Obstetric violence: return pregnancy and childbirth to mother and baby

There is a form of violence exerted by the medical institution during pregnancy and childbirth on the body of women, who are deprived of the power to decide.

One of the fashionable series, The Handmaid”s Tale, based on the wonderful book of the same name by Margaret Atwood, portrays a world where the birth rate has dropped to a limit where the very survival of the human species is in danger. To put a drastic solution to this disaster, a group of fascist ideology based on a perverse reading of the Bible establishes a dictatorship in a part of the United States that it will call Gilead. In it, women of “bad life”, that is, divorced, lesbians, single mothers are given to wealthy families to act as “maids.” That is, to be raped by husbands in a ritual that tries to dignify that violation, and to literally incubate the creatures that they will have to deliver to said couple.


The so-called dystopias, portraits of a violent society where the struggle points towards survival itself, are works that allow us to denature dynamics that are present in our society so frequently that they become invisible. Faced with Margaret Atwood”s work of fiction, we can wonder how much of this is already happening, now and here.

Something that should be a voluntary, desired and natural experience that has all the social support has become an “event” mediated by laws, opinions, morals and dynamics that are often contradictory to each other, which place the question of reproduction in the center of a hurricane difficult to solve.


From laws against abortion , which eliminate not only the voluntary nature of pregnancy but also put at risk and, de facto, end the lives of thousands of women in the world who are led to clandestine abortions, to business resistance to hire women in reproductive age , which forces a choice between reproduction and economic solvency (if there is room for choice), through the restriction of access to assisted reproduction for lesbians or the lonely upbringings that take place in much of the world. world, where the community has been fragmented into individuals or, at most, couples, with hardly any support network.


In the midst of all this question there is also a form of violence that has been denounced, for years, by feminist movements, among others: obstetric violence. This is understood as a form of violence exerted by the medical institution during pregnancy and childbirth on the body of trans women and men who go through these processes, who also suffer transphobic violence. This framework is part of the sexist violence and the perverse drifts of a capitalism that applies a chronology to the cycles of life that does not correspond to the needs of life itself but to the profit and expenditure rates of the market.

These practices are materialized in processes of dispossession of women of the power to decide on their pregnancy and delivery, in which they stop being the protagonists to become an object, with the application of invasive and even risky processes and techniques, unnatural protocols as well as neglect, teasing or invasion of the privacy of women during pregnancy and during childbirth.

Examples of this are the very high rate of caesarean sections , which in Spain reaches 25% of births, a figure well above that recommended by the WHO, the alteration of the natural and necessary rhythms of childbirth due to the indiscriminate injection of oxytocin to accelerate the process without the express knowledge on the part of women of other alternatives, or the use of the so-called “delivery tables”, the usual horizontal stretchers where women have to pass their labor without being able to move and in a position that it makes expulsion extremely difficult, although it facilitates the comfort of medical personnel. It is only necessary to ask in our environment and the stories of bad experiences during childbirth that had little to do with the delivery itself multiply.

Obstetric violence also includes the child at the time of its birth, to which processes that we can qualify as “adult-centered” are applied, that is, they apply the gaze of an adult without taking into account the needs of the child, who also they are, at the time of birth, emotional needs and attachment to the mother.


What we cannot deny is that infant and maternal mortality rates have drastically decreased with the implementation of medical protocols in pregnancy and childbirth, but there is a negative part: the extreme institutionalization of this process has led us by a drift of almost industrial objectification of the bodies that urgently needs to be revised to return the voluntary process of pregnancy and childbirth to its natural function and regain the experience of a natural process that must be accompanied in the most respectful way possible.

The essential essay Caliban y la bruja, by Silvia Federici, gathers the history of what has been called “witch hunt” and which was nothing more than a great genocide of women in Europe between the 15th and 17th centuries under the accusation of witchcraft.

These women, represented to this day as old (in a negative sense), ruthless and fearsome, were actually midwives, healers and women who knew the art of plants and healing through them, who attended pregnancies and who they performed abortions and passed on knowledge based on centuries of experience to their daughters and granddaughters.


With his disappearance, all ancestral knowledge was lost and passed on, under the sign of science, in the universities where women were banned. In Spain we did not have access to universities until 1910, just a century ago. Men, therefore, became the expert voice of a process that they did not know directly, and women became passive objects of their own pregnancy and childbirth.

Modern gynecology, on the other hand, recognizes as its “father” the American physician James Marion Sims, who laid the foundations of this science by performing live operations, without anesthesia and without their consent, on enslaved black women of whom we retain only three names: Anarcha Westcott, Betsy and Lucy.

Despite the enormous suffering that all of them had to endure, their memory has been lost and the knowledge extracted from their torture was applied to heal white women. In April 2018, New York City removed his statue from public space.

At present we continue to speak of ethno-obstetric violence, which is the violence suffered by women who are victims of racism during pregnancy and childbirth. When several discriminations come together in a single experience, we speak of a situation of intersectionwhich accentuates each of the violence when coming into contact with another.

In Europe, a bloody example is the treatment that Roma women receive, which includes forced sterilizations but also difficulty in accessing medical care and postpartum support, as well as specific surveillance by social services in processes that are not at all they would be watched or questioned in clown families.

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