We recently talked to you from Mothers Today about the following article: The Obstetric Violence Observatory is created to change the reality of women, but today I want to talk to you about what exactly obstetric violence is in case there are women (or even men) who do not know what these two words are so important to know. Obstetric violence can leave very severe emotional wounds and very difficult to cure, which is why you have to pay attention to any aspect that needs to be assessed.
Pregnancy should be thought of as a process where women must have control over their own pregnancy, it is their body and the baby that is forming inside will be their child forever from the moment they became pregnant. Unfortunately, some women suffer abuse during pregnancy and childbirth.Their wishes are not respected, and acts are even performed against their will.
It can cause physical damage, but the emotional ones are the most serious
Obstetric violence encompasses actions or omissions that harm women in pregnancy, childbirth, and postpartum, in both public and private healthcare. This includes everything from procedures that are not indicated or not consented to, to derogatory treatment, infantilization, threats or humiliation that violate their dignity. Although it shouldn't happen, it continues to happen and often goes unseen because women They don't report it out of fear or lack of knowledge of their rights.
There are women who are subjected to incorrect procedures, who are neglected, or even worse, who suffer some form of verbal abuse in healthcare settings. Although this may not seem normal in our healthcare system, Unfortunately, these things still happen. And that by not reporting it or by remaining silent, more women may be affected and continue to suffer the consequences of not saying anything.
This is also a structural and institutional violenceThis is linked to hierarchical dynamics that place healthcare staff above the patient, where patriarchal culture and a lack of training in rights and a gender perspective perpetuate dehumanizing practices. Therefore, we are talking about a phenomenon that transcends individual malpractice and it affects the quality of care and public health.
Various studies and surveys conducted in different countries, including Spain, indicate that a significant proportion of women report having experienced some type of mistreatment or non-consensual intervention during their reproductive care. Some studies report high percentagesAnd it is described that some women undergo unnecessary procedures or procedures performed without proper informed consent. Furthermore, it has been observed that the most vulnerable women (adolescents, immigrants, ethnic minorities or those with a lower socioeconomic level) report disrespectful treatment more frequently.
In this context, every case matters: even one case is one too many When it comes to human rights and maternal health, visibility and denunciation are essential to driving changes in protocols, training, and organizational culture.
Obstetric violence not only causes physical harm in some casesBut the most damaging aspect is undoubtedly the psychological and emotional harm. Can you imagine how it must affect a woman when a nurse tells her not to scream while pushing or until the medical procedures are finished? I know a woman who has suffered from depression for years because she wasn't allowed to scream during her natural childbirth. Can you imagine that? I couldn't imagine my own birth without the screams I needed to release all that pain.
Childbirth is a very important and intimate process for a woman with her baby.And the medical staff must be by the woman's side to support, guide, and assist her in everything necessary, always respecting her needs, her interests, and the natural process of childbirth whenever possible. Fortunately, these cases are rare, but these isolated cases should not be silenced. All women have the right to a dignified prenatal, childbirth and postpartum experience and positive so that it is healthy for both the woman and the baby.
So what is obstetric violence exactly?
Obstetric violence is any act that goes against the agreement between the pregnant woman and the doctor during the prenatal plan or the birth of the baby. Not only should the wishes of the birth be respectedA pregnant woman must have her rights intact both during pregnancy and childbirth, but also in the event of a miscarriage. From a rights-based perspective, this is recognized as a violación de los derechos humanos and of sexual and reproductive rights, by affecting the autonomy, integrity and dignity of women.
International health organizations have warned about mistreatment and disrespect during childbirth care in health centers, emphasizing that the absence of informed consent, the denial of pain reliefHumiliating treatment and violations of privacy are incompatible with respectful care. Furthermore, monitoring groups and user associations define this violence as... appropriation of the body and reproductive processes through hierarchical practices, unjustified medicalization, and pathologization of natural processes.
During pregnancy
- Failure to provide medical services to a pregnant woman
- Offensive comments of any kind
- Not providing enough information to pregnant women for them to be able to make their own decisions
- Neglect of quality healthcare
- Infantilize or disempower women in prenatal consultations
- Perform repeated invasive examinations without justification or without explaining its necessity
- To violate the privacy and confidentiality in the consultation
- Prevent or hinder the presence of a companion of choice in ultrasounds or visits
During the delivery
- Refusal of admission
- Denying the company of a person designated by the pregnant woman
- Perform a medical procedure without consent of the pregnant woman
- Performing invasive or unnecessary procedures, especially due to the application of oxytocin and episiotomy
- The deprivation of food or water
- Any type of verbal action that humiliates you, degrades you, makes you feel vulnerable, or causes insecurity or fear
- Delay the newborn baby's contact with the mother
- Apply maneuvers not recommended such as pressure on the abdomen
- Practice cesarean sections or instrumental deliveries without clearly indicating risks and alternatives
- To impose a specific position to give birth or restrict movement without clinical reason
- Shaving, enemas or repeated vaginal examinations by multiple people without justification
If you should or want to have an abortion
- Denial or delay of treatment
- Threats, coercion, or attempts to make you feel guilty for that decision
- Inappropriate Questions About Abortion
- Performing invasive medical procedures or without the consent and relevant explanation
- Inappropriate invocation of conscientious objection without guaranteeing referral and care
In Spain, it is legal to have an abortion freely up to the 14th week of pregnancy. According to current regulationsYoung women aged 16 and 17 can decide without parental authorization, with safeguards of information and adequate support.
You must know your rights
It does not matter if the care a pregnant woman receives is by public or private personnel, all women have the right to prenatal care, including regular check-ups and consultations throughout the pregnancy and until after delivery, and This care must be of high quality and performed by qualified healthcare personnel.
All women must be well informed about the risks, procedures and options they have in order to be in control and make their own decisions in their pregnancy safely. The doctor should provide a warm and respectful environment. so that women feel comfortable at all times and feel free to ask any questions they may have. Furthermore, The doctor's personal opinion should not interfere never in the decision-making of the pregnant woman.
The position in which the woman wants to give birth is also her decision. I know of a case in which the woman wanted to give birth squatting and they would not let her and it was she herself who disobeyed the medical staff because she felt more comfortable that way, and the medical staff ended up accepting it. The doctor cannot impose the position so that the woman gives birth. Other procedures such as the application of oxytocin to accelerate labor, episiotomy or epidural without the consent of the pregnant woman, are also obstetric violence.
Key rights include: informed consent real and understandable; accompaniment continued by the chosen person; mobility and freedom of position during labor; privacy and confidentiality; pain relief when requested and it is safe; immediate skin-to-skin contact and support for breastfeeding; and respect for birth planadjusting it only when there are duly explained clinical reasons.
Types of obstetric violence
Physical obstetric violence
It is the one that directly impacts a woman's body. Examples: routine episiotomies or without explanation, unjustified cesarean sections, inductions without indicating alternatives, procedures without anesthesia when this is necessary, unjustified immobilization or over-medicalization which adds risks. The physiology of childbirth requires time, safety, and support, not rigid protocols.
Psychological or verbal obstetric violence
It includes paternalistic treatmentHumiliation, jokes or reproaches, minimizing pain, undermining decisions, or hindering emotional expression are all forms of abuse. Phrases like "don't scream," "you don't know how to give birth," or "if it hurt, you shouldn't have gotten pregnant" constitute mistreatment. The word and the attitude They have a decisive influence on the experience of childbirth and on subsequent mental health.
Institutional or structural violence
It refers to systematized practices in centers and services: protocols that prioritize system convenience in relation to women, lack of resources, inadequate attention times, lack of training in gender perspective and communication, or hierarchies that inhibit clinical listening. This dimension requires organizational and training changes, as well as accountability.
Why does obstetric violence occur?
The causes are multifactorial. On the one hand, patriarchal culture and hierarchical models In medicine, practices that reduce autonomy have become normalized. On the other hand, educational deficits in communication, informed consent, and emotional management of childbirth. Some studies also point to a relationship with the burnout The healthcare staff's behavior can contribute to dehumanization. Pressure to adhere to schedules or protocols, even when they don't align with the physiology of each birth, also plays a role.
There are biases that exacerbate the problem: it has been observed that women in the most vulnerable situations Socially or culturally disadvantaged groups suffer more disrespectful treatment. The lack of systematic data and efficient complaint and redress mechanisms contributes to this. violence remains invisible or be confused with unavoidable complications, when many are avoidable and preventable.
Effects and consequences on health
The impact can be physical, but especially psychological and emotionalPostpartum depression, post-traumatic stress disorder, anxiety and panic, tokophobia (intense fear of future childbirth), irritability, guilt and devaluationIt can affect the mother-baby bond and breastfeeding, and even the decision to have more children. Postnatal care should include mental health monitoring and referral circuits accessible to perinatal psychology.
Scientific literature indicates that a considerable proportion of mothers may present symptoms consistent with post-traumatic stress Following traumatic births, the WHO recommends postnatal care protocols to support perinatal grief and the mental health of mothers in order to reduce avoidable suffering.
Are you a victim of obstetric violence?
If you think that you are being or that you are a victim of obstetric violence, do not shut up and report what has happened. Complaints can be made in the same health center or in the corresponding justice delegation or to a support center for pregnant women so that they can guide you in your complaint. Nobody deserves to be ignoredNegligence or violence at any stage of life in healthcare, and especially not for a pregnant woman. Humane treatment is a right for everyone, regardless of whether it is public or private healthcare.
Before making a claim, try document everything possibleNote the dates and professionals involved, request the complete medical history (including partogram and consent forms), keeps reports and collects testimonies from the accompanying person. You can file a complaint with the Customer Service from the hospital (preferably in writing and with proof of delivery), and also contact the relevant department. Additionally, consider going to the Patient Advocate from your community and user associations that provide support and advice.
If you are considering taking legal action, consult with a specialized legal team in health law and obstetric violence. There are administrative and judicial avenues, and in certain cases, international human rights mechanisms can be activated. Observatory of Obstetric Violence And organizations like El Parto es Nuestro have useful resources to support these processes.
Prevention and good practices for a respectful birth
Prevention starts with information and empowerment for women and for the transformation of services. Key points:
- Create and share a birth plan with clear preferences, knowing that it can be adapted if the clinical situation requires it and always explaining it.
- To guarantee continuous accompaniment of choice for the woman during dilation, childbirth and immediate postpartum.
- Empowering freedom of movement and postureavoiding unnecessary restrictions and favoring physiological positions.
- Offer analgesia and pain relief in an informed and respectful manner, including pharmacological and non-pharmacological options.
- Reduce unnecessary interventions: limit episiotomies, do not perform inadvisable maneuvers, use oxytocin only when indicated.
- Respect privacy and confidentialityminimizing explorations and always explaining them before performing them.
- Ensure Immediate skin-to-skin contactEarly initiation of breastfeeding and postnatal support, also in cesarean sections when safe.
- Boost the training in gender approachCommunication skills and emotional management of childbirth for all staff.
Models of care focused on the physiology of birth, interdisciplinary teams and evidence-based protocols They improve maternal and infant outcomes and reduce trauma. Many hospitals are already making progress in this direction, demonstrating that respectful and safe care is possible.
Gynecological violence: beyond childbirth
Violence against women doesn't only occur in delivery rooms. It can also happen in gynecological consultations: lack of information Regarding procedures, painful examinations without considering complaints, moralizing comments or judgments about the body or sexual life, and decisions made without consulting the user. Sexual and reproductive health care must be respectful, confidential and focused on the autonomy of women, from an initial review to any intervention.
Protecting maternal health and reproductive rights is a shared goal: reduces physical and emotional consequencesIt strengthens trust in the healthcare system and lays the foundation for fairer societies. With clear information, empathetic support, and evidence-based and informed decisions, every woman can experience her pregnancy, childbirth, and postpartum period with safety, respect, and empowerment.