Human Rights in Childbirth in Italy partnered with 10 Italian mothers’ associations (La Goccia Magica, Nanay, Centro Alma Mater, Forum Parto Naturale, Ciao Lapo Onlus, Rinascere al Naturale, Comitato per la Buona Nascita, Innecesareo Onlus, Città delle Mamme Frascati, and Cerchidarcobaleno) in organizing and coordinating the social media campaign “#bastatacere: le madri hanno voce” addressing the phenomenon of obstetric violence (also known as abuse and disrespect in childbirth, mistreatment, birth trauma), that started on April 4th and ended on April 19th, 2016. The campaign was elaborated and led by Elena Skoko and Alessandra Battisti. Full report in Italian is available here.
#Bastatacere campaign was launched as a new Facebook Page, and in 15 days received 21.621 likes, over 1.136 photo-banners and many more stories in written format, it had 700.000 daily visitors and over 70.000 daily interactions. The campaign received over 60 articles in mainstream press and blogs on the Internet.
The campaign format included a personal story of a traumatic childbirth experience written on a paper and then photographed (photo-banner). The campaign lasted 15 days and it required anonymity regarding the names of places and persons in order to protect the women who were sharing the stories of abuse and disrespect in maternity care, since in Italy defamation is a penal offense.
Coincidentally, a campaign of the same name, Basta tacere!, was conducted 44 years ago in Italy (1972) where women inside the growing feminist movement lamented the very same issues regarding the reproductive and maternity healthcare they have been receiving at the time. The comparison of two initiatives brought forward a long-term situation that has still not been properly addressed by the institutions and the society reminding us that abuse in maternity assistance was and remains a feminist issue.
After the closing of the campaign, we formed the Obstetric Violence Observatory Italy (OVOItalia) as part of the international coordination of observatories InterOVO. OVOItalia’s aim is to continue the collection of stories on obstetric violence. OVOItalia provided a survey QuestOVO where the stories continue to be shared in a data-friendly format. #Bastatacere campaign and QuestOVO represent the first national data (identified as “gray literature“) on the phenomenon. The Italian campaign introduced the term of “obstetric violence” to the large audience and to the media that manifested spontaneous interest from its very start.
#Bastatacere initiative was openly and directly linked to two official documents:
- the law proposal “Norms for the Protection of the Rights of Women and Newborns in Childbirth and Regulation for the Promotion of Physiological Birth”
- the WHO Statement on “The prevention and elimination of disrespect and abuse during facility-based childbirth”.
In Italy, on March 11th 2016, Hon. Adriano Zaccagnini submitted to the Italian Parliament the law proposal “Norme per la tutela dei diritti della partoriente e del neonato e per la promozione del parto fisiologico” (“Rules for the Protection of the Rights of Women and Newborns in Childbirth and Regulation for the Promotion of Physiological Birth”). The law proposal was based on the draft written by Alessandra Battisti and Elena Skoko with direct collaboration with Italian mother-activists. The Bill demands the respect of fundamental human rights of mothers and newborns, since individual and public health outcomes and safety during childbirth cannot be reached without the acknowledgment and protection of fundamental human rights of the human being. In #bastatacere campaign we asked the women to tell us if what is written in this bill confirmed their experiences. The response was beyond our expectation.
The Bill introduces the offense of obstetric violence in compliance with the WHO Statement on “The prevention and elimination of disrespect and abuse during facility-based childbirth” (2014). WHO highlights that abuse, neglect or disrespect during childbirth can amount to a violation of a woman’s fundamental human rights, as described in internationally adopted human rights standards and principles. Reports of disrespectful and abusive treatment during childbirth in facilities include:
- outright 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,
- gross 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.
- Among others, adolescents, unmarried women, women of low socio-economic status, women from ethnic minorities, migrant women and women living with HIV are particularly likely to experience disrespectful and abusive treatment”.
In the campaign, we put this list of abuses in evidence for women to understand what experiences were considered as obstetric violence, since the phenomenon is not officially or culturally acknowledged, not even by women who experienced it. The list turned out to be very useful, as many women did not understand what happened to them and what were they supposed to tell.
#Bastatacere campaign had a shocking and profound impact on the public opinion, on the maternity care providers, on mothers, and on the institutions that finally have to find the way to acknowledge and address the phenomenon of obstetric violence.
Text by Elena Skoko and Alessandra Battisti