Women’s Experience of Obstetric Violence: A Grounded Theory Study of Perception Formation During Childbirth

Objective: Women formulate varying perceptions of obstetric interventions, examinations and other aspects of care such as birth positions. Our study explored women’s perception formation during childbirth in order to better understand factors that influence whether an obstetric situation is experienced as obstetric violence. Design: Grounded theory study of 12 narrative interviews. Setting: German obstetric hospital wards Participants 12 mothers who gave birth in a hospital maximum 12 months ago. Methods: Narrative interviews were conducted. Data collection, analysis and theory formation followed a circular process according to grounded theory. Main Outcome Measures A theoretical model explaining why women experience obstetric situations as violent or not. Results: Within our sample, experiences of obstetric violence were related to low situational sense of coherence which was influenced by the comprehensibility and manageability of the situation as well as further framing conditions (context, personal conditions, preceedings). The level of situational sense of coherence influenced whether an experience was appraised as violent or not. Positive experiences were connected to higher situational sense of coherence. Conclusions: If obstetricians and midwives understand the perception formation process and keenly and continuously consider women’s situational sense of coherence during childbirth, they may help to reduce the potential for obstetric violence and increase the satisfaction with the childbirth experience.