Evaluation of prevalence of obstetric violence and its associated factors: A meta-analysis study

This study was conducted to assess the prevalence and associated factors of obstetric violence experienced by women during pregnancy, labor, or the postpartum period. The study employed a meta-analysis approach and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was performed using predefined English keywords in the Web of Science, Scopus, CINAHL Ultimate, MEDLINE Ultimate, and OVID databases for studies published between 1 January 2007 and 31 December 2023. Study selection, quality assessment, and risk of bias assessment were conducted by two independent reviewers. We included 41 studies with a total sample size of 43 977 women. The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist for prevalence studies, and the risk of bias was evaluated using the risk of bias tool developed by Hoy et al. Meta-analysis and narrative synthesis were performed to pool the data from the studies. Meta-regression was conducted to assess the effects of moderator variables on the prevalence of obstetric violence in the combined study. Heterogeneity between studies was evaluated using Cochran's Q and Higgins's I² tests, and publication bias was assessed using funnel plots and Egger's regression intercept test. Data analysis was performed using Comprehensive Meta Analysis 4 software. The overall prevalence of obstetric violence experienced by women during pregnancy, labor, or postpartum was 61.7%. The meta-analysis data showed significant heterogeneity with an I² value of 99.258%. In the meta-regression, the variables of study country, country income level, study setting, study design, and risk of bias were found to have a statistically significant effect on obstetric violence. As a result of the narrative synthesis, 40 risk factors and 14 protective factors were identified as being associated with obstetric violence. Publication bias was found in the total obstetric violence, online study setting, cross-sectional studies, and moderate risk of bias datasets. In conclusion, the combined prevalence of obstetric violence is high; the factors associated with obstetric violence should be addressed, and future studies should examine the prevalence of obstetric violence in different socio-demographic groups and the factors influencing it in more detail.