Obstetric violence in Finland: Analyzing the actions of healthcare staff in birthing narratives

Abstract

Problem: Obstetric violence is a form of gender-based violence rooted in structural inequality and discrimination. It is a globally prevalent phenomenon, affecting up to 59 % of birthing individuals globally and approximately 45 % in high-income countries. Despite its prevalence, research in Finland remains scarce, and little is known about how birthing individuals describe this phenomenon. Background: Most research on obstetric violence has focused on structural and professional perspectives, with less attention to birthing individuals' experiences. Their accounts are essential for understanding how obstetric violence manifests and impacts maternity care. Studies highlight the role of communication, power dynamics, and institutional practices in shaping birthing experiences. However, research on these perceptions in Finland is limited. Aim: This study aims to describe birthing individuals' experiences of healthcare staff actions in situations perceived as obstetric violence, providing insights to support ethical, patient-centered care. Methods: This study employed a qualitative descriptive design with an inductive approach. Written birth narratives (n = 30) were analyzed using inductive content analysis. Background details such as age, number of births, or time elapsed since birth were unavailable. The narratives were coded and categorized to identify how healthcare staff actions were perceived. Findings: Four categories emerged from the data: (1) ignoring, (2) manipulating, (3) showing aggression, and (4) nurturing. Discussion: The findings demonstrate that obstetric violence in Finland is experienced through being ignored, manipulated, or subjected to aggression by healthcare staff. At the same time, nurturing care, characterized by compassion, professionalism, and responsible communication, was seen to protect birthing individuals' sense of dignity and sense of participation in care. These results support international evidence and underscore the importance of consistent, respectful care practices. Conclusion: Preventing obstetric violence requires ethical decision-making and respect for birthing individuals' autonomy. Clinical expertise alone is insufficient; compassionate, respectful care is essential in matemity healthcare.