International Day on the Elimination of Violence against Women: Time to stop obstetric violence

Schermata 2017-11-25 alle 00.04.41

Brussels, 25th November 2017- On this day, La Goccia Magica, CiaoLapo, the Italian Obstetric Violence Observatory and Make Mothers Matter (MMM) spotlight the need to promote respectful maternity care in full compliance with the World Health Organization (WHO) statement.[1] We urge Governments to eliminate all forms of obstetric violence, institutional[2] and against women, according to article 12 of the CEDAW Convention.[3]

Many women across the globe still experience disrespectful, abusive or neglectful treatment during pregnancy, childbirth and postpartum care. Women in vulnerable situations are particularly likely to experience disrespectful and abusive treatments. Such treatments include physical abuse, profound humiliation and verbal abuse, coercive or unconsented medical procedures (including sterilization), lack of confidentiality, failure to get fully informed consent, refusal to give pain medication, violations of privacy, refusal of admission to health facilities, neglecting women during childbirth to suffer life-threatening avoidable complications, and detention of women and their newborns in facilities after childbirth due to an inability to pay.

Although, in some countries (Venezuela, Argentina, Mexico, Chile, Brazil) laws are in place to eliminate obstetric violence, in the rest of the world the phenomenon is not even acknowledged. It is almost impossible for women to report it, as it is considered “normal”, both in medical as well as in legal contexts. The extent of the phenomenon is not known but it pertains to both developed and developing countries.

For instance, the first Italian survey[4] conducted by Doxa Institute in September 2017, commissioned by national civil society associations of mothers, found that one in three Italian women felt excluded from fundamental choices related to her childbirth. The most negative practice, suffered by 54% of Italian women, was the performance of episiotomy. For an estimated 1,6 million Italian women, it was practiced without informed consent. Of these women, 15% (400.000) perceived the practice as genital mutilation and another 13% (350.000) felt deceived by medical personnel as they did not communicate the negative consequences. The equivalent of one million women (21%) declare they suffered some form of obstetric violence during their first experience of childbirth.

Therefore, we all urge Governments to:

  1. Support research and data collection in order to measure the prevalence of obstetric violence during pregnancy, childbirth, and postpartum and investigate its impact on the health and autonomy of women;
  2. Adopt national strategies on the involvement of maternity health care users in the decision-making process, at individual and policy levels;
  3. Implement accountability and transparency policies in health care facilities allowing users to make informed decisions;
  4. Support of women’s choices on birth settings (including homebirth and midwifery-led birth centers), as part of a regular offer within maternity care;
  5. Set up channels for women to report about their childbirth experience without stigma or fear;
  6. Regulate a system of remedies and monetary compensation for human rights violations during childbirth and postpartum;
  7. Design educational programmes on the respect of human rights in childbirth for both health care providers and users, starting from schools to universities;
  8. Include women and mothers in educational programmes aiming at teaching health care providers how to treat a childbearing woman and babies with dignity and respect.

In addition, we are launching a 16 day campaign until International Human Rights Day on 10th December 2017 to end obstetric violence around the world. To participate, please use #obstetricviolence and #orangetheworld because every woman has the right to the highest attainable standard of health, including the right to dignified, respectful health care throughout pregnancy and childbirth, as well as the right to be free from violence and discrimination.[5]

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Notes to Editors – Background

Obstetric violence is the “appropriation of a woman’s body and reproductive processes by health personnel, in the form of dehumanizing treatment, abusive medicalization and pathologization of natural processes, involving a woman’s loss of autonomy and of the capacity to freely make her own decisions about her body and her sexuality, which has negative consequences for a woman’s quality of life.”[6]

An episiotomy is a surgical intervention in the muscular area between the vagina and the anus made just before delivery to enlarge a vaginal opening. Although the procedure was once common practice to facilitate the expulsion of the newborn, the WHO now considers the practice outdated and unnecessary except on rare occasions. In comparison to potential spontaneous tearing that may occur during childbirth, the episiotomy is much more dangerous and invasive, carrying a high risk of infection and haemorrhage as well as a longer postpartum recovery time.

About Make Mothers Matter

Make Mothers Matter (MMM) is an international NGO created in 1947 to raise the awareness of policy makers and public opinion on the contribution of mothers to social, cultural and economic development. MMM brings together and represents a network of 45 organisations from 23 countries around the world. MMM has no political or religious affiliations, and thus transparently voices the concerns of mothers at international level with permanent representatives at the United Nations (with a General Consultative Status) and at the European Union. www.makemothersmatter.org

About La Goccia Magica

The Magic Drop is a volunteer association of peer to peer moms who have had direct experience with breastfeeding. The purpose is to provide information and help all those moms who desire it, highlighting the importance of direct support from one mother to another to learn how to identify the needs of their child and to meet them in the best way. www.lagocciamagica.it

About CiaoLapo

CiaoLapo Onlus is an association that deals with the protection of high-risk pregnancy, perinatal health and offers psychological support to families in the loss of a child before and after birth. Founded in 2006 by two parents who prematurely lost their child, Lapo, promotes the health of parents and families through psychological support and the creation of a network of training, composed of gynecologists, midwives, nurses, psychologists and parents. www.ciaolapo.it

About OVO Italia

The Italian Obstetric Violence Observatory (OVOItalia) was born as a continuation of the social media campaign #bastatacere, with the purpose of preserving and disseminating the collected testimonies, continuing to give voice to mothers and raise awareness of Italian society towards the phenomenon of obstetric violence through advocacy, research and data. OVOItalia is part of the international movement on obstetric violence InterOVO. http://www.ovoitalia.wordpress.com

For more information & interviews please contact:

Olalla Michelena
Make Mothers Matter, Secretary General EU Delegation
olalla@mmmeurope.org
+32 477 62 77 07

[1] http://www.who.int/reproductivehealth/topics/maternal_perinatal/statement-childbirth-govnts-support/en/

[2] http://www.may28.org/obstetric-violence/

[3] Convention on the Elimination of All Forms of Discrimination against Women. 175 countries have ratified it.

[4] https://ovoitalia.wordpress.com/2017/11/04/first-data-on-obstetric-violence-in-italy

[5] http://www.humanrightsinchildbirth.org/rights/

[6] http://www.oas.org/en/mesecvi/docs/MESECVI-SegundoInformeHemisferico-EN.pdf

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