Rethinking the Definition of Obstetric Violence: Reflections from a Collective and Regional Perspective
July 29, 2025Birthing Bodies, Transformative Voices
August 8, 2025Obstetric Good Practices: Beyond Protocols, Towards an Ethics of Comprehensive Care
Barcelona, July 2025
From IPOV, an urgent reflection on the present and future of obstetric care. Ethical training, perinatal memory, peer support, and institutional transformation come together in this powerful essay by the San Isidro team—mapping a path toward good practices that place the dignity of birthing people and caregivers at the centre.
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.
- Nury Benavides, Lic. – On-call midwife and Coordinator of the Early Childhood Programme (PIM) at San Isidro Mother and Child Hospital
Institution
San Isidro Mother and Child Hospital. Buenos Aires, Argentina.
As part of the Midterm Meeting of the IPOV Project, held in Tarragona in June 2025, the IPOV San Isidro working group, following a collective conversation among all the researchers present, produced this essay, which brings forth powerful reflections on what we refer to as good obstetric practices.
Good obstetric practices are not merely about correct procedures or updated protocols. The concept expands and deepens when approached from a comprehensive, situated, and institutionally transformative perspective.
A key point is the recognition of collective experiences that, although not yet systematized or institutionalized, are already paving the way for what can be considered good practices. In contexts such as Argentina or Uruguay—countries marked by strong inequalities but also by a rich tradition of perinatal activism—good practices often emerge from the ground up: they are born from daily routines, from relationships with service users, from peer support, from shared knowledge, and from the memories of those who give birth and those who accompany them.
One example mentioned is the case of birth centres such as Casa Laietània in Catalonia, which have become points of reference even in countries where such spaces do not yet exist. This reveals a back-and-forth movement: places that inspire, and professionals who, even within adverse systems, find ways to do things well. Sometimes it’s through small actions; other times, it’s through entire structures built with great effort—but always, they leave a lasting mark.
A recurring theme is the importance of ongoing training—not only as a means of acquiring technical knowledge, but also as a space for ethical transformation. Good practices require a deep process of self-reflection on our own beliefs, ingrained habits, professional wounds, and the silences that persist within institutions.
For instance, perinatal death is notably absent from most training curricula. And this is not only about how to support a woman experiencing a pregnancy loss—though that alone demands sensitivity and preparation—but also about how professional teams support one another. What happens to the midwife who delivers a stillborn baby? To the obstetrician who has to break the news? To the nurse or psychologist who continues to care for the family in the hours and days that follow?
This collective testimony proposes that if the impact of death is not addressed among professionals, that unprocessed pain eventually seeps into the care provided to women. Good practices, therefore, are not only directed toward service users—they must also include the care of caregivers. This is where clinical and emotional dimensions meet, where pedagogical concerns intersect with institutional realities, and where ethics and politics are inseparable.
A key phrase resonates throughout the discussion: “We cannot act as if the problem belongs to someone else—we are part of it too.” This sense of professional self-awareness—challenging though it may be—is perhaps one of the clearest signs that true good practice is taking place.
Because good practices are not only those that prevent unnecessary episiotomies or encourage skin-to-skin contact. They are also the ones that challenge hierarchies, open spaces for listening, support colleagues in times of pain, and allow open dialogue—even about death.
At IPOV, we continue to believe that another obstetric model is not only possible, but already underway. And conversations like these—honest and open—are the clearest evidence that real change begins when we see ourselves as part of the very systems we seek to transform.
