A silent pandemic of violence against providers in obstetrics and gynecology: A mixed-methods study based on a global survey

Abstract

Objectives: To quantify and qualify the experience of workplace violence (WPV) in a global sample of providers in obstetrics and gynecology (OBGYN).

Methods: We performed a mixed-methods analysis on data from a global survey. Survey content was designed around categorical and open-ended questions in relation to WPV; the occurrence and character, the physical and psychological consequences, training and support structures, and perceived triggers of the experience of WPV. Quantitative data were analyzed using descriptive statistics and text data using mixed deductive-inductive content analysis. These data were integrated using convergent joint display.

Results: Between October 2023 and January 2024, survey responses were collected from 77 individual countries. Among the final sample, 764/1016 (75.2%) had experienced WPV, 699/1016 (68.8%) verbal, and 123/1016 (12.1%) physical violence. The violence affected physical health, psychological health, or job satisfaction for 106/764 (13.9%), 36/7642 (47.4%), and 222/764 (29.1%) of individuals respectively; 216/764 (28.3%) received support. Main WPV triggers were staff shortages, lack of security personnel, and long waiting times, identified by 38.8%, 37.5%, and 37.3% of respondents respectively. Qualitative data indicated that violence caused severe and long-lasting suffering. Catalysts for WPV were often reported as complex interplays between unmet or unrealistic expectations and insufficient resources. Lack of support for WPV was explained as violence being "part of the job" and a culture of assumed resilience among providers.

Conclusion: WPV against OBGYN providers seems to be ubiquitous, arises from a complex interplay of factors, and causes significant injury while receiving insufficient mitigation and support.

Keywords: healthcare providers; obstetrics and gynecology; sexual and reproductive health and rights (SRHR); violence; workplace violence.

FIGURE 1

Inclusion into study of workplace violence against providers of obstetrics and gynecology.

FIGURE 2

Reported perpetrator according to 764 doctors or nurses subjected to violence while on duty. Percentages exceed 100 since respondents may have experienced workplace violence from several different perpetrators.