“Real decision-making is hard to find” - Swiss perinatal care providers’ perceptions of and attitudes towards decision-making in birth: A qualitative study

•Poor decision-making often lies at the core of negative birth experiences.•Ineffective communication and loss of autonomy represent forms of mistreatment.•Our study reveals insights into how ineffective communication can unfold.•Themes are: otherness of birth, ethical fading, physiology-pathology-dichotomy.•We provide points of leverage for enhancing decision-making in birth.