Obstetric violence: how to recognize it?

If you have experienced your birth as a negative or traumatic event, if you have felt infantilized, silenced or humiliated, you may have suffered obstetric violence.

Written and verified by the psychologist Elena Sanz on November 27, 2021.

Last update: November 27, 2021

Childbirth is one of the most significant events in a woman’s life. It is a time of great emotional vulnerability and in which the care received must be of the highest quality. This implies not only ensuring the physical well-being of the mother and the baby, but also respond to the psychological needs and fundamental rights of women. When this does not happen, we are facing a case of obstetric violence.

Unfortunately, this malpractice tends to go unnoticed and does not usually receive sanction of any kind; thus, it continues to perpetuate itself in time. In addition, most women are unaware of their rights and, therefore, cannot identify that these have been violated during pregnancy and delivery. In either case, the psychological damage has taken place and can lead to serious long-term problems. How to recognize this form of violence?

What is obstetric violence?

Obstetric violence is a form of mistreatment suffered by pregnant women, in labor or in the puerperium, by health professionals. It can refer to behaviors of action or omission that impact on the physical or psychological plane. It constitutes a violation of sexual and reproductive rights, and has been classified as a form of gender violence.

Now, when we talk about this type of violence, we are not referring to an error or specific medical negligence, but to a systematized behavior that humiliates, harms and puts the integrity of these women at risk.

The attitudes or actions that are included under this category are widely extended and standardized; so much so that many health professionals do not recognize their wrongdoing and mothers do not identify that they have been victims of abuse. And it is that the origin is deep and well rooted.

It arises from a misconception of pregnancy and the pregnant woman. It is common in medical settings to be infantilized and silenced; furthermore, passivity is expected on the part of the patient. From this perspective, the autonomy and decision-making capacity of women are denied during the process.

Obstetric violence has been normalized throughout history. However, society is increasingly aware of the importance of eradicating it.

How to identify obstetric violence?

Given how standardized these types of procedures are, it can be difficult to recognize that violence is being experienced. For this reason, below we present some of the most common modalities and manifestations.

Lack of information

Health professionals must not only control the correct outcome of pregnancy and labor, but also They must offer the woman all the relevant information, in addition to being open and willing to answer her questions. This applies both in prenatal checkups and during delivery and after the baby is born.

The woman must know at all times what is being done to her and for what purpose, and has the right to ask questions and ask for explanations. If this information is not provided, is hidden, or questions are not answered, violence is taking place.

Absence of consent

In addition to being informed, the woman must give her consent for the practices that are going to be performed on her. Administering medications, performing medical maneuvers or proceeding in any way that goes against the will of the pregnant woman is to violate her rights.



Humiliation and invalidation of emotions and desires

Many women have had to endure disparaging comments from medical or nursing staff during their pregnancy or delivery. Comments like: “Don’t yell, stop making a fuss”, “Having thought about it before having sex” or “Don’t be a complainer, it’s not that bad” they are out of place and also constitute violence.

On the other hand, not allowing a family member to accompany the woman during childbirth when it is medically feasible, or not respecting the mother’s wishes regarding the type of delivery she wantsThey are also clear signs to watch out for.

Harmful and unjustified medical procedures

One of the most widespread obstetric violence practices is the performance of unnecessary medical procedures, which are harmful and often go against the express wish of the woman.

For example, the World Health Organization (WHO) states that the justifiable percentage of caesarean sections is between 10 and 15%; however, they are usually practiced in up to 25% of deliveries. Similarly, episiotomy is justifiable 15% of the time, but is performed routinely in 45% of the cases.

There are another series of very common practices that are carried out unnecessarily and that harm the natural outcome of childbirth; this encompasses the following:

  • Synthetic oxytocin administration to speed up labor.
  • Indiscriminate vaginal examination.
  • Performing the Hamilton maneuver to induce labor (detaching the amniotic sac from the uterus).
  • Application of the Kristeller maneuver (pushing the upper part of the uterus with the fists or the forearm to accelerate the birth).

Inattention and abandonment

Finally, many women wait for hours alone and unattended in the dilation process, which causes them to experience great anxiety and fear, without obtaining support or answers.

Also, after giving birth, the right of mother and child to be together is not always respected and practice skin to skin, even when medically possible. This inattention can cause emotional damage.

Consequences of obstetric violence

Obstetric violence is not a minor issue; It affects a large percentage of women and has a significant impact on their physical and mental recovery.

Due to these practices, childbirth can be experienced as a negative and traumatic event, which increases the risk of postpartum depression and disorders such as postpartum traumatic stress disorder. This not only damages the mother’s psychological well-being, but also makes it difficult to bond emotionally with the baby.

Obstetric violence can lead to problems such as postpartum depression and difficulties in the mother-baby bond.


Possible solutions to obstetric violence

To eradicate obstetric violence, it is essential as a society to give it visibility and become aware of the importance of respecting sexual and reproductive rights.

Childbirth is not a disease; it is a natural process in which the woman is not a passive subject, but the main agent and the absolute protagonist. Thus, the delivery must be accompanied, but not intervened, unless strictly necessary.

If you are going to be a mother, find out about your rights. Remember that you can design a birth plan and it must be respected. You must be informed and consulted throughout the process, and you do not have to accept paternalistic, humiliating or humiliating attitudes on the part of health professionals.

Choosing a center that is committed to humanized delivery or having the accompaniment of a doula are very convenient decisions. Anyway, If this type of violence occurs, it is permissible to report it.

The legislation in this regard is different in each country, and there is still a long way to go to guarantee that the rights of pregnant women are respected. For example, in Spain, they are working on a reform of the law that recognizes the existence of obstetric violence in order to legislate against it.

If you have been a victim of any of the cases described here, do not hesitate to seek professional help. Managing what you’ve experienced will help you avoid having sequelae that could influence your future health.

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