{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:47:28Z","timestamp":1792097248805,"version":"4.4.0"},"reference-count":26,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,29]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Mistreatment and obstetric violence constitute significant human rights violations with profound implications for maternal mental health. These detrimental practices persist globally, particularly in contexts where underfunded health systems, workforce shortages and entrenched gender inequalities intersect, depriving women of adequate psychosocial support and culturally sensitive mental healthcare. Although awareness of the immediate harms of mistreatment is increasing, its cumulative effects throughout the maternal care continuum remain insufficiently understood. This review will synthesise evidence on the impact of mistreatment on perinatal mental health, identify critical gaps and advocate for systemic change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis protocol complies with the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A thorough literature search will be executed across multiple electronic databases, including CINAHL\u2014Cumulative Index to Nursing and Allied Health Literature, Embase via Ovid, MEDLINE, PsycInfo, PubMed, Scopus, as well as other significant or specialised databases and grey literature. The review will incorporate only non-randomised study types and observational studies (cohort, cross-sectional, case-control), along with mixed-method and qualitative studies. Abstract and full-text screening will be performed by two reviewers using Covidence. The methodological quality of the included studies will be assessed using the Newcastle-Ottawa Scale for observational studies, the Risk of Bias in Non-Randomised Studies of Interventions, the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Statistical heterogeneity will be evaluated using the Higgins test. Meta-analysis will be conducted using R statistical software V.4.4.4, employing random effects models to determine the weights. The study results will be reported sequentially, beginning with primary outcomes, followed by secondary outcomes and significant subgroup outcome analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required as no original data will be collected. The findings of this review will be disseminated through publication and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251044379.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105355","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T13:00:35Z","timestamp":1763038835000},"page":"e105355","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Obstetric violence across the maternal care continuum and its impact on women\u2019s perinatal mental health in low- and middle-income countries: a systematic review and meta-analysis protocol"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3645-6600","authenticated-orcid":false,"given":"Meresa Berwo","family":"Mengesha","sequence":"first","affiliation":[{"name":"Department of Midwifery, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abadi","family":"Kidanemariam Berhe","sequence":"additional","affiliation":[{"name":"Department of Reproductive and Family Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia"},{"name":"Tigray Health Research Institute, Mekelle, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tosin Philip","family":"Oyetunji","sequence":"additional","affiliation":[{"name":"Ayotosin Oyetunji Foundation, Ilorin, Kwara, Nigeria, Ilrorin, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0968-4627","authenticated-orcid":false,"given":"Hale","family":"Teka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mekelle University, Mekelle, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"2025120413273137000_15.11.e105355.1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.3390\/socsci14020109","article-title":"Obstetric Violence: Reproductive and Sexual Health Trajectories of Racialised Brazilian Women in Portugal","volume":"14","author":"Rusu","year":"2025","journal-title":"Soc Sci (Basel)"},{"key":"2025120413273137000_15.11.e105355.2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.rhm.2016.04.002","article-title":"Moving beyond disrespect and abuse: addressing the structural dimensions of obstetric violence","volume":"24","author":"Sadler","year":"2016","journal-title":"Reprod Health Matters"},{"key":"2025120413273137000_15.11.e105355.3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.rhm.2016.04.004","article-title":"Invisible wounds: obstetric violence in the United States","volume":"24","author":"Diaz-Tello","year":"2016","journal-title":"Reprod Health Matters"},{"key":"2025120413273137000_15.11.e105355.4","doi-asserted-by":"crossref","unstructured":"K\u00fc\u00e7\u00fck E , Ye\u015fil\u00e7i\u00e7ek \u00c7alik K . 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