{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:38:36Z","timestamp":1773304716286,"version":"3.50.1"},"reference-count":54,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether women's perceptions of respectful intrapartum care are influenced by the use of epidural, oxytocin, or episiotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>National survey\u2010based cohort study using data from the Swedish Pregnancy Survey 8\u2009weeks postpartum (NPS\u20108) merged with Swedish Pregnancy Register (SPR) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sweden, 2022\u20132023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Primiparous women with a singleton pregnancy, cephalic presentation, spontaneous onset of labour, a live fetus at \u2265\u200937\u2009weeks gestation, and a vaginal birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Associations between respectful care and epidural analgesia, oxytocin, or episiotomy and their combinations were analysed using logistic regression to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Four NPS\u20108 items assessing women's perceptions of being treated respectfully, receiving support, being informed, and being involved in decision\u2010making during childbirth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 34\u2009111 women, 20\u2009363 (59.7%) responded, with the majority feeling respected during childbirth. Compared with women who had spontaneous vaginal births, those with instrumental births more frequently reported inadequate support (17.7% vs. 11.0%), insufficient information (25.1% vs. 16.2%), and lack of involvement in decision\u2010making (29.2% vs. 17.1%). Among women with spontaneous vaginal births, those subjected to an episiotomy were less likely to report being involved in decision\u2010making (77.8% vs. 83.8%; aOR 0.60, 95% CI 0.50\u20130.73). The combination of episiotomy and oxytocin was associated with the lowest adjusted odds of involvement in decision\u2010making (77.0% vs. 84.6%; aOR 0.54, 95% CI 0.43\u20130.69).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Women with spontaneous vaginal births were less likely to report being involved in decision\u2010making when they underwent an episiotomy, or if oxytocin augmentation was followed by an episiotomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18329","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T07:22:47Z","timestamp":1754896967000},"page":"1844-1855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medical Interventions and Women's Perceptions of Respectful Intrapartum Care: A National Survey\u2010Based Cohort Study"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0147-7084","authenticated-orcid":false,"given":"Karin","family":"Johnson","sequence":"first","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Women's Health and Allied Health Professionals Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1401-1539","authenticated-orcid":false,"given":"Charlotte","family":"Elvander","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1497-3079","authenticated-orcid":false,"given":"Kari","family":"Johansson","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Women's Health and Allied Health Professionals Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1615-2829","authenticated-orcid":false,"given":"Sissel","family":"Saltvedt","sequence":"additional","affiliation":[{"name":"Department of Women's Health and Allied Health Professionals Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Women's and Children's Health, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0968-6534","authenticated-orcid":false,"given":"Malin","family":"Edqvist","sequence":"additional","affiliation":[{"name":"Department of Women's Health and Allied Health Professionals Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Women's and Children's Health, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-019-0729-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-022-01460-4"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14962"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0233114","article-title":"Left Powerless: A Qualitative Social Media Content Analysis of the Dutch #Breakthesilence Campaign on Negative and Traumatic Experiences of Labour and Birth","volume":"15","author":"Pijl M. S. G.","year":"2020","journal-title":"PLoS One"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745506519844044"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2024.101858"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-005671"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15237"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0290434"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2015.01.011"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2021.103212"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06928-8"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.01.002"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12593"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06360-y"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.4873"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.10.002"},{"key":"e_1_2_10_19_1","unstructured":"Y. C. P.Skogsdal C.Elvander C.Hed et\u00a0al. \u201cThe Annual Report of the Swedish Pregnancy Register 2023 \u201d2024. The Swedish Pregnancy Register www.graviditetsregistret.se."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003103"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31472-6"},{"key":"e_1_2_10_22_1","article-title":"Epidural Versus Non\u2010Epidural or no Analgesia for Pain Management in Labour","volume":"5","author":"Anim\u2010Somuah M.","year":"2018","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2024.2357168"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12666"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13266"},{"key":"e_1_2_10_26_1","unstructured":"Sveriges Kommuner och Regioner \u201cThe Swedish Association of Local Authorities and Regions (SALAR): The Regions' Efforts for Women's Health \u201d2023 [cited Jan 10 2025] pp 138 https:\/\/skr.se\/download\/18.3ecbf48018722d64006266c4\/1680182194171\/Regioneras_insatser_kvinnors_halsa_2022.pdf."},{"key":"e_1_2_10_27_1","unstructured":"M.Ahlberg \u201cPROM and PREM Questions in the Pregnancy Register\u2013A Pilot Study \u201d2015 The Swedish Pregnancy Register Stockholm Sweden."},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-254"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/02646838.2020.1748582"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.12691\/ajams-8-2-1"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2011.00491.x"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0903-2"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01564.x"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1356-y"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(02)70189-0"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2022.103429"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31992-0"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228378"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e41254"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.01.041"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2018.07.004"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.01.040"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2022.100779"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06626-5"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2737-8"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.02.009"},{"key":"e_1_2_10_47_1","unstructured":"Institute for Safe Medication Practices (ISMP) \u201cISMP's List of High\u2010Alert Medications \u201d2008 www.ismp.org."},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.08.023"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340802220352"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0171804"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2017.01.005"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1136\/jme-2022-108601"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15830"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04475-8"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2017.11.003"}],"updated-by":[{"DOI":"10.1111\/1471-0528.70082","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000}}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.18329","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T07:45:20Z","timestamp":1759823120000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.18329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":54,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/1471-0528.18329"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.18329","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]},"assertion":[{"value":"2025-03-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}