Work

Medical Interventions and Women's Perceptions of Respectful Intrapartum Care: A National Survey‐Based Cohort Study

Year: 2025

Type: article

Abstract: OBJECTIVE: To investigate whether women's perceptions of respectful intrapartum care are influenced by the use of epidural, oxytocin, or episiotomy. DESIGN: National survey-based cohort study using data from the Swedish Pregnancy Survey 8 weeks postpartum (NPS-8) merged with Swedish Pregnancy Register (SPR) data. SETTING: Sweden, 2022-2023. POPULATION: Primiparous women with a singleton pregnancy, cephalic presentation, spontaneous onset of labour, a live fetus at ≥ 37 weeks gestation, and a vaginal birth. METHODS: Associations between respectful care and epidural analgesia, oxytocin, or episiotomy and their combinations were analysed using logistic regression to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). MAIN OUTCOME MEASURES: Four NPS-8 items assessing women's perceptions of being treated respectfully, receiving support, being informed, and being involved in decision-making during childbirth. RESULTS: Of 34 111 women, 20 363 (59.7%) responded, with the majority feeling respected during childbirth. Compared with women who had spontaneous vaginal births, those with instrumental births more frequently reported inadequate support (17.7% vs. 11.0%), insufficient information (25.1% vs. 16.2%), and lack of involvement in decision-making (29.2% vs. 17.1%). Among women with spontaneous vaginal births, those subjected to an episiotomy were less likely to report being involved in decision-making (77.8% vs. 83.8%; aOR 0.60, 95% CI 0.50-0.73). The combination of episiotomy and oxytocin was associated with the lowest adjusted odds of involvement in decision-making (77.0% vs. 84.6%; aOR 0.54, 95% CI 0.43-0.69). CONCLUSION: Women with spontaneous vaginal births were less likely to report being involved in decision-making when they underwent an episiotomy, or if oxytocin augmentation was followed by an episiotomy.

Source: BJOG An International Journal of Obstetrics & Gynaecology

DOI: 10.1111/1471-0528.18329

Authors: Karin Johnson, Charlotte Elvander, Kari Johansson, Sissel Saltvedt, Malin Edqvist

Institutions: Karolinska University Hospital, Karolinska Institutet

Language: English

Topic: Maternal and Perinatal Health Interventions

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Gender equality

Open Access status: hybrid

Estimated APC paid: $5,190