DOI: 10.1177/17455057261455494 ISSN: 1745-5057

Recent obstetrical and gynaecological care experiences and their sociodemographic and mental health correlates: A latent class analysis

Léa Jeanne Séguin, Sylvie Lévesque, Arianne Jean Thorn, Isabelle Boucoiran, Sarah Landry, Natacha Godbout
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Background

High-quality obstetrical and gynaecological care is vital for physical, psychological, and sexual health. However, research has documented widespread patterns of dehumanized and discriminatory care, with marginalized groups disproportionately impacted. Such care can cause lasting harm, underscoring the need for a trauma-informed and person-centred research to better understand and address these experiences.

Objectives

The present study aimed to: (1) identify profiles of recent obstetrical and gynaecological patient-provider interactions in Québec, Canada, and (2) examine their links to sociodemographic characteristics, mental health, and sexual wellbeing.

Design

The current study is cross-sectional.

Methods

A community sample ( n = 1490) having received gynaecological or obstetric care in the last seven years in Québec completed an online survey assessing sociodemographic characteristics, mental health and sexual wellbeing indicators, as well as provider mistreatment, perceived discrimination, and decisional autonomy during the most recent care experience.

Results

Latent class analyses (LCA) identified a four-class solution. Humanizing care (39.7%) featured high decisional autonomy and no mistreatment or perceived discrimination. Subpar care (30.7%) showed moderate autonomy with provider neglect, but no discrimination or provider aggression. Dehumanizing care (17.7%) and patronizing care (11.8%;) involved discrimination and neglect, with the former also facing judgement, aggression, and rights infringements, and the latter, low autonomy but no provider aggression. Dehumanizing care class participants were the youngest and most likely to be socially marginalized (e.g., gender- and sexually diverse, racialized, less educated) and to report poor mental health and poor sexual wellbeing. Humanizing care participants were predominantly older and cisheterosexual and were the least likely to report poor mental health and sexual wellbeing. Subpar care and patronizing care classes included more gender- and sexually diverse individuals and intermediate levels of poor mental health and sexual wellbeing.

Conclusion

This study reveals systemic mistreatment in medical care and urges structural reforms, including anti-Black racism training and culturally competent, inclusive practices in gynaecology and obstetrics.

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