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Meghan A. Bohren; Aditi Iyer; Aluisio J.D. Barros; Caitlin R. Williams; Alya Hazfiarini; Luisa Arroyave; Veronique Filippi; Catherine Chamberlain; Tamar Kabakian-Khasholian; Kaveri Mayra; Roopan Gill; Joshua P. Vogel; Doris Chou; Asha S. George; Olufemi T. Oladapo.
Applying an intersectionality lens to maternal health has implications for framing clinical practice, research, and policy, and has the potential to improve understanding—and therefore action—to improve health and well-being for all, especially those marginalised by systems of power. This means moving from a one-size-fits-all approach to more contextually-relevant approaches that enable community-led design and implementation to redress historical power imbalances. Many of the maternal health inequities described throughout this Series Paper are viewed by the global and maternal health communities as entrenched and immovable. Yet these inequities are entrenched only in so far as the global health community continue to leave underlying structural drivers unaddressed. We have offered a set of possible new research, policy, and clinical practice approaches that seek to address the challenges of eradicating entrenched inequities. This list is not exhaustive and should not be viewed as a checklist for “doing intersectional equity for maternal health.” Indeed, there is no single way to assure intersectional equity will work for all people and in all settings. Rather than presenting a playbook, we hope these reflections spur the global health community, and specifically the maternal health community, to imagine, invent, and co-create new approaches that move the world closer to a better, more equitable, and just future.
Patrizia Quattrocchi y Natalia Magnone (compiladoras).
This volume brings together various research studies and reflections on obstetric violence in Latin America, examining the capacity of healthcare systems to ensure a respectful and human rights-based childbirth experience. Originating from the Symposium on Rights and Violence in Pregnancy, Childbirth, and Birth Care, held at the 56th International Congress of Americanists (2018, Salamanca), thirteen specialists from eight countries analyzed this issue from multiple perspectives. Part I focuses on the legal dimension, including studies on Mexican legislation, the role of criminal law, its connection to gender-based violence, and the obstacles to therapeutic abortion. Part II presents the experiences of women and obstetric professionals, exploring the consequences of obstetric violence, the agency of pregnant women, and the impact of activism advocating for respectful childbirth in different countries. This book offers an updated and critical analysis of the scope and challenges of research and health policy regarding obstetric violence in the region.
Roberto Castro, Sonia M. Frías (Coordinadores)
Obstetric violence (OV) arises from feminist struggles for reproductive rights and is shaped by political, legal, medical, and academic dynamics. It includes both medicalized practices and symbolic violence, where oppressive norms are accepted as natural. Historically, modern medicine displaced midwives and traditional childbirth, enforcing a biomedical model seen as superior. However, research exposes institutional childbirth as often violent and disempowering. Many women internalize this as personal misfortune, reinforcing symbolic violence, while others resist by reclaiming their autonomy during labor.
Luis Iván Díaz García, Universidad Católica de Temuco. Yasna Fernández
The study examines the legal and factual situation of obstetric violence in Latin America, highlighting that most countries lack specific regulations, with only Venezuela, Argentina, and Mexico having enacted laws—though in Mexico, only at the state level. Empirical studies indicate that obstetric violence persists despite these legal frameworks, with resistant institutional and professional cultures. In Chile, there is no specific law on the issue; existing patient rights legislation only addresses violence from patients toward healthcare staff, and a 2015 bill remains stalled. The findings suggest that laws alone are insufficient, requiring broader cultural change, public awareness, medical education reforms, and institutional measures to prevent the victimization of women in perinatal care.
CR Williams, C Jerez, K Klein, M Correa, JM Belizán, G Cormick
In recent years, Latin America has introduced the legal concept of obstetric violence, addressing both poor-quality obstetric care and mistreatment of women during childbirth. Emerging from advocacy by women's groups, feminists, professional organizations, and public health researchers, this framework defines obstetric violence as a form of gender-based violence and clinical malpractice. While the passage of these laws empowers women to claim their rights, lasting improvements require collaboration between healthcare institutions, advocacy groups, legal bodies, and public health researchers. Legislation alone is insufficient, but it lays the groundwork for protecting the right to dignified, quality maternal care.
Virginia Savage and Arachu Castro
Mistreatment during childbirth lacks a clear definition and standardized assessment, especially in Latin America and the Caribbean. This study reviews 57 research papers and eight legal documents (2000–2017) to identify best practices. While global studies use disrespect and abuse or mistreatment, obstetric violence is the prevalent term in the region. Common themes include medicalization, gender inequality, and violations of women's rights. Most studies use qualitative methods, but mixed-methods approaches, including direct observation, are recommended for better evaluation. Regardless of the conceptual framework used in future research, studies should aim to: (1) measure the perceived and observed frequencies of mistreatment in maternal health settings, (2) examine the macro- and micro-level factors driving mistreatment, and (3) assess its impact on the health outcomes of women and newborns.
Graduand: Laura Zazzaron
Supervisor: Ch. Prof. Sara De Vido - Assistant supervisor: Ch. Prof. Luis Fernando Beneduzi
Obstetric violence has gained increasing recognition in recent years, particularly in Latin America, where it is linked to broader struggles for women's rights. Despite some progress, it remains largely unaddressed at the international level, with no specific legal framework in place. Obstetric violence stems from the medicalization of childbirth and includes both physical and verbal mistreatment, violating numerous human rights. While some countries have enacted laws, their enforcement is weak, and institutional violence persists, with the state often failing to protect reproductive rights. Vulnerable groups, such as Indigenous and low-income women, are disproportionately affected, facing multiple layers of discrimination. Future research should explore whether increased legal recognition leads to improved reporting and better healthcare practices. Latin America's efforts in addressing obstetric violence serve as a model for other regions, but more needs to be done to achieve formal international recognition and effective measures to combat this form of gender-based violence.
Virginia Savage and Arachu Castro
Ethnic minority women in Latin America, particularly Indigenous and Afrodescendant populations, face healthcare discrimination. A literature review (2000–2015) highlights biases leading to neglect, abuse, and language barriers, discouraging care-seeking and worsening health disparities. To improve health outcomes, discrimination in healthcare must be recognized as a key driver of inequities. However, strategies focused solely on provider behavior have limited impact, as they fail to address women's needs and the broader socioeconomic inequalities shaping healthcare interactions.
Lynn M. Morgan a & Elizabeth F.S. Roberts
This paper introduces reproductive governance as a framework for analyzing how states, religious institutions, NGOs, and other actors regulate reproductive behaviors through laws, economic incentives, coercion, and moral discourses. In Latin America, reproductive governance is shifting as debates on abortion, contraception, sterilization, and assisted reproductive technologies increasingly revolve around morality and competing rights claims. The concept can be applied broadly to understand evolving political rationalities in reproductive policies.
