Obstetric Violence, Perinatal Mental Health and Restorative Justice

Perinatal Mental Health and Obstetric Violence: Tensions, Impacts and Restorative Horizons

Obstetric violence and perinatal mental health are interrelated phenomena that have gained relevance in interdisciplinary research on human rights, gender and public health.

Within the framework of the IPOV project (International Platform on Obstetric Violence), which seeks to develop conceptualisations and global strategies to address obstetric violence, it is crucial to explore how these experiences affect the psychological well-being of women, pregnant people, their babies and families, as well as the possible practices of reparation.

This text is an invitation to systematically and in depth elaborate the implications of obstetric violence for perinatal mental health and to investigate modes of restoration that take into account subjective aspects in healthcare settings and within activist movements for respectful perinatal care.

Author: María Fernanda González.
Universidad Nacional de Entre Ríos | perinatal mental health, genre, activism, obstetric violence.

Obstetric violence is defined as a set of practices of mistreatment, coercion or dehumanisation exercised during gynaecological and obstetric care, which violate the autonomy and dignity of pregnant people (Quattrocchi, 2019; González et al., 2025). Recent studies show that these experiences can trigger depression, anxiety, postpartum post-traumatic stress disorder and affect the mother–infant bond (Olza, 2013; Smorti et al., 2019; Radoš et al., 2020; Larkin et al., 2021; De Souza et al., 2017; Freitas et al., 2019; Laínez Valiente et al., 2023; Pavez & Arriagada, 2024). Obstetric violence operates not only at a physical level, but also at psychological and symbolic levels, generating harms that are subjectively experienced and that often go unrecognised by health systems.
The regulatory framework in Latin America has evolved from the Organic Law in Venezuela (2007) to laws and protocols in Argentina, Mexico, Uruguay and Chile, linking reproductive rights and respectful childbirth with bodily autonomy and the dignity of women. However, many inequities and inequalities persist in the implementation and in the integration of perinatal mental health into healthcare provision (González et al., 2025; IPOV, 2024).

Feminist activisms and the epistemology of respectful childbirth have made visible the political, epistemic and subjective dimensions of these forms of violence. Concepts such as epistemic injustice (Fricker, 2007; Massó Guijarro, 2023) help us understand how women’s testimonies are discredited or how they lack the tools to name what they have experienced, thus perpetuating harm. Collective spaces such as activist groups, support networks and obstetric violence observatories function not only as mechanisms for reporting abuse but also as spaces of support in processes of symbolic and emotional repair, where the act of saying “I do believe you” seeks to restore the agency and dignity of pregnant people (González, 2020; González et al., 2025; Ahmed, 2022; Jerez, 2022).

In this context, restorative justice is proposed as an innovative approach to address the psychosocial impact of obstetric violence. The restorative justice approach emerges as an alternative for addressing the consequences of obstetric violence from a logic of reparation and collective responsibility, beyond mere legal sanction. Recent initiatives (Abojer, De Cicco et al., 2024) have explored the limits and possibilities that these restorative dialogue processes between affected women and health professionals may have, fostering acknowledgment of harm, apologies and the rebuilding of trust. These practices could have a significant impact on maternal mental health by validating suffering and opening up pathways towards the re-signification of traumatic experiences. Restorative justice not only seeks to repair but also to transform institutional cultures that perpetuate violent practices, promoting spaces for training, supervision and professional care (García Conto, González, García Presas, Brígidi and Quattrocchi, under review).

Finally, it is crucial to update perinatal care guidelines by incorporating protocols for the detection of psychosocial risk, institutional violence and psychological support, as well as by promoting the participation of service users in the design and evaluation of services. This strengthens a rights-based approach centred on the experiences of women and pregnant people, and contributes to the prevention of future obstetric violence.

Conclusion

The relationship between obstetric violence and perinatal mental health shows that obstetric events, such as childbirth but also abortions, pregnancy loss and, more broadly, gynaecological and obstetric care, can be both traumatic scenarios and contexts of respectful and humanised care. The integration of feminist, psychosocial and restorative justice approaches broadens the understanding of the impact of obstetric violence, promoting collective forms of reparation and strengthening mental health. These developments contribute directly to the objectives of IPOV, providing evidence, conceptualisation and action-oriented strategies aimed at respectful and humanised care that recognises the subjective experience and the voice of women.

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