TOPLINE:

Disrespectful maternity care during childbirth and/or postpartum affected nearly 1 in 4 women, and this experience was associated with an increased risk for postpartum depression symptoms at 2 months.

METHODOLOGY:

• Researchers conducted a population-based observational study from the French national perinatal 2021 survey to assess the association between disrespectful maternity care experienced during childbirth and/or postpartum and the prevalence of postpartum depression symptoms at 2 months.
• They included 7189 women who delivered during 1 week in March 2021 and completed the 2-month postpartum questionnaire. Participants were categorised as the low-risk group (no prior psychiatric care, no prenatal depressive symptoms, and no prenatal psychological distress) and the high-risk group (reporting at least one vulnerability factor).
• Postpartum depression symptoms were evaluated using the Edinburgh Postnatal Depression Scale (EPDS) score, with a cutoff value of ≥ 13 indicating the presence of depressive symptoms.

TAKEAWAY:

• Overall, 24.9% of women reported experiencing disrespectful maternity care, and 16.6% of these women reported postpartum depression symptoms at 2 months (an EPDS score ≥ 13).
• After adjusting for confounders, the risk for postpartum depression symptoms was 37% higher in women who experienced disrespectful maternity care (adjusted relative risk, 1.37; 95% CI, 1.20-1.56; E value, 2.08) than in those who received respectful maternity care.
• The association between disrespectful maternity care and postpartum depression symptoms remained significant across both low-risk and high-risk groups, with a postpartum depression symptom prevalence of 9.1% and 24.2%, respectively.

IN PRACTICE:

"Given the worrying incidence of PPD [postpartum depression] and its serious consequences, respectful maternity care should be considered a key potential modifiable risk factor. Raising awareness and providing professionals with the necessary resources to ensure respectful maternity care are relevant priorities for implementation and evaluation," the authors wrote.

SOURCE:

This study was led by Marianne Jacques, Université Paris Cité, Inserm U1153, Centre for Research in Epidemiology and Statistics, Obstetric, Perinatal, Paediatric Life Course Epidemiology Research Team, Paris, France. It was published online on November 30, 2025, in BJOG: An International Journal of Obstetrics and Gynaecology.

LIMITATIONS:

Attrition likely underestimated depression, particularly among severely depressed women who may not have responded at 2 months, and may have influenced the observed prevalence of disrespectful maternity care. Women with postpartum depression symptoms may be more prone to report or recall disrespectful care around delivery or postpartum than psychologically well women. The study design limited the ability to draw casual inference.

DISCLOSURES:

This study was supported by a grant from the Mustela Foundation. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.