Obstetric Good Practices – A Collective Reflection from IPOV
August 2, 2025Secondment Between Spain and Italy
August 11, 2025Birthing Bodies, Transformative Voices
Authors
- Dr Laura Abojer – Head of the Obstetrics Department at San Isidro Mother and Child Hospital
- Dr Javier De Cicco – Obstetrician specialising in high-risk pregnancies and Head of Emergency Services at San Isidro Mother and Child Hospital
- Ivana Iriarte, Lic. – Certified breastfeeding counsellor and doula at San Isidro Mother and Child Hospital. Licentiate in Communication Sciences.
Institution
San Isidro Mother and Child Hospital. Buenos Aires, Argentina.
Conversation between Núria Vives Parés and the IPOV San Isidro team on obstetrics and respectful movement
Palafrugell, July 2025
During the IPOV San Isidro team’s visit to Barcelona, a deep, honest and moving conversation took place in Palafrugell (Girona), at the L’EIX Centre for Body Pedagogy, with Núria Vives Parés — an internationally recognised expert in movement pedagogy and applied anatomy in childbirth. This dialogue formed part of IPOV’s ongoing efforts to eradicate obstetric violence and transform maternity care models.
From the outset, a key difference was brought to the table: in Latin America, despite challenges, there has been progress in recognising obstetric violence as a real and pressing issue. Legislation has been developed, research conducted, and spaces for training and reflection created. In many countries across the European Union, however, the term remains denied or met with resistance.
One of the central topics was the perineum (pelvic floor) as a site of health, pleasure and dignity. In hospitals such as Sant Pau, postpartum follow-up to assess and support pelvic floor health has become a strong recommendation — recognising that a poorly indicated episiotomy or suture without adequate follow-up not only causes physical harm but can also have deep impacts on a woman’s sexual, relational and emotional life.
Throughout the discussion, the importance of raising awareness through prevention, active listening and deep respect for the body was emphasised. A powerful text was cited: “A little cut that changed my life”, in which a woman recounts how an unnecessary episiotomy caused a devastating shift in her life. “The body is not an object. It is not a battlefield. It is a territory of life,” the group concluded.
At this point, Núria made a crucial clarification: the goal is not to oppose episiotomies per se, but to question their routine use. Every birth, every woman, every baby is different. The perineum must be supported with awareness — both in physiological births and in interventions. Instruments such as spatulas or forceps can be used gently, only when necessary, and always with informed and appropriate consent.
Núria explained that when the pelvic floor muscles are exposed to accumulated, unnecessary forces, a physiological protective mechanism is triggered — the myotatic reflex. When the body senses a risk of tearing, the muscles contract automatically as a defence. Instead of softening and adapting to the baby’s head, they become rigid. This is why understanding how interventions can add unnecessary tension to the body is so vital.
The conversation also touched on medical training — and how a pathologising approach has erased the physiology of birth. Núria shared her experiences teaching in hospitals, where inviting doctors to reconnect with their own bodies through simple anatomical awareness exercises often opened doors to understandings that medical school had closed. “Many ask: ‘Why were we never taught this?’ The answer is simple: they were trained to intervene, not to accompany.”
There was also discussion about institutional bullying, fragmented teams, work overload and the silent suffering many professionals carry. “We need spaces of care for those who care,” one participant insisted.
The San Isidro team shared their own evolving journey — a team in transition, working to build an intersectional approach that centres women’s agency. The essential role of midwives, often underestimated, was highlighted. The team also expressed how inspired they were by the visit of Ana Rosetti — midwife, director of the SEAO School in Florence, IPOV researcher — and her proposal for an obstetric model rooted in salutogenesis and Midwifery Care.
The event was also a celebration — of networks, of encounters, of embodied knowledge. Laughter, stories, pain and dreams were shared. The pelvis was discussed as a living, mobile structure, with memory and infinite possibilities. The group reflected on how anatomical language — shaped by men within a narrow mechanical paradigm — has long limited our understanding of birthing bodies. And they reclaimed the need to change language in order to change practice.
Núria closed the gathering with an invitation to all professionals: a simple but transformative gesture. Before entering the room of a labouring woman, pause for a second, feel your breath, inhabit your own body. Because you cannot care for another if you are not present in yourself.
From IPOV San Isidro, we continue to sow this seed — of respect, of humanity, of science with conscience. And we extend our heartfelt thanks to Núria for nurturing it with her luminous presence.
Discover more about Núria Vives Parés and her work:
- @nuriavivesanatomia
- www.nuriavivesanatomia.com
- www.partoymovimiento.com
- www.perineintegracionymovimiento.com
Image from the “Birthing Bodies, Transformative Voices” dialogue in Palafrugell (Girona), reflecting on sexual and reproductive health, obstetric violence, and respect for the body.
