Breastfeeding in Research on Obstetric Violence: A Scoping Review
Abstract
Introduction. Obstetric violence (OV) constitutes a violation of human rights, undermining women’s autonomy, dignity, and perinatal experience. Although breastfeeding (BF) is a central component of the reproductive continuum and a key indicator of quality of care, its violation as a specific form of OV has not been widely studied.
Materials and Methods. A scoping review was conducted across the databases PubMed, LILACS, the Biblioteca Virtual de Salud, and ProQuest. All studies that simultaneously addressed OV and any dimension of BF were included, with no restrictions on language or year of publication.
Results. 651 studies were identified, of which 42 met the inclusion criteria and were included in the review. The analysis revealed several key themes related to obstetric violence (OV) and breastfeeding (BF): a) compliance with international recommendations for the immediate initiation of breastfeeding, the omission of which constitutes a form of healthcare negligence; b) the quality of professional care, respect for maternal autonomy, and adequate technical and emotional support during the postpartum period; and c) the long-term impact of OV on breastfeeding and institutional practices that may themselves constitute OV.
Conclusions. This scoping review aims to provide a conceptual basis that will facilitate the development of more robust analytical tools and frameworks in future research. However, BF and its specific dimensions are rarely considered in the different ways of exploring OV in scientific literature. Understanding which aspects of BF are considered when researching OV is essential for identifying conceptual gaps, guiding future research, and strengthening clinical and institutional interventions.
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3 Ley 17/2020, de 22 de diciembre, de modificación de la Ley 5/2008, del derecho de las mujeres a erradicar la violencia machista (Internet). Boletín Oficial del Estado, n.º 10 (13 de enero de 2021). Disponible en: https://www.boe.es/boe/dias/2021/01/13/pdfs/BOE-A-2021-464.pdf
4 Mena-Tudela D, Roman P, González-Chordá VM, Rodriguez-Arrastia M, Gutiérrez-Cascajares L, Ropero-Padilla C. Experiences with obstetric violence among healthcare professionals and students in Spain: A constructivist grounded theory study. Women Birth [Internet]. 2023;36(2):e219-26. Disponible en: http://dx.doi.org/10.1016/j.wombi.2022.07.169
5 Sacks E. Defining disrespect and abuse of newborns: a review of the evidence and an expanded typology of respectful maternity care. Reprod Health [Internet]. 2017;14(1):66. Disponible en: http://dx.doi.org/10.1186/s12978-017-0326-1
6 Ballesta-Castillejos A, Gómez-Salgado J, Rodríguez-Almagro J, Ortiz-Esquinas I, Hernández-Martínez A. Factors that influence mothers’ prenatal decision to breastfeed in Spain. Int Breastfeed J [Internet]. 2020;15(1):97. Disponible en: http://dx.doi.org/10.1186/s13006-020-00341-5
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14 Kajjoune I, de Brouwere V, Manoussi A, Elomrani S, Assarag B. The experience of childbirth in a supervised setting in the province of Essaouira, Morocco: what is the reality? Sex Reprod Health Matters [Internet]. 2023;31(5):2272712. Disponible en: http://dx.doi.org/10.1080/26410397.2023.2272712
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16 Galle A, Manaharlal H, Griffin S, Osman N, Roelens K, Degomme O. A qualitative study on midwives’ identity and perspectives on the occurrence of disrespect and abuse in Maputo city. BMC Pregnancy Childbirth [Internet]. 2020;20(1):629. Disponible en: http://dx.doi.org/10.1186/s12884-020-03320-0
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2 Pérez D’Gregorio R. Obstetric violence: a new legal term introduced in Venezuela. Int J Gynaecol Obstet [Internet]. 2010;111(3):201-2. Disponible en: http://dx.doi.org/10.1016/j.ijgo.2010.09.002
3 Ley 17/2020, de 22 de diciembre, de modificación de la Ley 5/2008, del derecho de las mujeres a erradicar la violencia machista (Internet). Boletín Oficial del Estado, n.º 10 (13 de enero de 2021). Disponible en: https://www.boe.es/boe/dias/2021/01/13/pdfs/BOE-A-2021-464.pdf
4 Mena-Tudela D, Roman P, González-Chordá VM, Rodriguez-Arrastia M, Gutiérrez-Cascajares L, Ropero-Padilla C. Experiences with obstetric violence among healthcare professionals and students in Spain: A constructivist grounded theory study. Women Birth [Internet]. 2023;36(2):e219-26. Disponible en: http://dx.doi.org/10.1016/j.wombi.2022.07.169
5 Sacks E. Defining disrespect and abuse of newborns: a review of the evidence and an expanded typology of respectful maternity care. Reprod Health [Internet]. 2017;14(1):66. Disponible en: http://dx.doi.org/10.1186/s12978-017-0326-1
6 Ballesta-Castillejos A, Gómez-Salgado J, Rodríguez-Almagro J, Ortiz-Esquinas I, Hernández-Martínez A. Factors that influence mothers’ prenatal decision to breastfeed in Spain. Int Breastfeed J [Internet]. 2020;15(1):97. Disponible en: http://dx.doi.org/10.1186/s13006-020-00341-5
7 Vila-Candel R, Soriano-Vidal FJ, Franco-Antonio C, Garcia-Algar O, Andreu-Fernandez V, Mena-Tudela D. Factors influencing duration of breastfeeding: Insights from a prospective study of maternal health literacy and obstetric practices. Nutrients [Internet]. 2024;16(5):690. Disponible en: http://dx.doi.org/10.3390/nu16050690
8 Nascimento GS do, Santos VR dos, Marcolino E de C, Araújo-Monteiro GKN de, Dantas AMN, Santos-Rodrigues RC dos. Obstetric violence: A conceptual analysis in the Nursing context. Aquichan [Internet]. 2022;22(4):1-25. Disponible en: https://www.redalyc.org/journal/741/74174336008/74174336008.pdf
9 Lopez-Cortes OD, Betancourt-Núñez A, Bernal Orozco MF, Vizmanos B. Scoping reviews: una nueva forma de síntesis de la evidencia. Investig educ médica [Internet]. 2022;11(44):98-104. Disponible en: http://dx.doi.org/10.22201/fm.20075057e.2022.44.22447
10 Brandão T, Cañadas S, Galvis A, De Los Ríos MM, Meijer M, Falcon K. Childbirth experiences related to obstetric violence in public health units in Quito, Ecuador. Int J Gynaecol Obstet [Internet]. 2018;143(1):84-8. Disponible en: http://dx.doi.org/10.1002/ijgo.12625
11 Montanari Vergallo G, De Paola L, Napoletano G, Circosta F, Gullo G, Marinelli S. Obstetric violence: if you can recognize it, you can prevent it. Arch Gynecol Obstet [Internet]. 2024;310(5):2745-7. Disponible en: http://dx.doi.org/10.1007/s00404-024-07722-9
12 Galle A, Berghman H, D’Hauwers S, Vaerewijck N, Valente EP, Mariani I, et al. Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards. BMJ Open [Internet]. 2024;14(12):e086937. Disponible en: http://dx.doi.org/10.1136/bmjopen-2024-086937
13 Mena-Tudela D, Iglesias-Casás S, González-Chordá VM, Cervera-Gasch Á, Andreu-Pejó L, Valero-Chilleron MJ. Obstetric violence in Spain (part I): Women’s perception and interterritorial differences. Int J Environ Res Public Health [Internet]. 2020;17(21):E7726. Disponible en: http://dx.doi.org/10.3390/ijerph17217726
14 Kajjoune I, de Brouwere V, Manoussi A, Elomrani S, Assarag B. The experience of childbirth in a supervised setting in the province of Essaouira, Morocco: what is the reality? Sex Reprod Health Matters [Internet]. 2023;31(5):2272712. Disponible en: http://dx.doi.org/10.1080/26410397.2023.2272712
15 Fors M, Falcon K, Brandão T, Vaca A, Cañadas S, Viada González CE. Reliability and dimensionality of EPREVO («Experiencias de Parto relacionadas a Violencia Obstétrica»): Development of a new instrument, Ecuador. Int J Womens Health [Internet]. 2021;13:569-77. Disponible en: http://dx.doi.org/10.2147/IJWH.S305741
16 Galle A, Manaharlal H, Griffin S, Osman N, Roelens K, Degomme O. A qualitative study on midwives’ identity and perspectives on the occurrence of disrespect and abuse in Maputo city. BMC Pregnancy Childbirth [Internet]. 2020;20(1):629. Disponible en: http://dx.doi.org/10.1186/s12884-020-03320-0
17 Oliveira LLF de, Trindade RFC da, Santos AAPD, Pinto LMTR, Silva AJC da, Almeida MS. Characterization of obstetric care developed in teaching hospitals in a capital of northeast Brazil. Rev Bras Enferm [Internet]. 2021;75(1):e20200896. Disponible en: http://dx.doi.org/10.1590/0034-7167-2020-0896
18 Sadler M, Leiva G, Olza I. COVID-19 as a risk factor for obstetric violence. Sex Reprod Health Matters [Internet]. 2020;28(1):1785379. Disponible en: http://dx.doi.org/10.1080/26410397.2020.1785379
19 Martínez-Vázquez S, Rodríguez-Almagro J, Hernández-Martínez A, Martínez-Galiano JM. Factors associated with postpartum post-traumatic stress disorder (PTSD) following obstetric violence: A cross-sectional study. J Pers Med [Internet]. 2021;11(5):338. Disponible en: http://dx.doi.org/10.3390/jpm11050338
20 Loreto TM, Kuhn Dos Santos JF, Nomura RMY. Understanding the opinion of doctors on obstetric violence in Brazil to improve women’s care. Midwifery [Internet]. 2022;109(103294):103294. Disponible en: http://dx.doi.org/10.1016/j.midw.2022.103294
21 Azevedo-Pereira HA, Lettiere-Viana A, Gomes-Sponholz F, Monteiro JC dos S. Repercussões da violência obstétrica no processo de amamentação: análise sob a ótica racial. Acta Paul Enferm [Internet]. 2024;37. Disponible en: https://acta-ape.org/article/repercussoes-da-violencia-obstetrica-no-processo-de-amamentacao-analise-sob-a-otica-racial/
22 Fors M, Falcón K, Brandão T, López M, Mena-Tudela D. Investigating obstetric violence in Ecuador: A cross-sectional study spanning the last several years. Healthcare (Basel) [Internet]. 2024;12(15):1480. Disponible en: http://dx.doi.org/10.3390/healthcare12151480
23 Ferreira TSB, Moutinho CB, Almeida ER, Oliveira AJS, Rodrigues CAO, Versiani C de C, et al. Factors associated with maternal well-being during childbirth among postpartum women in Minas Gerais. Rev Bras Enferm [Internet]. 2024;77(6):e20230304. Disponible en: http://dx.doi.org/10.1590/0034-7167-2023-0304
24 Bayar R. Silent Scream Obstetric Violence. Int J Caring Sci. 2025;16(1):488-95. Disponible en: https://internationaljournalofcaringsciences.org/docs/47.bayar.pdf
25 Restrepo-Sánchez A. Autonomy, violence, and consent in the obstetric field. Hypatia [Internet]. 2025;40(3):498-524. Disponible en: http://dx.doi.org/10.1017/hyp.2024.84
26 Arias Fuentes FF, Arteaga E, San Sebastián M. Social inequalities in women exposed to obstetric and gyneco-obstetric violence in Ecuador: a cross-sectional study. BMC Womens Health [Internet]. 2022;22(1):419. Disponible en: http://dx.doi.org/10.1186/s12905-022-01998-2
27 de Oliveira Paes LB, Fabbro MRC, de Oliveira Toso BRG, de Castro Bussadori JC, Ruiz MT, Salim NR, et al. Factors intervening in the childbirth experience: a mixed-methods study. BMC Pregnancy Childbirth [Internet]. 2024;24(1):14. Disponible en: http://dx.doi.org/10.1186/s12884-023-06175-3
28 Ghanbari-Homaie S, Meedya S, Mohammad-Alizadeh-Charandabi S, Jafarabadi MA, Mohammadi E, Mirghafourvand M. Recommendations for improving primiparous women’s childbirth experience: results from a multiphase study in Iran. Reprod Health [Internet]. 2021;18(1):146. Disponible en: http://dx.doi.org/10.1186/s12978-021-01196-7
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