students\u0026rsquo; perceptions of respectful maternity care\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. It has also been widely used across various countries\u003csup\u003e\u003cspan additionalcitationids=\"CR9 CR10 CR11\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. The SPRMC is an 18-item instrument measured on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), and is structured around three factors explaining 37.44% of the variance: Factor 1 \u0026ndash; Respectful Care (10 items), Factor 2 \u0026ndash; Safety and Comfort (5 items), and Factor 3 \u0026ndash; Supportive Care (3 items). The internal consistency showed a good Cronbach\u0026rsquo;s alpha of 0.81 for the total scale, 0.81 for the Respectful Care subscale, 0.69 for Safety and Comfort, and 0.62 for Supportive Care. Test-retest reliability after one week was confirmed by a Pearson correlation coefficient (r\u0026thinsp;=\u0026thinsp;0.91, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The total score is calculated by summing the raw scores of all items, taking into account that items 1 to 10 are reverse-worded. The total score ranges from 18 to 90 points, with higher scores indicating greater perceived respectful care\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eBased on the above, the aim of the present study was to culturally adapt and translate the Student Perceptions of Respectful Maternity Care (SPRMC) instrument\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e for the Spanish context.\u003c/p\u003e"},{"header":"MATERIAL AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eDesign\u003c/h2\u003e\u003cp\u003eFor this study, a cultural adaptation and translation of the Student Perceptions of Respectful Maternity Care (SPRMC) instrument into the Spanish context was conducted. Key steps for cultural and linguistic adaptation followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e, a specific methodological standard for evaluating measurement instruments in health and psychological research.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eTranslation and scale adaptation\u003c/h3\u003e\n\u003cp\u003eFirst, we contacted the original questionnaire author to request permission for translation and adaptation. Subsequently, the SPRMC scale was translated into Spanish using guidelines for healthcare translation and cross-cultural adaptation to achieve equivalence between original and translated versions\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. In the translation and cultural adaptation phase of the instrument, a professional bilingual translator with experience in health and gender terminology was responsible for performing the direct translation from English to Spanish. Subsequently, the research team\u0026mdash;composed of experts in maternal health, sexual and reproductive rights, and research methodology\u0026mdash;conducted a thorough review of the translated items, ensuring the semantic, conceptual, and cultural equivalence of the items with respect to the original version. Although the classic procedure of double translation and back-translation suggested by Sousa and Rojjanasrirat\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e was not followed, rigorous internal review controls were implemented, which allowed maintaining the fidelity of the content of the original instrument in the new linguistic and cultural context. Thus, the process included a critical evaluation by experts in reproductive health and psychometry, aimed at identifying and correcting possible linguistic ambiguities or cultural inadequacies. These strategies allowed for the implementation of rigorous quality controls. The original English and preliminary Spanish versions are available as Supplementary Note 1 and 2.\u003c/p\u003e\n\u003ch3\u003eValidation\u003c/h3\u003e\n\u003cp\u003eA focus group of 5 experts (3 scale-validation researchers and 2 mothers close to the research team) evaluated item relevance for respectful maternity care\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. The experts scored each item as \"Not at all adequate\" (1), \"Somewhat adequate\" (2); \"Adequate\" (3) and \"Very adequate\" (4) as well as the names of the factors of the SPRMC scale. Items reaching consensus were retained; others were revised per expert suggestions and re-evaluated. Content Validity Index (CVI) was calculated per Polit and Beck\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e for items and overall scale. Inter-expert agreement was measured using modified Kappa; values\u0026thinsp;\u0026gt;\u0026thinsp;0.74 were considered excellent\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. The questionnaire was modified per expert suggestions.\u003c/p\u003e\n\u003ch3\u003eSample size\u003c/h3\u003e\n\u003cp\u003eAll study participants were enrolled in a university course on sexual and reproductive rights, offered by the Universitat Jaume I as part of their academic and/or continuing education in health sciences. While part of the group was made up of undergraduate university students, other participants were already working as health professionals and were taking the program as part of their continuing education. Since they were all actively involved in the same educational environment and participated in the course as students, they were considered a relevant and homogeneous population for the purposes of the study, which focused on analysing perceptions generated in an academic training context on respectful care in maternity.\u003c/p\u003e\u003cp\u003eThe sample size was determined following the methodological recommendations of Anthoine et al\u003csup\u003e18\u003c/sup\u003e. According to Anthoine et al.\u003csup\u003e18\u003c/sup\u003e, for instrument validation studies, a sample size of between 5 and 10 participants per item is suggested. Since the instrument has 18 items, a target range of 90 to 180 participants was established. The final sample of 209 participants exceeded this threshold, thus meeting the minimum criteria used to perform an exploratory factor analysis (EFA)\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Non-probabilistic convenience sampling was used, administering questionnaires (sociodemographic/obstetric variables and SPRMC-Spanish) to students enrolled in a sexual/reproductive rights course at a Spanish public university (September\u0026ndash;December 2024). Questionnaires with \u0026gt;\u0026thinsp;10% missing items were excluded.\u003c/p\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eDescriptive analysis included means, SDs, and 95% CIs for quantitative variables, and absolute frequencies/percentages for qualitative variables. Construct validity was assessed via Exploratory Factor Analysis (EFA)\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. Kaiser-Meyer-Olkin (KMO) index and Bartlett\u0026rsquo;s sphericity test confirmed factor analysis applicability. EFA used Minimum Residual extraction with Oblimin rotation. Factor loadings\u0026thinsp;\u0026gt;\u0026thinsp;0.4 retained items in a given factor, based on parallel analysis\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eInternal consistency of subscales and total scale was evaluated using McDonald\u0026rsquo;s ω, as the measurement scale was ordinal. Values between 0.7\u0026ndash;0.9 indicate adequate internal consistency \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. In order to make the results of this study comparable with preliminary studies, Cronbach's α was also calculated.\u003c/p\u003e\u003cp\u003eRelationships between total scale and its factors were examined using Spearman\u0026rsquo;s correlation coefficient to assess structural coherence. Correlations of 0.50\u0026ndash;0.70 were considered good, and \u0026gt;\u0026thinsp;0.7 were regarded as strong\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. Bivariate analyses assessed effects of sociodemographic/control variables on scale scores. Mann-Whitney U tests were used when Kolmogorov-Smirnov normality assumptions were violated. Statistical analysis was performed using Excel and Jamovi v.2.3.28, with significance at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eEthical considerations\u003c/h2\u003e\u003cp\u003eThis study was conducted in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 7 April 2016 on the protection of natural persons, the Spanish Organic Law 3/2018 of 5 December on Personal Data Protection and Digital Rights Guarantee, and the principles of the Declaration of Helsinki. The study was approved by the Human Research Ethics Committee of the Universitat Jaume I (code: CEISH/127/2023). Students provided written informed consent after being informed of the research purpose. Participation was voluntary, and ethical standards were upheld throughout.\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003eSample description\u003c/h2\u003e\u003cp\u003eFor the analysis of these results, a total of 219 questionnaires were obtained. Of these, 4.56% (n\u0026thinsp;=\u0026thinsp;10) were excluded for being incomplete by more than 10%. The final sample consisted of 209 questionnaires. The mean age was 30.7 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;9.63; Minimum\u0026thinsp;=\u0026thinsp;18; Maximum\u0026thinsp;=\u0026thinsp;55) years, and 95.2% (n\u0026thinsp;=\u0026thinsp;199) were women. A total of 71.4% (n\u0026thinsp;=\u0026thinsp;142) were healthcare professionals and 28.6% (n\u0026thinsp;=\u0026thinsp;57) were university students. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the descriptive characteristics of the sample.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDescriptive results of the study (n\u0026thinsp;=\u0026thinsp;209).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWoman\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e95.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you ever been pregnant? (n\u0026thinsp;=\u0026thinsp;199)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e70.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e29.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you ever give birth? (n\u0026thinsp;=\u0026thinsp;62)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e91.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you personally experienced obstetric violence?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e69.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e30.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you ever witnessed a woman giving birth?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e23.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e161\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e77.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eClinical experience in gynaecology and obstetrics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e78.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eDuring your clinical experience, have you seen a woman suffer obstetric violence? (n\u0026thinsp;=\u0026thinsp;165)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e64.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaybe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWere all the women you encountered during your clinical experience treated in the same way? (n\u0026thinsp;=\u0026thinsp;165)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e133\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e68.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e31.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDuring your academic training, have you received education with a gender perspective?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e29.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e148\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e70.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDo you consider your training with a gender perspective to be sufficient?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e69.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e30.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eDuring obstetric care, are women judged for their feelings\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e157\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e79.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaybe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you heard of the concept \u0026ldquo;obstetric violence\u0026rdquo;?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e194\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e92.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDo you consider yourself sufficiently trained in obstetric violence?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e170\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e82.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eThe term \"obstetric violence\" criminalize healthcare professionals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e69.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e30.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDuring your training, were you taught to practice or be complicit in obstetric violence?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e59.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e40.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you ever felt forced or pressured to carry out practices you perceived as violent?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e101\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e48.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e51.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you witnessed obstetric violence during your training?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e31.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e65.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eValidation\u003c/h2\u003e\u003cp\u003eThe expert group evaluated each item and minor changes were introduced to 15 of the 18 items, resulting in the final version as comparatively shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e; achieving an overall content validity index greater than 0.74.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eContent validity results of the \u0026ldquo;Student Perceptions of Respectful Maternity Care (SPRMC)\u0026rdquo; scale after consensus with native translators.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdapted version\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFinal version\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eI-CVI*\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePc**\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eK***\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1.Es necesario rega\u0026ntilde;ar a una mujer si no coopera con el personal sanitario. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnchanged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2.Estoy de acuerdo en que las mujeres deber\u0026iacute;an \"dejar su dignidad en la puerta\", ya que, dar a luz no tiene nada de privado. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2. Estoy de acuerdo en que las mujeres deber\u0026iacute;an \"dejar su dignidad fuera\", ya que, el parto no tiene nada de privado. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3.La confidencialidad es dif\u0026iacute;cil de mantener en la atenci\u0026oacute;n a la maternidad. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3. Es dif\u0026iacute;cil mantener la confidencialidad en la atenci\u0026oacute;n a la maternidad. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4.Estoy demasiado ocupado para saludar a todas las mujeres con una sonrisa. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4. Tengo tanto trabajo que no puedo saludar a cada mujer con una sonrisa. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5.Procedimientos rutinarios como el tacto vaginal y la palpaci\u0026oacute;n abdominal no requieren permiso. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5. Procedimientos rutinarios como el examen vaginal y la exploraci\u0026oacute;n abdominal no requieren permiso. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6.Las creencias culturales de las mujeres son tan variadas que no se puede esperar que el personal las tenga todas en cuenta. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnchanged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7.No tiene sentido dar todos los detalles sobre los procedimientos de parto porque algunas mujeres no lo entender\u0026aacute;n. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7. Dar todos los detalles sobre los procedimientos de parto no tiene sentido porque algunas mujeres no los entender\u0026aacute;n. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8.A menudo estoy demasiado ocupado para ofrecer opciones de parto a las mujeres. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8. A menudo tengo tanto trabajo durante el parto que no puedo ofrecer opciones a las mujeres. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9.A menudo es dif\u0026iacute;cil mantener un entorno tranquilo para las mujeres durante el parto. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9. Frecuentemente, es dif\u0026iacute;cil mantener un ambiente tranquilo para las mujeres durante el parto. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10.Si las mujeres no cuidan de su propia salud, no deben esperar el mismo trato que las dem\u0026aacute;s. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10. Si las mujeres no cuidan de su propia salud, no deben esperar el mismo cuidado que a las dem\u0026aacute;s. (R)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11.Las mujeres de parto necesitan un espacio libre de molestias innecesarias.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11. Las mujeres durante el parto necesitan un espacio libre de interrupciones innecesarias.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12.Tengo la responsabilidad de ayudar a las mujeres a sentirse seguras durante el parto.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnchanged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13.Intento limitar la exposici\u0026oacute;n del cuerpo de la mujer cuando la atiendo.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13. Intento preservar la intimidad del cuerpo de la mujer mientras la cuido.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14.Escuchar activamente las historias de las mujeres valora sus experiencias.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14. Al escuchar activamente las historias de las mujeres valoras sus experiencias.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15.Explico a la mujer los beneficios y los riesgos antes de cualquier intervenci\u0026oacute;n.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15. Explico a la mujer los beneficios y los riesgos antes de cualquier procedimiento.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16.Debe animarse a las mujeres a participar activamente en su atenci\u0026oacute;n.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16. Se debe animar a las mujeres a participar activamente en sus cuidados.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17.Todas las mujeres deben recibir el apoyo que necesitan para la lactancia.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17. Cada mujer deber\u0026iacute;a recibir el apoyo que necesita con la lactancia materna.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18.Hay que animar a las mujeres a hablar con otras mujeres pu\u0026eacute;rperas sobre sus experiencias.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18. Hay que animar a las mujeres a hablar con otras mujeres sobre sus experiencias de maternidad.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e*I-CVI: Item-level Content Validity Index\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e**Pc: Probability of chance agreement\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e***K: Modified Kappa Index\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eKMO (0.768) and Bartlett (χ\u0026sup2; = 890; p\u0026thinsp;\u0026le;\u0026thinsp;0.001) confirmed the feasibility of factor analysis. Thus, exploratory factor analysis yielded a total of 41.1% of the explained variance in 5 factors for the SPRMC scale, as observed in the scree plot (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The distribution of total variance explained by each factor was relatively equitable: Factor 1\u0026thinsp;=\u0026thinsp;10.73%, Factor 2\u0026thinsp;=\u0026thinsp;9.08%; Factor 3\u0026thinsp;=\u0026thinsp;7.75%; Factor 4\u0026thinsp;=\u0026thinsp;6.91% and Factor 5\u0026thinsp;=\u0026thinsp;6.59% of the explained variance. Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the factor matrix for each item, presenting factor loadings and item distribution across the factors suggested by exploratory factor analysis. Additional analyses indicated that the obtained model had good overall fit (RMSEA\u0026thinsp;=\u0026thinsp;0.0399; 90% CI of RMSEA\u0026thinsp;=\u0026thinsp;0.0137\u0026ndash;0.0599; TLI\u0026thinsp;=\u0026thinsp;0.929; BIC = -292; χ\u0026sup2; = 97.6; df\u0026thinsp;=\u0026thinsp;73; p\u0026thinsp;=\u0026thinsp;0.029).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactor matrix of each item\u003csup\u003ea\u003c/sup\u003e, showing the factor loadings and the distribution of items within each factor suggested by the exploratory factor analysis.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eItems\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e\u003cp\u003eFactors\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eScolding a woman is necessary if she does not cooperate with health care providers.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.607\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI agree that women should \u0026ldquo;leave their dignity at the door\u0026rdquo; as there is nothing private about giving birth.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.627\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConfidentiality is hard to maintain in maternity care.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.337\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI am too busy to greet every woman with a smile.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.290*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRoutine procedures like vaginal examination and abdominal palpation do not require permission.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.571\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWomen\u0026rsquo;s cultural beliefs are so varied that staff cannot be expected to accommodate them all.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.707\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThere is no point providing all the details about birth procedures because some women will not understand.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.615\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI am often too busy to provide birth options to women.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.663\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIt is often hard to keep a calm environment for women during labour.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.633\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIf women do not look after their own health, they should not expect the same treatment as others.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.503\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLabouring women need a birth space free from unnecessary disturbance by others.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.229*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI have a responsibility to help women feel safe during labour and birth.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.731\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI try to limit exposing a woman\u0026rsquo;s body when providing care.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.835\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eActively listening to women\u0026rsquo;s stories values their experiences.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.447\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI explain benefits and risks to a woman before any procedure.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.408\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWomen should be encouraged to actively participate in their care.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.711\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEvery woman should receive support she needs with breastfeeding.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.443\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWomen should be encouraged to talk to other postpartum women about their experiences.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.343\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003ea\u003c/sup\u003e factor loadings above 0.3\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e*The weighting of this item was calculated to determine which factor had the greatest influence.\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe internal consistency of the total scale measured by McDonald's ω showed an overall value of 0.812, indicating adequate internal consistency, which did not increase significantly when removing any item (Supplementary Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e). For each factor, internal consistency was: Respectful Care\u0026thinsp;=\u0026thinsp;0.736; Safety and Comfort\u0026thinsp;=\u0026thinsp;0.740; Supportive Care\u0026thinsp;=\u0026thinsp;0.632; Safe Space\u0026thinsp;=\u0026thinsp;0.548; Disrespect and Autonomy\u0026thinsp;=\u0026thinsp;0.617. Cronbach's α yielded an overall result of 0.761, indicating a good level of reliability; it will not improve if any item is removed.\u003c/p\u003e\u003cp\u003eRegarding the correlation between the total scale and its factors, all correlations were statistically significant, with a strong relationship observed between \"Respectful Care\" and \"Safe Space\" with the total scale. A good correlation was also observed between the total scale and the factors \"Safety and Comfort\", \"Supportive Care\" and \"Disrespect and Autonomy\". These results suggest that all highlighted correlations are positive with \"Respectful Care\" and \"Safe Space\" being the strongest, while although \"Safety and Comfort\" is weaker, it remains significant (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation matrix between the total scale score and its factors\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal scale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRespectful care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSafety and comfort\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSupportive care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSafe space\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eLack of respect and autonomy\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal scale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRespectful care\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.801***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSafety and comfort\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.544***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.399***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSupportive care\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.565***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.406***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.371***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSafe space\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.755***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.397***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.246***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.285***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLack of respect and autonomy\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.652***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.483***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.292***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.245***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.334***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eSpearman\u0026rsquo;s Rho *** p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eFinal scale and interpretation\u003c/h2\u003e\u003cp\u003eOnce the factors and item distribution were calculated, the total scale had a maximum score of 90 points and a minimum score of 18 points. The item and factor distribution is presented in Supplementary Note 3.\u003c/p\u003e\u003cp\u003eFor the \"Respectful Care\" factor, a maximum score of 25 points and a minimum of 5 points were established. For the \"Safety and Comfort\" factor, the maximum score was 15 points and the minimum 3. For \"Supportive Care\", a maximum score of 20 points and a minimum of 4 were set. For \"Safe Space\", a maximum score of 15 points and a minimum of 3 were determined. And for the \"Disrespect and Autonomy\" factor, a maximum score of 15 points and a minimum of 3 were established. Thus, a higher score for the total scale, as well as for each factor, indicates a greater perception of respectful maternity care. Finally, the name given to this scale was: Perception of Respectful Maternity Care (CUMARE).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eCUMARE scale results\u003c/h2\u003e\u003cp\u003eFor the CUMARE scale, a mean of 82.8 points (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;5.64; Maximum: 90; Minimum: 65) was obtained for the total. Results for each factor were: Respectful Care\u0026thinsp;=\u0026thinsp;23.2 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14; Maximum: 25; Minimum: 13) points; Safety and Comfort\u0026thinsp;=\u0026thinsp;14.3 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;1.43; Maximum: 15; Minimum: 3) points; Supportive Care\u0026thinsp;=\u0026thinsp;19 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;1.33; Maximum: 20; Minimum: 12) points; Safe Space\u0026thinsp;=\u0026thinsp;12.5 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;2.01; Maximum: 15; Minimum: 7) points; Disrespect and Autonomy\u0026thinsp;=\u0026thinsp;13.8 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;1.44; Maximum: 15; Minimum: 9) points.\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows statistically significant differences between the total CUMARE scale and its factors with the previously described sociodemographic and control variables. Participants who had a previous pregnancy showed significantly higher scores for the total CUMARE scale (p\u0026thinsp;=\u0026thinsp;0.011) and for the \"Supportive Care\" factor (p\u0026thinsp;=\u0026thinsp;0.036). Statistically significant differences were also found for the \"Disrespect and Autonomy\" factor (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with women who had experienced a pregnancy obtaining the highest scores.\u003c/p\u003e\u003cp\u003eHaving experienced obstetric violence personally showed higher scores for the total CUMARE scale (p\u0026thinsp;=\u0026thinsp;0.015) and the \"Disrespect and Autonomy\" factor (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Participants who felt sufficiently trained about obstetric violence obtained statistically significantly higher scores for the total CUMARE scale (p\u0026thinsp;=\u0026thinsp;0.002), the \"Safety and Comfort\" factor (p\u0026thinsp;=\u0026thinsp;0.030), \"Supportive Care\" (p\u0026thinsp;=\u0026thinsp;0.010), \"Safe Space\" (p\u0026thinsp;=\u0026thinsp;0.021), and \"Disrespect and Autonomy\" (p\u0026thinsp;=\u0026thinsp;0.005).\u003c/p\u003e\u003cp\u003eIt is noteworthy that no statistically significant differences were found in the total scale score or its factors, except for the \"Disrespect and Autonomy\" factor (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), based on whether feminist topics had been addressed in academic training.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eInferential analysis between the Percepci\u0026oacute;n sobre los cuidados respetuosos a la maternidad (CUMARE) scale, its factors, and sociodemographic and control variables.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"20\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c18\" colnum=\"18\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c19\" colnum=\"19\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c20\" colnum=\"20\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u003cp\u003eCUMARE scale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e\u003cp\u003eRespectful care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e\u003cp\u003eSafety and comfort\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c14\" namest=\"c12\"\u003e\u003cp\u003eSupportive care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c17\" namest=\"c15\"\u003e\u003cp\u003eSafe space\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c20\" namest=\"c18\"\u003e\u003cp\u003eLack of respect and autonomy\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003ep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c17\"\u003e\u003cp\u003ep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c18\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c19\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c20\"\u003e\u003cp\u003ep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.776\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.608\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.518\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.495\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.818\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.798\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWoman\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.45\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eYou are\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.556\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.902\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.624\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.775\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.370\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProfessional\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eHave you ever been pregnant? (n\u0026thinsp;=\u0026thinsp;199)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.239\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.138\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.036\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e84.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.92\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eHave you ever give birth? (n\u0026thinsp;=\u0026thinsp;62)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.350\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e24.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.437\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.196\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e13.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.702\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.528\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e84.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.88\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eObstetric violence in personal level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.071\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.719\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.148\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.219\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e84.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eHave you ever witnessed a woman giving birth?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e81.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.178\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.231\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.039\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.386\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.492\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.36\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eClinical experience in gynaecology and obstetrics\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e81.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.278\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.257\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.181\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.882\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.483\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDuring your academic training, have you received education with a gender perspective?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.141\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.191\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.393\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.49\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eHave you heard of the concept \u0026ldquo;obstetric violence\u0026rdquo;?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e79.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.260\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e13.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.818\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e11.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.169\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.43\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDo you consider yourself sufficiently trained in obstetric violence?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.030\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.021\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e13.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.97\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDo you believe that the term \u0026ldquo;obstetric violence\u0026rdquo; criminalize health professionals?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.677\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.774\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0.809\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.809\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.734\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.284\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.484\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.39\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDuring your training. were you taught to practice or be complicit in obstetric violence?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.887\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.785\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.925\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.281\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.587\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.041\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e18.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.19\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eHave you witnessed obstetric violence during your training?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.243\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.615\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.244\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.608\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.850\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eHave you ever felt forced or pressured to carry out practices you perceived as violent?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.517\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.856\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.283\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.641\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e1.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.911\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e13.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e2.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c18\"\u003e\u003cp\u003e14.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.38\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"20\"\u003e\u003csup\u003ea\u003c/sup\u003e U Mann-Whitney test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eAccording to the reviewed literature, no Spanish version of the SPRMC scale currently exists. Therefore, this study conducted a translation and cultural adaptation of the SPRMC scale to the Spanish context and evaluated its psychometric properties.\u003c/p\u003e\u003cp\u003eThe results indicated that the Spanish version of the SPRMC scale\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e, named CUMARE, is a valid and reliable instrument for assessing the perceptions of respectful maternal care among Spanish nursing students. The reliability analysis showed adequate internal consistency, with no significant increased observed when any item was removed. The items considered for removal were the same as those excluded in previous local adaptation of the scale\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Therefore, the items: \u0026ldquo;I have so much work that I cannot greet each woman kindly\u0026rdquo; and \u0026ldquo;Women during childbirth need a space free from unnecessary interruptions\u0026rdquo; were retained out of respect for the original version.\u003c/p\u003e\u003cp\u003eThe original SPRMC scale obtained a total of 3 factors: Respectful care, Safety \u0026amp; Comfort and Supportive care. However, the Spanish adaptation obtained 5 factors through exploratory factor analysis. This difference may be associated with sociocultural, contextual and healthcare system differences between countries in which each study was conducted (Nepal and Spain). The first three factors in the Spanish version align with those of the original and account for the highest variance. On the other hand, the emergence of two new factors labelled as \u0026ldquo;Safe space\u0026rdquo; and \u0026ldquo;lack of respect and autonomy\u0026rdquo; may reflect unique aspects of maternity care experiences in the Spanish healthcare system. Despite these differences, all identified dimensions are consistent with frameworks highlighted in the RCM literature\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIt seems like in spite of the availability of existing tools, analysis reveals significant methodological and psychometric discrepancies among instruments measuring respectful maternity care\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. This disparity may hinder the ability to measure and compare research findings across different contexts. Therefore, adapting already established tools may offer advantages over developing new ones from scratch\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. On this matter, further work on confirmatory factor analysis of the CUMARE tool appears beneficial.\u003c/p\u003e\u003cp\u003eAlthough multicomponent interventions; those involving structural changes, staff training, and community engagement, appear most effective in implementing RMC frameworks, the training, attitudes, behaviours, and motivation of healthcare professionals continue to play a crucial role in achieving steady change\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Future studies in the Spanish context could evaluate the outcome of educational interventions CUMARE, as has been done in other settings\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eRegarding comparative results, having personal experience through pregnancy and/or childbirth plays a key role in shaping perceptions related to obstetric care\u0026mdash;an observation also made in previous studies on obstetric violence\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. On the other hand, some authors state that disrespect and abuse during childbirth is equivalent to obstetric violence\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. From our perspective, although there is some overlap between the two concepts, there are also important distinctions that must be acknowledged. Both concepts highlight harmful practices in obstetric care and can have negative consequences for women\u0026rsquo;s health, violating fundamental human rights. Nevertheless, obstetric violence is a concept rooted in feminist and human rights movements, with political and legal implications, whereas disrespect and abuse stems from a more academic perspective.\u003c/p\u003e\u003cp\u003eAdditionally, obstetric violence is framed as a form of gender-based violence, involving systemic oppression and structural inequality perpetuated by the medical-patriarchal system. It is closely linked to reproductive rights, feminism, and women\u0026rsquo;s autonomy. In contrast, disrespect and abuse is a more neutral term lacking legal recognition, though it can still inform health policy design\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. Therefore, while the concepts share some elements, they are not equivalent from conceptual, feminist, or political perspectives. They can coexist and both require measurement and accountability through validated tools.\u003c/p\u003e\u003cp\u003eIn this sense, the use of tools that assess perceptions of RMC, as CUMARE, and the perception of obstetric violence like PercOV-S\u003csup\u003e33\u003c/sup\u003e in a supplementary way may offer a deeper and nuanced vision of obstetric care. Providing reflexion on both positive aspects related to respectful practices as the negative experienced related to violence. Furthermore, this dual approach may ease a better comprehension of the contextual, structural, and relational factors that influence the quality of maternity care, thereby supporting the design of more holistic interventions aimed at transforming the care model from a human rights and equity perspective, as suggested by other authors\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. Some of the findings in this study point in that direction; however, future research should address this issue in greater depth.\u003c/p\u003e\u003cp\u003eThis study presents several limitations that should be considered when interpreting its findings. First, the sample was selected though non-probability convenience sampling, which may limit the generalizability of the results. Although an adequate sample size was achieved for psychometric analyses, most participants were women with prior training in health-related fields, which may have contributed to greater sensitivity toward respectful maternity care. Second, although established methodological guidelines for cross-cultural adaptation of instruments were followed, a confirmatory factor analysis was not conducted to validate the resulting factorial structure. This represents an opportunity for future research. Additionally, as the tool measures perceptions, the potential presence of social desirability or response bias cannot be ruled out. A potential limitation of the study is the heterogeneity of the participants' academic and professional profiles. However, all individuals were exposed to the same training on sexual and reproductive rights in a controlled academic setting, justifying their joint inclusion in the analysis. One potential methodological limitation is that the sample size criterion used was based on the traditional rule of participants per item, which has been questioned in recent years. However, the sample size achieved exceeds the minimum suggested by various previous guidelines and allows for exploratory analyses with a reasonable basis of confidence. Despite these limitations, the study successfully achieved the cultural and psychometric adaptation of a tool for measuring perceptions of respectful maternity care in the Spanish academic context.\u003c/p\u003e\u003cp\u003eFinally, the CUMARE scale is a valid and reliable tool. In educational settings, CUMARE can be used as a resource for training in ethical, communication, and person-centred care competencies in health-related degree programs such as Nursing, Medicine, or Midwifery. Its application as a pedagogical tool would encourage students to critically reflect on the care provided and facilitate a structured analysis of the elements that define respectful maternity care. From a clinical perspective, its systematic use can help identify areas for improvement in maternity care, particularly regarding respect, safety, support, and women\u0026rsquo;s autonomy. Furthermore, the scale could be integrated into continuing professional development programs for healthcare providers, promoting an institutional culture oriented toward respect and the protection of sexual and reproductive rights.\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eThe cultural adaptation and Spanish translation of the Student Perceptions of Respectful Maternity Care (SPRMC) instrument has resulted in the CUMARE scale. A valid and reliable tool for assessing perceptions of respectful maternity care within Spanish academic settings. The resulting factorial structure, comprising 5 dimensions, reflects both elements shared with the original version and new categories relevant to de Spanish healthcare system, such as \u0026ldquo;Safe space\u0026rdquo; and \u0026ldquo;Lack of respect and autonomy\u0026rdquo;. Thus, CUMARE serves a useful instrument for evaluating the impact of educational programs aimed at promoting a maternity care model grounded in human rights and respect for women. Its implementation in training environments may contribute to raising student awareness and strengthening the paradigm of Respectful Maternity Care. Future research should include confirmatory factor analyses and explore the application of CUMARE in other educational and clinical contexts. In addition, its combined use with specific instruments on obstetric violence is recommended to provide a more holistic and critical vision of obstetric care, making easier the design of transformative interventions from a feminist, equity-based and human-rights oriented approach.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eWe would like to express our deepest gratitude to all the nursing students who voluntarily participated in this study and generously shared their knowledge. Their contributions are invaluable for training future nurses in respectful, compassionate, and woman-centred maternity care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding sources:\u0026nbsp;\u003c/strong\u003eThis study is part of a research project funded by the Women\u0026rsquo;s Institute (Ministry of Equality, Government of Spain) under the 2023 Call for Grants for Feminist Research (Grant Code: 07-2-ID23). Additional financial support was provided by the Universitat Jaume I (Grant Code: GACUJIMB-2024-02).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMarisol MEJUTO-PREGO: Conceptualization; investigation; writing \u0026ndash; original draft; methodology; validation; visualization; writing \u0026ndash; review and editing; data curation.\u003c/p\u003e\n\u003cp\u003eDesir\u0026eacute;e MENA-TUDELA (corresponding author): Conceptualization; Methodology; investigation; methodology; writing \u0026ndash; original draft; formal analysis; visualization; writing \u0026ndash; review and editing; supervision; validation; project administration; resources.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement:\u0026nbsp;\u003c/strong\u003eDataset available on request from the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdditional Information (including a Competing Interests Statement):\u0026nbsp;\u003c/strong\u003eThe authors declare that there are no conflicts of interest related to this manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. \u003cem\u003eThe prevention and elimination of disrespect and abuse during facility-based childbirth\u003c/em\u003e. \u003cem\u003eWorld Health Organization\u003c/em\u003e (2015). doi:WHO/RHR/14.23.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWhite Ribbon Alliance. The Universal Rights of Childbearing Women. Washington, DC. (2011).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCantor, A. G. et al. Respectful Maternity Care: A Systematic Review. \u003cem\u003eAnn Intern. Med\u003c/em\u003e \u003cb\u003e177\u003c/b\u003e, (2024).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDhakal, P., Gamble, J., Creedy, D. K. \u0026amp; Newnham, E. Development of a tool to assess students\u0026rsquo; perceptions of respectful maternity care. \u003cem\u003eMidwifery\u003c/em\u003e \u003cb\u003e105\u003c/b\u003e, 103228 (2022).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMart\u0026iacute;nez-Garc\u0026iacute;a, E. et al. 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Ther.\u003c/em\u003e \u003cb\u003e20\u003c/b\u003e, 105\u0026ndash;113 (2016).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSousa, V. D. \u0026amp; Rojjanasrirat, W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. \u003cem\u003eJ. Eval Clin. Pract.\u003c/em\u003e \u003cb\u003e17\u003c/b\u003e, 268\u0026ndash;274 (2011).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePolit, D. F., Beck, C. T. \u0026amp; Owen, S. V. Is the CVI an Acceptable Indicator of Content Validity? \u003cem\u003eRes. Nurs. Health\u003c/em\u003e. \u003cb\u003e30\u003c/b\u003e, 459\u0026ndash;467 (2007).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSquires, A. A valid step in the process: A commentary on Beckstead. \u003cem\u003eInt. J. Nurs. 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Items Psicothema\u003c/em\u003e \u003cb\u003e34\u003c/b\u003e, 7\u0026ndash;17 (2022).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWilliams, B., Onsman, A. \u0026amp; Brown, T. Exploratory Factor Analysis: A Five-Step Guide for Novices. \u003cem\u003eAustralas J. Paramed\u003c/em\u003e. \u003cb\u003e8\u003c/b\u003e, 1\u0026ndash;13 (2010).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLloret-Segura, S., Ferreres-Traver, A. \u0026amp; Hern\u0026aacute;ndez-Baeza, A. Tom\u0026aacute;s-Marco, I. El an\u0026aacute;lisis factorial exploratorio de los \u0026iacute;tems: Una gu\u0026iacute;a pr\u0026aacute;ctica, revisada y actualizada. \u003cem\u003ePsicol.\u003c/em\u003e \u003cb\u003e30\u003c/b\u003e, 1151\u0026ndash;1169 (2014).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCampo-Arias, A. \u0026amp; Oviedo, H. C. Psychometric properties of a scale: internal consistency. \u003cem\u003eRev. Salud p\u0026uacute;blica\u003c/em\u003e. \u003cb\u003e10\u003c/b\u003e, 831\u0026ndash;839 (2008).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHazra, A. \u0026amp; Gogtay, N. Biostatistics Series Module 6: Correlation and Linear Regression. \u003cem\u003eIndian J. Dermatol.\u003c/em\u003e \u003cb\u003e61\u003c/b\u003e, 593\u0026ndash;601 (2016).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMiller, S. et al. Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. \u003cem\u003eLancet\u003c/em\u003e \u003cb\u003e388\u003c/b\u003e, 2176\u0026ndash;2192 (2016).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMoridi, M., Pazandeh, F., Hajian, S. \u0026amp; Potrata, B. Midwives\u0026rsquo; perspectives of respectful maternity care during childbirth: A qualitative study. \u003cem\u003ePLoS One\u003c/em\u003e. \u003cb\u003e15\u003c/b\u003e, 1\u0026ndash;12 (2020).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDhakal, P., Gamble, J., Creedy, D. K. \u0026amp; Newnham, E. Quality of measures on respectful and disrespectful maternity care: A systematic review. \u003cem\u003eNurs. Heal Sci.\u003c/em\u003e \u003cb\u003e23\u003c/b\u003e, 29\u0026ndash;39 (2021).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBeaton, D. E., Bombardier, C., Guillemin, F. \u0026amp; Ferraz, M. B. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. \u003cem\u003eSpine (Phila. Pa.\u003c/em\u003e). 25, 3186\u0026ndash;3191 (2000).). 25, 3186\u0026ndash;3191 (2000). (1976).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKasaye, H., Sheehy, A., Scarf, V. \u0026amp; Baird, K. 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Health\u003c/em\u003e. \u003cb\u003e17\u003c/b\u003e, E8022 (2020).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHajizadeh, K. et al. The psychometric properties of the respectful maternity care (RMC) for an Iranian population. \u003cem\u003eBMC Health Serv. Res.\u003c/em\u003e \u003cb\u003e20\u003c/b\u003e, 1\u0026ndash;7 (2020).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Respectful Maternity Care, Abuse and Disrespect, Obstetric Violence, Nursing, Students","lastPublishedDoi":"10.21203/rs.3.rs-7939702/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7939702/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe quality of care provided during pregnancy, childbirth, and postpartum has a direct impact on maternal health and women's experiences.\u003c/p\u003e\u003ch2\u003eAim\u003c/h2\u003e\u003cp\u003eTo culturally adapt and translate the \"Student Perceptions of Respectful Maternity Care (SPRMC)\" instrument into the Spanish context.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eCultural adaptation was conducted through a translation-back-translation process and review by an expert panel. Subsequently, construct validity and internal consistency of the scale were evaluated. A study was performed with a sample of 209 students.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFactor analysis identified a five-factor structure: Respectful Care, Safety and Comfort, Supportive Care, Safe Space, and Disrespect and Autonomy, explaining 41.1% of total variance. The instrument's internal consistency was 0.812 measured through McDonald\u0026rsquo;s ω.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eResults support the validity and reliability of the Spanish version of SPRMC. This tool may be useful in practice as a resource for training in ethical, communicative, and woman-centred care competencies.\u003c/p\u003e","manuscriptTitle":"The Spanish version of the Student Perceptions of Respectful Maternity Care scale: Cultural adaptation and psychometric validation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-28 18:24:27","doi":"10.21203/rs.3.rs-7939702/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-12T23:40:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-12T13:44:24+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-04T15:04:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-02T23:01:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"205291158414014526236995294288156118853","date":"2025-12-02T11:30:05+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-01T16:10:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"238908116437454481401101030567002742002","date":"2025-11-29T07:49:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"23036068806537461745188304186157652033","date":"2025-11-27T11:53:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"252638990577962699639405889892488346223","date":"2025-11-27T11:23:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"196954837307184792045690411592292399881","date":"2025-11-27T11:20:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"310668399656269331563619302024277172066","date":"2025-11-26T23:05:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"191156959825998609288048176665872851622","date":"2025-11-26T08:41:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"34915186853516605836678456887293562968","date":"2025-11-25T14:21:05+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-25T13:14:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-25T12:55:12+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-31T13:43:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-29T07:20:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-10-29T06:55:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"14a0f7d7-bd92-4215-abd1-df256427ea40","owner":[],"postedDate":"November 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":58737188,"name":"Health sciences/Health care"},{"id":58737189,"name":"Health sciences/Medical research"},{"id":58737190,"name":"Biological sciences/Psychology"},{"id":58737191,"name":"Social science/Psychology"}],"tags":[],"updatedAt":"2025-12-30T06:39:24+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-28 18:24:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7939702","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7939702","identity":"rs-7939702","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}