In maternity wards and hospitals, women may be at risk of being treated almost as a third person and not as the main participant in the process. This type of situation can occur worldwide. The World Health Organization (WHO) considers this as cruel and disrespectful treatment, which not only violates human rights, but also poses an additional threat to the health of the mother and the life of the child [1].
What is considered childbirth abuse?
This is a fairly broad concept, and it can include outright cruelty. In some places women have been known to be beaten to “bring them to their senses”, left alone, forced to lie in an uncomfortable position, insulted, shamed, ridiculed or deprived of anesthesia, among others. According to the WHO, women of low income and limited education, as well as very young mothers, are more likely to experience this [2].
More common still is what has become known as "obstetric aggression" (obstetric violence), which describes an objectification of women that results in the assumption that they do not have the right to decide over their own body. Depending on the country, anywhere from 15 to 98% of women experience this type of abuse in some form. Doctors may administer a drug to stimulate labor without your consent or break your waters with their hands to make labor move faster. They may refuse to give you pain relief or, on the contrary, insist on it when your wish is to give birth without the use of drugs. They may perform a dissection of the perineum (episiotomy) or a cesarean section with no medical indication; separate the mother from her baby after childbirth or perform any type of manipulation (even an examination) without explaining the need for it or detailing the procedure. All of these are examples of obstetric aggression [3]. And they should not be considered the norm.
What rights do I have during childbirth?
During childbirth you retain all of your human rights, including that of dignity and personal integrity. The United Nations Population Fund (UNFPA) explains what this means for a woman giving birth, and it includes:
choice of position during childbirth (standing, lying down, on all fours, in water, etc.);
choosing the place of delivery (at home or in the hospital);
choice of pain relief methods;
consent or refusal to breastfeed;
the right to be assisted by a partner or other companion during childbirth;
the inadmissibility of any procedures without prior explanation and consent.
At the same time, the obstetrician in charge of the delivery must constantly explain what is happening to both the woman herself and her partner, so that they can make responsible, informed decisions at each stage.
How can I stand up for my rights when I give birth?
The fact of the matter is that during childbirth, a woman can be especially vulnerable. That is why the WHO recommends giving birth in the presence and with the support of a loved one. Their role is not limited to providing you with moral support and some physical assistance, but also to become your strong and confident advocate and/or intermediary in communicating with medical personnel. They should help you voice your wishes, defend your rights and, by the very fact of their presence, help prevent cruel treatment [4].
Should the father of the child be the birthing companion?
The WHO believes that any person with whom the future mother has a trusting relationship can be a good birth companion. That includes the father of the child, a friend or girlfriend, a mother or other relative, or a doula [4].
Studies show that women who experienced partner-assisted labor were less likely to need anesthesia, forceps, or a cesarean section. Their children had better Apgar scores and they were less likely to develop postpartum depression [5].
This article was created in association with UNFPA, the United Nations sexual and reproductive health agency.
