Difference in the mode of delivery in obstetric patients who have experienced intimate partner or sexual violence compared to those who have not: A systematic review and meta‐analysis

Abstract

AbstractBackgroundA history of intimate partner violence (IPV) and/or sexual violence may impact a patient's birth experience. Limited information is available on the potential for re‐traumatisation through routine obstetrical practices and the effect on mode of delivery.ObjectivesTo identify whether there is a difference in mode of delivery between obstetrics patients who have experienced IPV/sexual violence compared to those who have not.Search StrategyMEDLINE and EMBASE were searched through inception to February 2024 for terms related to obstetric mode of delivery, IPV and sexual abuse.Selection CriteriaPeer‐reviewed, retrospective and prospective studies that contained original data.Data Collection and AnalysisTwo authors independently conducted data extraction. A random‐effects meta‐analysis was used to pool outcomes. Cochrane's chi‐squared test and the I2 statistic was used to examine the statistical heterogeneity of pooled effect estimates. All studies were evaluated using the risk of bias in a non‐randomised study‐I tool.Main ResultsThirty studies (n = 280 864) were eligible for inclusion. The likelihood of caesarean delivery was significantly higher in those who had experienced IPV/sexual violence compared to those who had not: OR = 1.16, CI = 1.05–1.27; I2 = 71. Pooled analysis of reported operative delivery rates did not reveal any significant increase in operative delivery rate for those who had experienced IPV/sexual violence versus those who had not: OR = 1.14, 95% CI = 0.89–1.45, I2 = 77%. Risk of bias for the included studies were moderate to serious.ConclusionsObstetrics patients with a history of IPV/sexual violence appear to be more likely to deliver via caesarean section as compared to those who do not.