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Sunday
Nov072010

“Obstetric Violence” Introduced as a New Legal Term in Venezuela

 

In an editorial published online on October 6, 2010 in the International Journal of Gynecology and Obstetrics, Dr. Rogelio Pérez D’Gregorio, President of the Society of Obstetrics and Gynecology of Venezuela described the specific mentions of the term “obstetric violence” as it appears in the Organic Law on the Right of Women to Be Free from Violence, enacted in Venezuela on March 16, 2007.

The law defines obstetric violence 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.”

Dr. Pérez D’Gregorio highlights two phrases for consideration, the first of which is “health personnel.” In Venezuela, this includes obstetricians, residents, medical students, nurses and technicians. Midwives are not included because, as Pérez D’Gregorio notes, “midwifery does not exist in obstetric practice in Venezuela, where all deliveries are attended by physicians in an institution.”

In addition, the phrase “the appropriation of the body and reproductive processes of women by health personnel” is, according to Pérez D’Gregorio, “contrary to good obstetric practice, whereby medication should only be used when it is indicated, the natural processes should be respected, and instrumental or surgical procedures should be performed only when the indication follows evidence-based medicine.”

The following acts executed by care providers are considered obstetric violence:

(1) Untimely and ineffective attention of obstetric emergencies; (2) Forcing the woman to give birth in a supine position, with legs raised, when the necessary means to perform a vertical delivery are available; (3) Impeding the early attachment of the child with his/her mother without a medical cause thus preventing the early attachment and blocking the possibility of holding, nursing or breast-feeding immediately after birth; (4) Altering the natural process of low-risk delivery by using acceleration techniques, without obtaining voluntary, expressed and informed consent of the woman; (5) Performing delivery via cesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman.

In these cases, the person or persons responsible are subject to a fine of two hundred and fifty (250 TU) to five hundred tax units (500 TU) and the court will submit a copy of the sentence to the professional body or union responsible for disciplinary actions.

 

 

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Reader Comments (7)

This is great, but I have difficulty thinking it's going to get much inforcement in a place that has fallen so far from the norm of physiological labor that they don't have (recognized) midwifes. Specifically, given how it's worded it seems like the doctor could just say that it 'wasn't possible' to allow for an alternate birthing position for instance and the woman would be left having to disprove the doctor, something I can't immagine would be doable without another doctor willing to call BS on a collegue. Still, some hope from having such a thing in writing.

November 8, 2010 | Unregistered Commenterjespren

!!! I want to see this picked up by FIGO.

November 8, 2010 | Unregistered CommenterSherry

I think he left out two of the main "invasive" procedures that, when done without consent, can be quite traumatizing to women and may be perceived as violence: cervical checks and AROM. Both should be done with prudence, and neither should be done without checking with the mother. After all, it is her vagina, and reaching in there to do anything without her consent is dehumanizing.

November 8, 2010 | Unregistered CommenterKK

I love this term! I'm surprised that it hasn't been used before (at least that I'm aware of), since violence is such an accurate description of what can happen during medicalized deliveries. I don't see how this law could be put into practice with such vague, conditional phrases ("when the necessary means to perform a vertical delivery are available"; "surgical procedures should be performed only when the indication follows evidence-based medicine"), but I'd rather focus on the positive. This is a great start!

November 8, 2010 | Unregistered CommenterAKristi

Agreeing that the proof is in the enforcement, but at least it adds a new useful term to the legal/ethical discussions of birth. I wonder what birth is like, generally, in Venezuela? Better or worse than here? Underground midwives/homebirths?

November 8, 2010 | Unregistered Commenteremjaybee

My first thought was, “How progressive. I wonder how long it will take to have the same legal protection extended to American women”. However, it is disturbing that dehumanizing and abusive treatment of women within the medical establishment must be legally defined and protected. To perform a procedure without consent, to falsely present clinical findings in order to perform a procedure (like major surgery) or to enter a woman’s body with out permission is already legally protected, isn’t it? But when we enter a U.S. hospital in labor, we sign a blanket consent form. By signing that are we giving away our basic human rights, our autonomy, our right to say “NO” to who and what enter our bodies? In no other specialty of medicine would this behavior be permitted to continue or be acceptable to its practitioners. Why is it the norm when it comes to caring for women? Do we need more access to Midwives? Do we need to make changes to the education of our Physicians?

November 8, 2010 | Unregistered CommenterU.S. Midwife

There's a "damned if you do, damned if you don't" feeling to this one:

"(1) Untimely and ineffective attention of obstetric emergencies"

That's pretty much the basis of lawsuits which claim that a cesarean should have been performed.

November 9, 2010 | Registered CommenterJill
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