Obstetric violence, which includes disrespect and abuse during childbirth, is an important human rights issue affecting the lives and health of millions of women and babies. It has been defined as “…the appropriation of the body and reproductive processes of women by health personnel, which is expressed as dehumanized treatment, an abuse of medication, and to convert the natural processes into pathological ones, bringing with it loss of autonomy and the ability to decide freely about their bodies and sexuality, negatively impacting the quality of life of women.” (1)
Midwives may be both accomplices or victims of obstetric violence. This form of structural gender violence has an enormous impact on their work and health. Many professionals leave their job or change professions to avoid being witnesses of obstetric violence, others suffer from mobbing when they try to defend women´s human rights in childbirth (2, 3).
The Declaration of the World Health Organization (September 30, 2014) on "Prevention and Eradication of disrespect and abuse during childbirth" called for:
. Greater support from governments and development for research and action
. Programmes to improve the quality of maternal health care, with a strong focus on respectful care
. Greater emphasis on the rights of women to dignified, respectful healthcare through pregnancy and childbirth
. The generation of data related to respectful and disrespectful care practices, systems of accountability and meaningful professional support
. The involvement of all stakeholders, including women, in efforts to improve quality of care and eliminate disrespectful and abusive practices
The Association Birth is Ours (El parto es nuestro) was founded by 21 mothers and a father in 2003. The main aims of the association included to provide psychological support to women recovering from caesareans and traumatic births, to improve maternal and infant care in Spain promoting respect for WHO recommendations and human rights related to reproductive health and elimination of discrimination against women, to provide information on physiological, emotional and social aspects of reproductive health and perinatal care, to decrease the rate of unnecessary caesareans and traumatic births, increasing maternal satisfaction and to recover mother´s and families central role as protagonists in childbirth promoting perception of childbirth as a physiological process to banish fears and interventions that are not evidence-based. In 2006 Birth is Ours started a specific online support group for birth attendants and the list is now a safe place for professionals to debate and disclose about obstetric violence. Currently El Parto es Nuestro is the leading organization for Human Rights in Childbirth in Spain and has opened groups in Ecuador, Argentina and Uruguay.
Since the Spanish association was founded, we have witnessed malpractice, abuse of power and obstetric violence in the reports submitted by users, families and health professionals in Spain.
In November 25 of 2014 a multidisciplinary organisation was created to act as a watchdog in Spain that works exclusively for the eradication of obstetric violence. OVO stands for "Observatory of obstetric violence” which is a multidisciplinary body, composed by five specialists in obstetric violence. OVO was created by the association El Parto es Nuestro and remains dependent of it. Its purpose is to publicly report the incidence of malpractices that constitute obstetric violence, whose victims are not only women and those around them, but also the professionals dedicated to the health and care of women in all stages of motherhood (3)
OVO's objectives are to serve as a channel of communication between health institutions, professional groups and associations of users, to promote collaboration among these three sectors and in doing so achieving the eradication of obstetric violence, acting as an organ of collection, analysis and disseminating information concerning obstetric violence, while looking for ways to network with international organisations with similar objectives, and that is why we are here today. OVO's main actions include collecting testimonials from users who have suffered obstetric violence, publishing an annual report on the incidence of obstetric violence in Spain and the practices that usually constitute it.
Through OVO's website: mothers are provided with the possibility of filling in an online questionnaire, and health professionals have the possibility of sharing their experiences of working in violent environments and sharing their proposals to prevent and / or eliminate it. Which also serves as data for OVO. OVO and other Watchdog organizations for the eradication of obstetric violence founded in Chile, Colombia, Argentina and France allied and created InterOvo, to work together towards the end of such type of gender violence.
Currently we are very aware of the need of developing specific interventions aimed at professionals to eradicate obstetric violence. In May 2014 we developed an online survey where midwives described the enormous impact obstetric violence had on their work and health, a huge burden of suffering and trauma. Many professionals reported leaving hospitals or clinical practice to avoid obstetric violence (4) .
This project aims at developing a sensitization campaign directed to midwives with the specific goals of:
- Helping them understand and identify obstetric violence´s consequences for their own health, specifically their mental health.
- Helping them prevent it by developing their own support resources and networks for prevention and eradication of obstetric violence
- Empower midwives so they can prevent obstetric violence and stand by labouring women and their babies and families providing best evidence based care.
- Promote healthy work environments in the delivery room or places where birth is attended that include both mother and professional´s needs to have safe and respectful deliveries.
(1) Perez D'Gregorio R. Obstetric violence: a new legal term introduced in Venezuela. Int J Gynaecol Obstet 2010 Dec;111(3):201-202.
(2) Olza Fernández I. “PTSD and obstetric violence”Midwifery Today, Midwifery Today Int Midwife. 2013 Spring;(105):48-9, 68.
(3) Villarmea, S., Olza I., Alcalde A. El parto es nuestro. El impacto de una asociación de usuarias en la reforma del sistema obstétrico de España. Dilemata, 7 (2015) 157-183
(4)Ruiz Berdun, MD; Olza, Ibone. The past and the present of obstetric violence in Spain”.VIJornadas Internacionais De História Da Psiquiatria E Saúde Mental,Editors: Ana Leonor Periea, Joao Rui Pita, pp.97-104, 2016.