Friday, November 26, 2010

Obstetric violence: a new legal term in Venezuela

I have just heard about this legal move in Venezuela from Jane Sandall on the Midwifery Research email group, that makes "obstetric violence" an action that midwives and doctors can be prosecuted for.

Obstetric violence may include:
  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
You may well say..."but that's in Venezuela...that doesn't happen here in New Zealand...or Australia...or the UK!"

But doesn't it?

I can certainly think of occasions when I would say obstetric violence was inflicted on a woman. If I was traumatised by watching, how on earth would the woman and her family be feeling?!

What I think is so interesting about this legislation is that it talks about carrying out procedures without a woman's consent. As midwives, I am sure we pride ourselves that we would never do this. But what about the times we get consent from a woman when she is in no state to really think for herself...is this obstetric violence? What about the times we get consent by using our power of health professional...bamboozling her with science and "I know best...I am the midwife" attitude...is that obstetric violence?" What about the times we give information in a biased way to get a woman's consent without giving her the full story...is that obstetric violence?

Food for thought.

The full details can be found in the article: International Journal of Gynecology & Obstetrics Volume 111, Issue 3, Pages 201-290 (December 2010).


Image: 'Tears II'
http://www.flickr.com/photos/33238999@N00/2594164716

10 comments:

Anna Hughes said...

Wow good find Sarah. Yep obstetric violence definately happens here. How many times have I heard women (including myself) being told by the medical professional 'I just want what's best for your baby', as though the woman doesn't or doesn't know what's best. All in order to convince the woman to do what they want. In my case it was to give IV antibotics to my newborn baby before the blood test even came back. I had requested we wait until then. As intended by the Dr I gave in and my baby had the antibotics 'just in case' and the blood test came back negative! Go Venezula!

Sarah Stewart said...

Hi Annas, I have definitely seen (and to my shame, been involved in) examples of obstetric violence. Here is a very interesting critique of this concept framed up as "birth rape":

What Feminists Should Know About Birth Rape: http://www.birthactivist.com/2010/11/what-feminists-should-know-about-birth-rape/

Anonymous said...

Wow! Thank you! I always wanted to write in my site something like that. Can I take part of your post to my blog?

Sarah Stewart said...

Hello anonymous, all my work is licensed creative commons BY which means you can take my work as long as you attribute it back to me. It would be lovely to know who you are and where your blog is :)

Anonymous said...

This article would make many OB's actually look at what they consider 'informed consent' and what everyone else does...

Sarah Stewart said...

Would it? It is very easy to rationalise anything you do as "for the good of the woman". After all...we're living in an age where women are forced to have c/section by law! Forgive my cynicism.

Anonymous said...

There's a practice called "stretch and sweep" that is being performed on women under the auspice of late pregnancy vaginal examination - a lot of the time without women's permission. Midwives seem to be the culprits, as they figure it may prevent induction if the woman goes over her due date, which leads to the cascade of intervention... I call that rape and it worries me that midwives are thinking they are doing the woman a "favour".

Megan said...

This kind of makes me sad for women here in America. I think most of this is common obstetric practice here. Informed consent is kind of a vague when insurance companies are involved......

Sarah Stewart said...

"Stretch and sweep" is definitely rape if it is done without a woman's permission. But it is an accepted option to try to prevent induction of labour: http://www.rcm.org.uk/midwives/features/how-to-perform-a-stretch-and-sweep

Richard said...

Yes, women, by and large know best in regard to children. My daughter had her son at home,and will have her next one there shortly. Hospitals are not always the best place, and often "the philosophy" is not good in such places.