Obstetric violence committed in Latin America is itself an epidemic—one that has seen the further erosion of women’s basic rights to bodily autonomy under the guise of medical professionalism. Obstetric violence can be loosely defined as practices that directly cause physical or psychological harm to a woman during childbirth or perinatal care, which encompass verbal abuse, the withholding of anesthetics, and the performance of unnecessary cesarean sections and episiotomies. In 2016 alone, 24% of Mexican women reported abuse in their last childbirth, and 17% reported non-consensual care. In a similarly unsettling revelation, 59.1% of women undergoing labour in Chile experienced an artificial rupture of membranes, while 81.5% received no orally-administered food or liquids. The direct consequence of hypermedicalization of childbirth across the continent has seen women’s demands of their birth plans neglected, and a proliferation of unneeded procedures.
This assault on the female body during childbirth is disturbingly shameful, yet it constitutes a less highlighted example of gender-based violence. Whereas sexual assault and domestic violence are readily condemned, the abuse experienced within Latin America’s maternity wards is veiled by the supposed propriety of its perpetrators; there is an institutional infallibility pronounced by practitioners while they cause potential harm and discomfort to their patients. Rather than confronting these issues head-on and seeking to improve the welfare of pregnant women, doctors defiantly contest the semantics of their misconduct. In 2019, a spokesperson for Rio de Janeiro’s Council of Medicine, which supervises the municipality’s doctors, declared that the term “obstetric violence” was invented in order to “defame” and sully their reputations. The same body also issued a resolution that forbade obstetricians from signing personal birth plans, labeling these important documents as “deleterious fads.”
A 2010 survey recorded that one in every four Brazilian women had suffered mistreatment during labour, many of whom were denied pain relief and experienced unjustified operations. In a well-covered case in Argentina, a 38 year-old expectant mother underwent a cesarean section following the unexplained injection of hormones intended to expedite her delivery. This same woman unwillingly underwent the hazardous Kristeller manoeuvre, where two men placed pressure on her uterus while an assistant lightly slapped her face to keep her conscious. Although this scene seems as though it was lifted from the pages of a chillingly dystopian novel, it is in fact only one example of how such deplorable treatment has worked itself into common practice.
Much like the continued struggle for pro-choice abortion, this issue can be reduced to one fundamental principle: the unquestionable right for women to their own corporeal sovereignty. The downplaying of such injustices represents a considerable setback to gender parity, and further propagates unequal power relations within our society. Likewise, in Chile, women are often physically isolated whilst in labour, forcing them to prepare for birth alone without a close family member or doula for support. Bereft of any guidance or emotional assistance, these women are then left exposed to and unprotected from the aforementioned malpractice so prevalent in these maternity wards.
It is peculiarly paradoxical that within a continent whose religious landscape remains so coloured by Marian devotion, there exists such a brazen disrespect for women’s rights during childbirth. In Mexico City, where the famous idol of Our Lady of Guadalupe draws in pilgrims to venerate a pious vision of femininity and maternal care, expectant mothers are maltreated and neglected. It surely follows that while women are in this incredibly vulnerable and stressful position, they should not be subject to the arbitrary whim and contingent decisions of those who they have entrusted with their well-being. Arachu Castro of Tulane University in New Orleans opines that the “authoritarian medical disposition” instilled in both male and female students is what subverts patient welfare. Critically, there needs to be far more transparency throughout the whole process, with medics being made fully aware of the rights and demands of their patients. Instead of these women being viewed as passive recipients of the obstetrician’s expertise, public health researchers and feminists have called for a “humanization of childbirth” in these Latin American countries.
However, there are initiatives beginning to emerge which endeavour to elucidate this systemic problem, as well as educate healthcare professionals in bestowing women’s perinatal demands the respect they rightly deserve. Furthermore, the Pan-American Health Organization plans to launch a seminar on respectful maternal care by October 2020. Brazil’s Ministry of Health has also introduced a program aimed at emphasizing women’s rights in obstetrics in over 100 teaching hospitals. In Arica, Chile, Madre Nativa (Native Mother) is a group that promotes humanized birth practices with educational programming and supports new mothers with legal aid and advocacy in prosecuting medical negligence. Although there is a long fight ahead, there is still hope that concerted efforts to educate obstetricians on their responsibility to respect the female body will bear fruit, leading to healthier, happier childbirths.