Ester Massó Guijarro Reflects on Obstetric Violence

Through the Lens of Epistemic Injustice During Her Secondment in Argentina

As part of her secondment within the IPOV – Respectful Care project, Ester Massó Guijarro carried out an academic and dialogue-based activity in Argentina focused on one of the most fertile and demanding approaches for understanding obstetric violence today: its analysis through the framework of epistemic injustice. Her stay, developed from 30 August 2024 to 25 December 2024, formed part of the collaboration between the UGR – University of Granada (Spain) and ACADP – Asociación Civil Argentina de Puericultura (Argentina), with Julieta Saulo as host.

A conference in a hospital setting

On 9 October 2024, Ester Massó Guijarro delivered the conference-conversation “Obstetric Violence: Analysis from Epistemic Injustice and the Prospective of a Concept in Flames” at the Hospital Municipal Materno Infantil de San Isidro, in the Province of Buenos Aires. The event took place in the hospital’s Aula Magna and was presented by FiloLab as part of her work in Buenos Aires within the IPOV framework. FiloLab also identifies Ester Massó as a researcher linked to the group and to the University of Granada’s participation in the consortium.

Why this topic matters

The title of the conference points to a central idea in Ester Massó Guijarro’s research: obstetric violence should not be understood only as a matter of inappropriate clinical practice, institutional failure, or legal dispute. It must also be examined as a problem of recognition, voice, interpretation, and power. In other words, it concerns not only what is done to women and birthing people, but also whether their experiences, words, pain, decisions, and knowledge are treated as credible and socially intelligible. This is precisely where the concept of epistemic injustice becomes analytically powerful.

Obstetric violence as epistemic injustice

This perspective is clearly grounded in Ester Massó Guijarro’s 2023 article, “Obstetric violence as epistemic injustice: childbirth trouble,” published in Salud Colectiva. In that article, she frames obstetric violence as a form of epistemic injustice drawing on feminist phenomenological philosophy, narrative bioethics, and the broader struggle for sexual and reproductive rights. The article also emphasizes Latin America’s pioneering role in naming and recognizing obstetric violence, while arguing that the concept has strong empirical and theoretical relevance despite ongoing tensions around its use.

Testimonial injustice and hermeneutical injustice

A key contribution of this framework is the distinction between testimonial injustice and hermeneutical injustice, following Miranda Fricker. In the obstetric field, testimonial injustice occurs when a woman’s or birthing person’s testimony is granted less credibility because of structural prejudice: for example, when pain, fear, refusal, or discomfort are dismissed, minimized, or reinterpreted by others as exaggeration, confusion, or lack of understanding. Hermeneutical injustice, by contrast, refers to situations in which shared interpretive tools are missing, making it difficult to name and understand one’s own experience as a form of harm. Ester Massó argues that this distinction is especially useful for grasping the systemic and biopolitical nature of obstetric violence.

More than a clinical issue

Seen in this way, obstetric violence is not exhausted by a list of interventions or isolated episodes. It also involves the broader conditions under which women’s embodied knowledge is ignored or displaced. The issue is not only whether an intervention took place, but also who is allowed to interpret what is happening, who defines whether something is normal, necessary, disproportionate, humiliating, or violent, and whose account counts when reconstructing the experience of childbirth. This is one of the reasons why Ester’s work is so relevant within IPOV: it pushes the conversation beyond procedural improvement and toward a deeper reflection on justice, recognition, and authority in maternity care.

“A concept in flames”

The second part of the conference title, “the prospective of a concept in flames,” is equally meaningful. Ester Massó’s work shows that the term “obstetric violence” remains contested, but precisely for that reason it continues to be necessary. In her 2023 article, she argues that the term retains full philosophical and political relevance, even amid resistance from parts of the biosanitary sector. Her more recent 2026 chapter develops this further, defending the term as an insurgent or insurrectionary concept: one that does not merely classify reality, but also exposes and condemns systemic harm. The expression “a concept in flames” can therefore be read as pointing to a concept that is still alive, disputed, politically charged, and capable of transforming how harm is perceived and addressed.

A decolonial, feminist, and public health perspective

This line of thought is continued in Ester Massó Guijarro’s 2026 chapter, “Decolonizing Bioethics, Feminizing Public Health: Obstetric Violence as Epistemic Injustice,” published in the volume Obstetric Violence as Gender Based Violence. There, she situates her analysis within decolonial, feminist, and narrative bioethics, combining a qualitative systematic literature review with phenomenological reflection. The chapter examines legal and social responses ranging from Venezuela’s pioneering 2007 legislation to emerging Spanish laws, while also highlighting debates about the naming of the concept itself. A central focus is the relation between testimonial and hermeneutical injustice and the embodied experiences of birthing women, particularly in dialogue with the work of Sara Cohen Shabot.

Why this contribution is important for IPOV

Within the IPOV project, this conference represents an especially valuable contribution because it reinforces the project’s interdisciplinary ambition. It brings philosophy, anthropology, public health, feminist theory, and bioethics into direct conversation with maternal care settings and professional audiences. It also helps make visible that respectful maternity care is not only a matter of better protocols or more humane language, but also of epistemic justice: ensuring that women and birthing people are recognized as subjects of knowledge, not merely as objects of intervention.

Bridging research and transformation

The activity held in San Isidro also illustrates the broader value of international secondments within IPOV. By connecting the University of Granada with the Asociación Civil Argentina de Puericultura and situating the discussion in a hospital environment, the exchange created a meaningful bridge between academic research and concrete care contexts. This is particularly important in a field where conceptual clarity, social recognition, and institutional change must move together if lasting transformation is to be achieved.

A contribution that opens debate

Ester Massó Guijarro’s conference in Argentina did more than present a theoretical framework. It opened a space for thinking about obstetric violence in a richer and more demanding way: as a form of structural harm linked to credibility, interpretation, power, and the politics of naming. In doing so, it contributed to one of IPOV’s central goals: building more rigorous, critical, and transformative ways of understanding violence in maternity care, while strengthening the dialogue needed to challenge it.