Restorative Justice in Childbirth

Within the framework of the IPOV – Respectful Care project, restorative justice practices are approached as a sensitive topic, under continuous review and evolution. The consortium’s team of specialized professionals and researchers is developing debates, texts, and resources to deepen the understanding of its ethical, institutional, and emotional implications. Through an interdisciplinary and respectful lens, the project seeks to contribute to the improvement of good practices and the creation of fairer, more reparative models in perinatal care.

We invite you to explore the selection of texts published by the IPOV – Respectful Care team on restorative justice — the result of a collective process of reflection and interdisciplinary dialogue around this evolving theme within the field of perinatal care. Access the texts at this link.

Use of the Concept in Academic Literature

Restorative justice is an approach to justice focused on repairing the harm caused to the victim through the active participation of both the victim and the responsible party, in contrast to the traditional punitive paradigm. In the context of obstetric violence, restorative justice seeks to acknowledge the harm suffered by the woman during childbirth care and to foster a process of dialogue, reconciliation, and reparation. This may include apologies, compensation, and changes in clinical practices — all aimed at restoring the victim’s dignity and preventing future harm.

In recent years, explicit references to restorative justice have appeared in academic publications in English in relation to obstetric violence. Below are some key examples:

Narratives and Restorative Justice in Childbirth

A review article in Reproductive Health (2017) by Lokugamage and Pathberiya discusses the emerging global debate on human rights in childbirth and suggests that incorporating restorative justice tools could be beneficial. The authors highlight that women’s stories and testimonies can serve to connect the parties and heal conflicts:

“Narratives are an important aspect of restorative justice processes and we suggest that this could be beneficial in the field of human rights in childbirth.”
This underscores that listening to women’s narratives is an essential part of a restorative process and could help recognize and repair violations of their rights during birth.

A Clinical Case as a Pioneer in Restorative Justice

A case study published in Archives of Women’s Mental Health (2023) by Olza et al. documents the experience of a woman who experienced an unperceived pregnancy (a pregnancy that went undetected until labor). She gave birth alone and was wrongfully convicted of attempted infanticide. Thanks to expert intervention, the conviction was overturned, and the court issued an apology to the mother. The authors regard this judicial reversal as a pioneering example of restorative justice in this context, as the institutional error was acknowledged and the harm partially repaired:

“The reversal of the original sentence is considered a pioneer case of restorative justice in the context of unperceived pregnancy and obstetric violence.”
This example illustrates how, beyond punishment, the system can take responsibility and act in accordance with restorative principles — recognizing harm and restoring dignity.

A Restorative Approach to Transform Obstetric Care

A philosophical essay in Hypatia (2023) analyzes obstetric violence through an ethical lens and proposes a transformation of obstetric care inspired by restorative justice. It argues that, within a technocratic system that has caused harm and loss of autonomy, professionals have a moral duty to “repair the harm” through care- and respect-centered practices:

“Following the approach of restorative justice, health professionals working under technocracy have a moral duty to learn caregiving skills and respect their patients’ autonomy. This is a way to repair the harm that the medical establishment has caused to pregnant/birthing people over time.”

The paper further describes how a restorative process in this context typically involves bilateral dialogue between healthcare providers (as “offenders”) and affected women, to reach a shared understanding of the harm and ways to recover from it. In essence, it advocates for safe spaces where both parties can discuss what happened, acknowledge wrongdoing, and agree on reparative and preventive measures.

These academic examples show that restorative justice is the term used in English to address the concept within the context of obstetric violence, illustrating how it is applied through victim storytelling, mutual understanding, and harm repair in maternity settings.

Legal and International Frameworks

At the legal and institutional level, obstetric violence has begun to be recognized as a form of gender-based violence and a human rights violation, although restorative approaches remain at an early stage in English-speaking contexts. Organizations such as the World Health Organization (WHO) and the United Nations (UN) have increasingly addressed this issue.

The WHO’s 2014 statement, Prevention and elimination of disrespect and abuse during facility-based childbirth, officially acknowledged the prevalence of disrespect and abuse during childbirth and called for “greater action, dialogue, research and advocacy” to eliminate such practices in maternity care.

Similarly, in 2019, the UN Special Rapporteur on violence against women identified obstetric violence as a global human rights concern, urging States to establish accountability and reparation mechanisms for affected women.

From a legal standpoint, several countries have responded to obstetric violence primarily through criminalization (e.g., defining it as a crime in some Latin American contexts). However, English-language analyses emphasize that relying solely on criminal law is insufficient. A legal review by the O’Neill Institute (Georgetown University) points out that punitive approaches alone have not been effective, and complementary strategies focused on changing clinical practices are essential:

“Relying primarily on criminal law to tackle obstetric violence… is not sufficient. According to the World Health Organization, greater action is needed to support changes in provider behavior, clinical environments, and health systems.”
In this view, restorative measures — such as staff training in respectful care, improved clinical environments, and patient empowerment — are seen as more effective than criminal proceedings in addressing power imbalances between women and healthcare providers.

Within these non-punitive responses, restorative justice emerges as a promising strategy. Scholars in ethics and victimology highlight it as an inclusive, victim-centered pathway to resolve conflicts arising from medical malpractice. For instance, a research blog from Durham University notes that restorative justice is widely recognized as “a key strategy” for resolving patient–provider conflicts.

This involves creating formal spaces where affected women can share their experiences, receive apologies or explanations from those involved, and participate in designing solutions — such as changes in hospital protocols or symbolic and material compensation. Although English-speaking countries lack specific legislation establishing restorative processes for obstetric violence cases, there is growing interest in integrating such approaches into health policy and victim care frameworks.

We recommend exploring the Durham University Law Research Blog, which offers a valuable space for reflection on restorative justice and reproductive health. In particular, the work of Camilla Pickles stands out for its insightful analysis of obstetric violence from a human rights perspective and its advocacy for restorative and ethical approaches to transforming perinatal care. Her contributions are a key reference for understanding how restorative justice can be applied within maternal health contexts.

Specialized Literature and Activism

The concept of restorative justice in obstetric violence also appears in specialized literature, advocacy initiatives, and reproductive rights activism. In the United States, the National Association to Advance Black Birth (NAABB) published the Black Birthing Bill of Rights (2020), which explicitly recognizes the right to restorative justice:

“I have the right to restorative justice and mediation to address obstetric violence, neglect, or other injustices.” This declaration serves as an advocacy tool rather than a legally binding instrument, calling for institutions to implement restorative mechanisms — such as mediation or community tribunals — instead of limiting redress to conventional lawsuits.

Movements for birth justice and reproductive justice have also embraced restorative and transformative justice frameworks. The term transformative justice emphasizes structural change and community accountability. For example, a collective of doulas and activists issued an open letter in The New York Times (2020) and a National Call for Birth Justice, demanding the creation of community tribunals for victims of obstetric mistreatment — mechanisms designed to foster recognition, dialogue, and systemic reform.

International organizations like Human Rights in Childbirth (HRiC) have facilitated narrative encounters where women share testimonies directly with healthcare providers and policymakers to promote empathy, acknowledgment, and institutional learning. Such initiatives, supported by WHO programs on respectful maternity care, draw from restorative justice principles by fostering accountability and healing through dialogue rather than punishment.

Sources:

1. Reproductive Health Journal – Academic studies on obstetric violence, human rights in childbirth, and restorative approaches in maternity care.
2. PubMed – Peer-reviewed case studies and clinical research on obstetric violence and restorative justice, including pioneering documented cases.
3. Cambridge University Press – Ethical and philosophical analyses of obstetric violence and restorative frameworks (e.g., Hypatia Journal, 2023).
4. O’Neill Institute – Georgetown University – Legal perspectives on non-punitive responses to obstetric violence and health system reform.
5. Durham University – Legal research blog and academic work (notably by Camilla Pickles) exploring restorative justice and reproductive rights.
6. The Childbirth Profession – Advocacy resources including the Black Birthing Bill of Rights (NAABB, 2020) that explicitly references restorative justice.
7. Provide Care – Birth justice and reproductive justice initiatives promoting community-based and transformative restorative practices.