Women's Autonomy in Obstetric Care: A Qualitative Study on Violations and Experiences.
Carme Perelló-Iñiguez, Victoria García-Garro, Desirée Mena-Tudela and 1 others
PMID 41916682WHAT IT FOUND
Women described obstetric care where information, consent, bodily privacy, support and personal values were often overlooked.
They felt decisions were made for them, not with them. Nurses and midwives can watch for these patterns in maternity care.
Key findings
01Women reported limited access to clear information about procedures, alternatives and consequences, which left them uncertain and distressed.
02Women described preferences and documented plans being overridden by protocols, administrative constraints or professional judgment, limiting their ability to influence or act on decisions.
03Women described vaginal examinations, episiotomies, sutures and exposure as routine practices carried out without prior explanation or explicit consent.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included a small purposive sample, so it cannot show how common these experiences are. Recruitment through digital platforms may have missed women with limited digital access or literacy. Interviews were retrospective, so accounts may reflect memory and emotional processing rather than objective events. The sampling strategy may have favoured women who experienced constraints, so positive autonomy experiences may be underrepresented. An older participant described care from decades earlier and was not treated as analytically equivalent to the others. The research team's theoretical lens may have shaped how themes were organised.
Declared interests
The work was supported by a Spanish government research programme. The authors declared no conflicts of interest.
The easy way to misread this
Do not read these themes as proof that a specific training or policy will improve autonomy. This was a qualitative study of women's retrospective experiences, not a trial of an intervention.