BACKGROUND: Respectful maternity care is a fundamental right for all women. However, reports of disrespect and abuse are prevalent in various childbirth settings. This study aimed to assess the disrespect and abuse experienced by women during childbirth and associated factors in Comprehensive health centers of Tehran, Iran. METHODS: This study employed a cross-sectional design to investigate the prevalence of disrespect and abuse among women who had recently delivered vaginally. The sample comprised 300 mothers who gave birth within the last five days in Tehran, Iran. Data collection occurred between April and September 2021 using a two-stage cluster sampling method and systematic random sampling technique. A demographic and midwifery questionnaire, alongside the Disrespect and Abuse Questionnaire, was used to collect data. Data were analyzed using SPSS version 26 at 95% significance level. RESULTS: This study revealed a high prevalence of disrespect and abuse, with 68.3% of mothers experiencing at least one form from the seven identified dimensions. When examining the factors contributing to the increase in disrespect and abuse, it was observed that Turk women had a 67% lower prevalence of disrespect and abuse compared to Fars women (OR: 0.339). Women with unwanted pregnancies were 2.3 times more likely to experience disrespect and abuse during labor (OR: 2.317). the prevalence of disrespect and abuse was 88% lower in women who received care from a physician compared to those who were attended by a midwife (OR: 0.129). Experience of disrespect and abuse increased 7.1 times when the mother was unaware of who was responsible for her care (OR: 7.190). Women without a companion during labor experienced 74% less disrespect and abuse compared to women who had a companion (OR: 0.263). Finally, women who did not undergo instrumental delivery had a 92% reduction in the incidence of abuse (OR: 0.088). CONCLUSION: This study revealed a high prevalence of disrespect and abuse during childbirth. All mothers should experience consistent and utmost respect throughout childbirth. The execution of respectful care must be the responsibility of all healthcare providers.