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Carmen Delia Medina Castellano · https://orcid.org/0000-0002-0167-9284 · carmen.medina@ulpgc.es
Objective: To encourage reflection on the existence of practices by healthcare professionals that violate women's rights in obstetric care and to highlight the need for legal norms to prevent and sanction such behavior. Methods: A literature review was conducted, along with an analysis of various international instruments and current Spanish regulations aimed at preventing violence against women. Results: There are few studies on obstetric care practices that can be classified as forms of obstetric violence. However, the legal framework currently in force in Spain, along with national and international health recommendations, may be sufficient to initially support women's autonomy during childbirth. Conclusion: Institutionalized violence persists in obstetric care, underscoring the need to promote respect for women's rights among healthcare professionals and to empower women in making informed decisions about their care.
Ester Massó Guijarro · Doctora en Filosofía y Antropología. Profesora titular de Filosofía Moral, Departamento de Filosofía I, Universidad de Granada, Granada, España.
Here is your corrected and refined text for clarity, coherence, and academic precision: This article theoretically frames the issue of obstetric violence as a form of epistemic injustice, drawing extensively from feminist phenomenological philosophy within the broader framework of narrative bioethics and the fight for sexual and reproductive rights. The first section explores the concept of obstetric violence, highlighting Latin America's pioneering role in its definition and recognition, as well as its empirical and hermeneutical applications. The second section examines how obstetric violence has been analyzed through the lens of epistemic injustice—both testimonial and hermeneutic—marking significant progress in understanding its systemic and biopolitical dimensions. The article concludes by reaffirming the empirical and theoretical relevance of the term as a "thick" philosophical concept, despite existing tensions between the biomedical (particularly medical) sector and citizen demands.
Desirée Mena-Tudela, Pablo Román, Víctor M. González-Chordá, Miguel Rodríguez-Arrastia, Lourdes Gutiérrez-Cascajares, Carmen Ropero-Padilla.
A 2021 study at Jaume I University (Spain) found that 38.3% of Spanish women identify as victims of obstetric violence, a structural form of gender-based violence. Through 20 in-depth interviews, healthcare professionals and students described it as a human rights violation and public health issue. The study highlights the need for systemic and policy-level interventions beyond individual accountability. Conclusion: Obstetric violence is the most precise term to characterize disrespect and mistreatment as manifestations of both interpersonal and structural violence, reinforcing gender and social inequalities. Its definition enhances awareness of violence against women and provides a foundation for regulatory measures through national policies and legislation, contributing to systemic efforts to address and prevent this form of gender-based violence.
Serena Brigidi · serena.brigidi1@urv.cat · Departament d’Antropologia, Filosofia i Treball Social. Universitat Rovira i Virgili, Tarragona. Presidenta del Observatorio de la Violencia Obstétrica (OVO).
Obstetric violence exposes women to non-consensual practices that cause physical and psychological harm, rooted in hierarchical, patriarchal, and colonial structures within the biomedical system. This article analyzes data from studies on migrant women (Pakistan, Morocco, China, and Senegal) and birth professionals in Barcelona. Using intersectionality and decolonial thought as a framework, it explores the historical and cultural construction of inequality and violence in reproductive health. The concept of intersectional obstetric stratification is proposed to expand the understanding of obstetric racism and expose systemic discrimination, particularly affecting migrant women. This approach challenges the universalism, essentialism, neutrality, and androcentrism embedded in biomedical practices.
Andrea Yupanqui-Concha (ORCID: 0000-0003-2698-6755), E-mail: andrea.yupanqui@umag.cl; Cristian Aranda-Farias (ORCID: 0000-0002-0151-7744), E-mail: cristian.aranda@umag.cl; Victoria A. Ferrer-Perez (ORCID: 0000-0002-8096-4031), E-mail: victoria.ferrer@uib.es.
Despite international condemnation, forced sterilization of women and girls with disabilities persists in 38 countries, including Spain. This qualitative study, using Constructivist Grounded Theory, analyzed the issue through 22 in-depth interviews with activists, professionals, and researchers across six Spanish regions. Participants described a health system of domination and exclusion, where the sexuality and reproduction of women with disabilities are systematically controlled, violating their human rights. Sexual violence is often normalized, reinforcing social exclusion and health inequities. Given its global occurrence, this issue is a critical concern for international public health.
Susana Iglesias, Marta Conde, Sofía González, Mª Esther Parada
Autora de correspondencia: Susana Iglesias Casás · Correo electrónico: matronasu@gmail.com
Investigating the perceived quality of care received by women during childbirth, cesarean section, or abortion in Spanish healthcare facilities, as well as their satisfaction with various human and technical aspects of the care provided, is essential. The birth of a new child or its loss are events that leave a significant mark on a woman's physical, psychological, and emotional health, as well as that of her family. As healthcare professionals, we must reflect on the impact of our care, the need to base it on scientific evidence, and our obligation to respect the rights of the woman and her baby, even if she is unaware of them or does not demand them. The results of this survey identify several areas where obstetric care practices, including patient treatment, can and should be improved.
Desirée Mena-Tudela, Susana Iglesias-Casás, Víctor Manuel González-Chordá, Águeda Cervera-Gasch, Laura Andreu-Pejó, and María Jesús Valero-Chillerón
This study highlights previously unassessed data on interventionism and medicalization during childbirth in Spain and their link to obstetric violence (OV). Findings indicate high levels of intervention, including risky maneuvers like Kristeller, across the country, with no significant regional differences. However, intervention rates vary by healthcare type: private healthcare shows higher interventionism, lower satisfaction, and greater perceptions of OV, while mixed healthcare reports lower intervention levels, higher satisfaction, and fewer OV cases, suggesting a role for female empowerment. The logistic regression model confirms that interventions strongly correlate with OV, though interventionism is only one aspect of the broader issue.
Júlia Martín-Badia, Noemí Obregón-Gutiérrez, and Josefina Goberna-Tricas.
This study analyzes how obstetric violence violates fundamental bioethical principles, both American (non-maleficence, beneficence, autonomy, and justice) and European (vulnerability, integrity, and dignity), which are interconnected rather than separate. From an individual perspective, midwives highlight that women experience malpractice when their vulnerability is ignored, leading to increased harm. Their dignity is compromised, their decision-making is undermined, and they are not treated as biopsychosocial beings, infringing on autonomy and beneficence principles. From a social perspective, obstetric violence reflects systemic gender inequalities, both within healthcare and society at large. The androcentric and paternalistic medical model victimizes women not only as patients but also as women. Obstetric violence is part of broader gender-based violence, rooted in patriarchal structures that shape women’s childbirth experiences. Regarding terminology, the study argues that what matters is recognizing women's negative experiences during childbirth rather than debating whether they should be labeled as violence or malpractice. Overemphasis on labels can hinder change if it fosters defensive attitudes among professionals. Instead, the focus should be on humanizing obstetric care through meaningful reforms rather than categorization alone.
Michelle Sadler , Gonzalo Leiva & Ibone Olza
Unfortunately, we carry a history spanning decades—if not centuries—of harmful biomedical childbirth practices that are not evidence-based and have proven difficult to change in clinical settings. The COVID-19 pandemic has highlighted the fragility of progress in protecting the rights of these groups. Rather than serving as an effective response to the crisis, these harmful practices constitute a violation of women’s human rights and a concealed manifestation of structural gender discrimination. The current rollback of women's rights during childbirth amid the pandemic exemplifies how easily health systems can infringe on the rights of mothers and their babies. Whether these harmful practices will be temporary or long-lasting remains uncertain, but there is a growing concern that they may lead to a regression in achieving positive birth experiences for women, newborns, and families worldwide.
Desirée Mena-Tudela, Susana Iglesias-Casás, Víctor Manuel González-Chordá, Águeda Cervera-Gasch, Laura Andreu-Pejó, and María Jesús Valero-Chillerón.
Spain faces a serious public health and human rights issue regarding obstetric violence (OV). The decentralized healthcare system may contribute to variations in OV perception across regions, while private healthcare appears more prone to OV. Updated protocols, staff training, and transparency policies are essential to improving care. Women’s lack of confidence, fear, and vulnerability during the perinatal stage often prevent them from questioning interventions, unintentionally perpetuating OV. Ensuring informed consent and challenging the technical and patriarchal authority in obstetric care are crucial. Additionally, maternal and infant health indicators, such as breastfeeding, require attention across pregnancy, birth, postpartum, miscarriage, and reproductive health. A comprehensive, legally protected approach to maternity care is necessary to prevent OV and safeguard women’s rights.
Silvia Costa Abós, Mahault Behaghel
Autora de correspondencia: Silvia Costa Abós · Correo electrónico: scosta@ub.edu
The fundamental idea behind home birth is the belief that women are capable of giving birth and that babies know how to be born. Birth is described in terms of power, strength, mystery, growth, and learning, often perceived as a transformative journey. The experience of giving birth and supporting labor is seen as a demonstration of human potential and resilience, with many women emerging empowered, more self-confident, and better prepared to face challenges. The COVID-19 pandemic has heightened concerns about hospital births, exposing pregnant women to fear, anxiety, and potential biological risks in environments treating infectious diseases. This crisis raises the question of whether hospitals are the best setting for low-risk births, especially given previous concerns about the over-medicalization and high-tech nature of childbirth. Growing demands call for a more humanized approach to maternity care, emphasizing natural birth settings where women retain agency and decision-making power while ensuring safety. This is a challenge that must be addressed in the near future.
Silvia Costa Abós, Mahault Behaghel
Autora de correspondencia: Silvia Costa Abós · Correo electrónico: scosta@ub.edu
The fundamental idea behind home birth is the belief that women are capable of giving birth and that babies know how to be born. Birth is described in terms of power, strength, mystery, growth, and learning, often perceived as a transformative journey. The experience of giving birth and supporting labor is seen as a demonstration of human potential and resilience, with many women emerging empowered, more self-confident, and better prepared to face challenges. The COVID-19 pandemic has heightened concerns about hospital births, exposing pregnant women to fear, anxiety, and potential biological risks in environments treating infectious diseases. This crisis raises the question of whether hospitals are the best setting for low-risk births, especially given previous concerns about the over-medicalization and high-tech nature of childbirth. Growing demands call for a more humanized approach to maternity care, emphasizing natural birth settings where women retain agency and decision-making power while ensuring safety. This is a challenge that must be addressed in the near future.
Serena Brigidi, Marta Busquets-Gallego
Autora de correspondencia: Serena Brigidi · Correo electrónico: serena.brigidi@uvic.cat
This article analyzes two cases of obstetric violence that occurred in Barcelona (2016-2017) at a subsidized first-level hospital in Catalonia. These cases are instrumental, illustrating how obstetric violence is shaped by gender and collective conditions across different care models. The study examines these cases from an intersectional gender perspective, focusing on autonomy and informed consent in pregnancy and childbirth. It critiques how individualistic ontological models have led to confusion between desire and rights, reinforcing Taylorist childbirth processes where violence is masked as altruism, childbirth is treated as a transaction, and health as a commodity. The article underscores the need to consider gender determinants and intersections to develop a more complex understanding of obstetric violence and to drive systemic change in maternity care.
Josefina Goberna-Tricas y Margarita Boladeras (Coordinadoras) presentan El concepto «Violencia Obstétrica» y el debate actual sobre la atención al nacimiento. Los autores de esta obra son: Ainoa Biurrun-Garrido, Margarita Boladeras, Francesc Botet, Serena Brigidi, Yolanda Canet Estévez, Guillermo M. Corral Manzano, Fina Birulés, Carme Adán, Francisca Fernández Guillén, Josefina Goberna-Tricas, Sarah Lázare Boix, Júlia Martín Badia, Noemí Obregón Gutiérrez, Montserrat Payà Sánchez, Dolores Ruiz-Berdún y M.ª Isabel Salgado Poveda.
The concept of obstetric violence generates significant resistance among some childbirth care professionals, who do not accept having their practices questioned. Everyone agrees that being a man does not predestine you to commit gender-based violence, just as being a professional in childbirth care does not automatically make you suspect of committing obstetric violence. An excellent practice—one unfortunately rarely taught in universities—is to regularly reflect on our clinical care practices. Doing this routinely and asking ourselves if there might be a better way to do things, instead of working in a certain manner "because it has always been done that way," can be highly beneficial. Engaging in such reflection would likely bring substantial benefits, including improving both our professional satisfaction and the experiences of the women who place their trust in us every day.
Rosa Llobera Cifre, Victoria A. Ferrer Pérez, Xènia Chela Àlvarez
Obstetric violence refers to dehumanized treatment and excessive medical intervention during pregnancy, childbirth, and postpartum, infringing on women's rights and impacting their health. This study, based on 12 semi-structured interviews using a phenomenological approach, reveals that dehumanized, disrespectful, and hierarchical care, along with insufficient support, often underpin obstetric violence. Unjustifiable clinical practices persist despite recommendations from governmental and international organizations, while inadequate physical environments hinder the natural progression of obstetric procedures. Violations of autonomy and information rights cause significant distress, and although women demonstrate awareness and agency, the institutional context often limits their ability to make effective decisions. Obstetric violence negatively affects women’s experiences and emotions in reproductive health, leaving lasting impacts on their lives.
Autora: Carla Cobo Gutiérrez. Directora: María Lourdes Sevilla Miguélez. Trabajo de Fin de Grado – Grado en Enfermería, Escuela Universitaria de Enfermería "Casa de Salud Valdecilla", Universidad de Cantabria, Junio 2016.
In the 1960s, feminist activism emerged to advocate for the right to respectful childbirth and to fight for women's rights in perinatal care. One of its goals was to popularize the term "obstetric violence", recognizing it as a form of gender-based violence linked to the biomedical model of care, which is characterized by excessive medicalization and interventionism in modern obstetric practices. Venezuela was the first country to legally recognize this type of violence, followed by other Latin American nations. However, Spain has yet to introduce any legislative provisions on this matter. Analysis of current obstetric care has shown that many routine procedures lack an evidence-based foundation, including the significant increase in cesarean sections, episiotomies, and other interventions observed in recent years. Contemporary research highlights a widespread lack of awareness regarding the rights of laboring women, affecting both health professionals and patients, leaving women increasingly vulnerable to having their rights violated. Given their specialized training and competencies, midwives hold a key role in reducing the impact of obstetric violence and advocating for more respectful maternity care.
Master Thesis: Silvia Bellón Sánchez
Main Supervisor: Marieke van Eijk – Utrecht University
Support Supervisor: Teresa Ortiz Gómez – Universidad de Granada
Obstetric violence, rooted in medicalization, professional authoritarianism, and sexism, remains a global issue despite increasing legal recognition in Venezuela, Argentina, and Mexico. These laws aim to protect women's and newborns' rights to respectful treatment and informed decision-making in both public and private obstetric care. However, in Spain, childbirth activism has adopted the term "obstetric violence" to expose systemic mistreatment, yet it remains largely disconnected from feminist activism, which has historically deprioritized health-related struggles. This gap raises questions about why and how Spanish activists use the term, whether they share a common definition, and how gender hierarchies influence obstetric violence. Given that childbirth organizations do not explicitly advocate for gender equality, this study explores their perspectives on the intersection of gender and obstetric care. Echoing María Llopis, it challenges feminism to reconsider: "Where is our feminist practice if we ignore the uterus?"
