Dear users, if you are aware of relevant global research that is not included in our database and relates to obstetric violence, we invite you to write to us. We accept open-source research from any country in the world. Your collaboration is essential to enrich our collection and support researchers worldwide. Likewise, if you find any errors, please do not hesitate to contact us. Thank you in advance for your cooperation.
RESEARCH · Conceptualizacion
Since its global adoption, the term obstetric violence is increasingly used to describe any and all violations occurring during reproductive healthcare, often with few conceptual boundaries. Consequently, it risks becoming an overly broad concept, making it difficult to operationalise in socio-legal reform efforts. This article draws on the Latin American origins of the concept and aims to provide a theoretical framework to support a focused and coherent socio-legal reform agenda. It proposes a universal definition of violence as the violation of physical or psychological integrity, contextualised through the view from everywhere approach. The article argues that violence qualifies as obstetric violence when the violation of integrity occurs in the context of antenatal, intrapartum, or postnatal care. Furthermore, the subject of the violence is the birthing woman, trans, or non-binary person. Applying the notion of a continuum of violence in reproductive healthcare ensures that different forms of obstetric violence are recognised and helps to identify overlaps with other types of violence.
Diogo Ayres-de-Campos, Frank Louwen, Victoria Vivilaki, Chiara Benedetto, Neena Modi, Miroslaw Wielgos, Melania-Elena Pop Tudose, Susanna Timonen, Marlene Reyns, Branka Yli, Pernilla Stenback, Inês Nunes, Burcu Yurtsal, Christophe Vayssière, Georges-Emmanuel Roth, Maria Jonsson, Petra Bakker, Enrico Lopriore, Stefan Verlohren, Bo Jacobsson.
Substandard and disrespectful care during labour can harm women's experiences and should concern healthcare professionals. Substandard care involves inadequate, withheld, or poorly executed interventions, while disrespectful care affects dignity, privacy, or beliefs. The term "obstetric violence" is rejected by the authors, as it implies intentional harm by obstetricians and fosters defensiveness instead of collaboration. They advocate for joint efforts to address the root causes of poor care through mutual understanding, trust, and respect.
Naming plays a crucial role in society. It shapes reality by making previously unseen events or unacknowledged experiences visible, influencing how society responds to them. This article explores the challenge of naming violence and abuse during childbirth, focusing on three key concepts: “mistreatment,” “disrespect and abuse,” and “obstetric violence.” Drawing from broader feminist literature, it reveals the hidden power dynamics involved in the naming process and questions whether “mistreatment” and “disrespect and abuse” are appropriate as dominant discourses. The article argues that any dominant discourse should not be shaped by the healthcare sector — as happens with “mistreatment” — given its leading role in perpetuating abuse and violence during childbirth. Finally, it highlights that understanding of this phenomenon is still in its early stages, and therefore the communicative framework should remain broad enough to include diverse terms, including “obstetric violence.”
Aline de Andrade Ramos Cavalcanti
This article analyzes the birth discourse of four feminist authors representative of second-wave feminism (Simone de Beauvoir, Shulamith Firestone, Adrienne Rich, and Lidia Falcón) to understand the historical conditions that allowed the emergence of a new model of childbirth care, driven by a movement of women and professionals since the 1970s, known as the Movement for the Humanization of Childbirth. The context that enabled the rise of discursive practices claiming feminism within these groups invites a critical analysis, considering the historical lessons of how biomedical discourse has shaped sexuality and women's bodies. What did these feminists think about natural childbirth at the dawn of the humanized childbirth movement? This is what we will explore.
Frank A. Chervenak, MD, MMM; Renee McLeod-Sordjan, DNP, APRN, HEC-C; Susan L. Pollet, Juris Doctor; Monique De Four Jones, MD; Mollie R. Gordon, MA, MD; Adriann Combs, DNP, NNP-BC; Eran Bornstein, MD; Dawnette Lewis, MD; Adi Katz, MD; Ashley Warman, MS, HEC-C; Amos Gru¨nebaum, MD
The term “obstetric violence” has been used in legislation and academic literature to describe mistreatment during pregnancy and childbirth. However, it is emotionally charged and may imply intentional harm by healthcare providers, when in many cases, mistreatment results from systemic issues, lack of training, or misunderstandings. A broader and more neutral term, “obstetric mistreatment,” better encompasses nonconsensual procedures, discrimination, neglect, and verbal abuse. The discourse should shift from “obstetric violence” to addressing structural issues in reproductive care, much like other medical fields avoid terms like “psychiatric violence.” Using “mistreatment in healthcare” allows for a more comprehensive approach to addressing unethical practices and promoting respectful, patient-centered care.
Belén Castrillo. Dra en Ciencias Sociales – UNLP Becaria posdoctoral CONICET en CIMeCS – IdIHCS. (UNLP/CONICET) – FaHCE
Obstetric violence, as an expression of the violation of human, sexual, and reproductive rights of women and their environment during the care of pregnancies and childbirth, has gained importance on the public and social agenda in recent decades. During the new millennium, policies, laws, and protocols have been created to humanize obstetric care, guarantee rights, and respond to the denunciation of one of the most invisible and naturalized forms of gender-based violence worldwide. In this article, I propose a double task: first, an analytical approach from a sociological perspective for the study of obstetric violence. Second, based on these conceptual lenses, a documentary analysis of a recently published UN Report (2019) on the global situation of this issue. The intersection between the global, through what is presented in this document, and the local, through the doctoral research I conducted and which inspires this article, aims to provide coordinates to further deepen the understanding of obstetric violence, targeting its prevention and eradication.
Obstetric violence, a term coined by activists in Latin America to describe violence during pregnancy, childbirth, and the postpartum period, has become a controversial feminist concept in global health policymaking as well as in obstetric and midwifery practice and research. Reflecting both theoretically and autoethnographically, we demonstrate its feminist value in addressing violence as embedded within the obstetric institution and argue that it can only be effective in driving change when clearly understood as institutionalized, intersectional violence. We therefore propose an abolitionist framework that refracts obstetric violence as institutionalized, intersectional, and racialized, by developing an abolitionist historiography of the obstetric institution and centering anti-Black obstetric racism as the anchor point where the afterlife of slavery, racial capitalism, systemic racism, and patriarchal biopolitics converge. Abolition offers a unique approach, not only dismantling violent institutions but also building futures grounded in Black, Indigenous, and independent doula and midwifery practices, oriented toward a life-affirming world of care. Unlike other forms of violence, where it is (more) straightforward to identify perpetrators, in this case, responsibility lies at structural levels of society. It is rooted in gender ideologies that strip women of their ability to make decisions about their own life processes and in the foundational paradigms of the biomedical system—an androcentric and reductionist model that has fostered a fragmented and pathological view of female reproductive processes. In the following pages, I present the debates that have led to the recognition of this form of violence both globally and in Chile, the terms used to describe it, and key indicators of childbirth care in the country that illustrate the current state of this issue. With this, I hope to highlight the urgency of addressing the quality of obstetric care as a public health concern and to contribute to the reflection and implementation of comprehensive care approaches.
Michelle Sadler
While progress has been made in recent decades in raising awareness of various forms of gender-based violence, one form has been particularly resistant to being named and recognized: obstetric violence. This type of violence occurs primarily within healthcare facilities and constitutes a serious public health issue as well as a violation of women's sexual, reproductive, and human rights. Unlike other forms of violence, where it is (more) straightforward to identify perpetrators, in this case, responsibility lies at structural levels of society. It is rooted in gender ideologies that strip women of their ability to make decisions about their own life processes and in the foundational paradigms of the biomedical system—an androcentric and reductionist model that has fostered a fragmented and pathological view of female reproductive processes. In the following pages, I present the debates that have led to the recognition of this form of violence both globally and in Chile, the terms used to describe it, and key indicators of childbirth care in the country that illustrate the current state of this issue. With this, I hope to highlight the urgency of addressing the quality of obstetric care as a public health concern and to contribute to the reflection and implementation of comprehensive care approaches.
Mary Ellen Stanton, Aparajita Gogoi
Mistreatment in childbirth is a significant issue affecting both human rights and healthcare. Serious violations occur worldwide, particularly around the time of birth, impacting both childbearing individuals and newborns. Some are taken into surgery for cesarean delivery without informed consent, while postpartum mothers are detained for days to extort payment for care. In some cases, babies are swapped in nurseries based on power and wealth, and newborns are handled roughly. Childbearing individuals face physical abuse and humiliation, with some being forced to clean the floor and bed immediately after giving birth. Mothers and newborns are often separated, and individuals are ridiculed for their choices, coerced into unwanted treatments, and denied the autonomy they deserve in their reproductive care.
Elizabeth O’Brien, Miriam Rich. Department of the History of Medicine, Johns Hopkins University, Baltimore, MD 21205–2113, USA (EO’B); Society of Fellows and Department of History, Dartmo
Drawing on a historical perspective reveals the extent of obstetric violence across different times and places, highlighting its deep entrenchment within specific historical structures, including racism, patriarchy, religious persecution, colonialism, and ethnonationalism. This history underscores the need to consider the social and political determinants of reproductive health outcomes, providing essential context for understanding and addressing persistent reproductive health inequities and injustices today. For clinicians, awareness of this history can deepen their understanding of how past oppressions continue to shape interactions between healthcare professionals and patients. It also reinforces the importance of delivering respectful reproductive care that upholds patient dignity, autonomy, and well-being. More broadly, by exposing the links between reproductive experiences and social inequity, attention to obstetric violence suggests that efforts to improve reproductive health must be informed by a broader awareness of social and political contexts. Furthermore, by explicitly naming the harms related to childbearing as violence, the framework of obstetric violence emphasizes the severity of these abuses and conveys an urgent need to address them. While the history of reproductive healthcare is marked by social and political injustices, its future can be shaped by those who recognize and challenge these inequities.
Stéphanie Batram-Zantvoort, Céline Miani, Oliver Razum
Recent public health research shows that many women worldwide report suboptimal treatment during facility-based childbirth. Existing approaches to measuring mistreatment often fail to integrate theoretical perspectives with empirical data. To address this gap, a new theory-based approach and multilevel framework are proposed to examine the cultural, institutional, and individual factors that impact "birth integrity." This research grounds the concept of birth integrity in medicalization, risk theory, embodiment, and intersectionality. A six-field framework is introduced to analyze the factors influencing both the protection and violation of birth integrity, recognizing that mistreatment can range from implicit and normalized to explicit and socially accepted. By offering a more comprehensive, theory-informed approach, this framework extends beyond traditional quantitative research, helping to deepen the understanding of gender-based violence and health inequalities in childbirth.
Sara Cohen Shabot. The Women’s and Gender Studies Program, University of Haifa, Israel
Obstetric violence—psychological and physical violence inflicted by medical staff on women during childbirth—has been described as a form of structural violence, specifically gender-based violence. Many women experience obstetric violence, often with devastating consequences. While this phenomenon has been primarily examined through the lens of health and social sciences, fundamental theoretical and conceptual questions remain largely unexplored. Until now, obstetric violence has been understood as an impediment to autonomy and individual agency over the body. In this article, I argue that obstetric violence occurs within a specific state of embodied vulnerability, which can be destructive to subjectivity. This destruction arises from a failure to recognize vulnerability, instead denying support and severing relationships—both between women and their own lived bodies, and between women and others. This perspective introduces a conceptual shift, suggesting that obstetric violence should be reconceptualized as a moment in which vulnerability is misrecognized, and ambiguity, relationality, and support (rather than autonomy) are systematically denied.
Michelle Sadler , Gonzalo Leiva & Ibone Olza
The measures implemented are neither strictly necessary nor evidence-based. They disregard human dignity and violate women’s rights. Even worse, they are causing harm, stress, and fear, as many pregnant women are not only afraid of contracting COVID-19 but also of being coerced into unnecessary obstetric interventions or being separated from their partners and newborns during and after labor. These experiences are likely to have long-term effects on maternal and infant mental health. Unfortunately, we carry a history spanning decades—if not centuries—of harmful biomedical childbirth practices that lack scientific evidence and have proven difficult to change. The COVID-19 crisis serves as a stark reminder of the fragility of the progress made in protecting the rights of women and newborns. Rather than constituting an effective response to the pandemic, these harmful practices represent a violation of women’s human rights and a disguised form of structural gender discrimination. The current rollback of women’s rights during childbirth amid the pandemic is a clear example of how easily health systems can infringe on the rights of mothers and their babies. It remains to be seen whether these harmful practices will be temporary, but there is a real concern that they could lead to a regression in the progress toward ensuring positive birth experiences for women, newborns, and families worldwide.
Mounia El Kotni & Elyse Ona Singer
Finally, in their article on reproductive violence in the Dominican Republic, Arachu Castro and Virginia Savage examine the disconnect between scholarly formulations of the rights-based framework of “obstetric violence” and local understandings of mistreatment and abuse among women seeking care in a public maternity hospital. They reveal how internationally circulating human rights frameworks are not always easily or seamlessly adopted by those they are intended to serve. In addition to analyzing these discrepancies and their implications for the future of such academic categories, the authors highlight how women’s resignation to poor-quality medical care can be understood as a form of “adaptive preference” in response to stark health disparities and inequitable access to high-quality maternal healthcare.
Caitlin R. Williams & Benjamin Mason Meier
Since the 1980s, efforts to name and eliminate mistreatment and abuse in sexual and reproductive health (SRH) services have spanned multiple disciplines and sectors. This broad approach is essential, as obstetric violence encompasses multiple, intersecting human rights violations. Developing effective responses requires multisectoral collaboration. The sexual and reproductive health and rights (SRHR) community has much to offer and much to gain. Strengthening partnerships with the human rights community can help establish shared norms and metrics that integrate both public health evidence and human rights standards. These norms and metrics can, in turn, be used to monitor the progressive realization of rights and facilitate accountability. Policy reforms aimed at strengthening protections against obstetric violence can also reinforce broader sexual and reproductive rights, particularly those at the intersection of multiple human rights. Expanding the community of practice dedicated to ensuring safe and respectful maternity care for all can further accelerate efforts to end obstetric violence.
Rajat Khosla, Christina Zampas, Joshua P. Vogel, Meghan A. Bohren, Mindy Roseman, and Joanna N. Erdman
International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the specific context of maternal mortality and morbidity, increasingly recognizing the provision and experience of care during and after pregnancy, including childbirth, as a critical human rights issue. However, international human rights standards on mistreatment during facility-based childbirth remain in an early stage of development, focusing largely on a limited subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a result, the full range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the complete spectrum of documented mistreatment is a crucial first step toward addressing human rights violations during facility-based childbirth, ensuring respectful and humane treatment, and developing a framework to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and outlines an agenda for further research and action.
Shannon Hennig completed her Master of Arts in Integrated Studies degree with a focus in Work, Organization and Leadership from Athabasca University in 2016.
Violence against women is a globally pervasive issue that takes multiple forms, affecting women regardless of age, class, race/ethnicity, or ability. Within a patriarchal paradigm, the subjugation of women is consistently present across cultures and is reflected in social structures, including healthcare facilities and systems. Obstetric violence refers to acts of abuse or disrespect experienced by women during the prenatal and postnatal periods, with a particularly high prevalence during labor and delivery. At a time of intense vulnerability, women may be subjected to verbal and physical abuse, lack of respect, coercion, gross violations of privacy, and the withholding of pain relief—often at the hands of their healthcare providers. These experiences parallel those of women who have suffered abuse by domestic partners and may influence their future decisions regarding access to healthcare services. Pregnancy and childbirth remain among the leading causes of death for women of childbearing age. In response, governments have sought to increase access to appropriate healthcare services, including emergency obstetric care provided in facilities with skilled birth attendants. Applying a human rights framework to women’s sexual and reproductive health offers a promising approach to addressing the underlying structural inequalities that lead to acts of violence and pose a threat to women’s health.
In 2015, as we review progress toward the Millennium Development Goals (MDGs), we recognize that despite significant reductions in mortality, the number of maternal and newborn deaths worldwide remains unacceptably high. Over the past decade, efforts to reduce adverse outcomes for pregnant women and newborns have focused on increasing skilled birth attendance. This has led to higher rates of facility-based births across all regions. Reports indicate that the proportion of deliveries attended by skilled health personnel in developing countries rose from 56% in 1990 to 68% in 2012. However, with the increasing utilization of health services, a growing proportion of avoidable maternal and perinatal mortality and morbidity now occurs within health facilities. In this context, poor quality of care (QoC) in many facilities emerges as a critical barrier to eliminating preventable maternal and newborn deaths.
We do not dismiss the use of normative standards and traditional accountability mechanisms in the broader effort to address mistreatment and abuse (D&A). However, if we are truly committed to the idea that quality starts with what women need and want, then efforts to improve care must begin where women live and give birth. These initiatives must confront the often harsh realities faced on the front lines of resource-constrained health systems by supporting and reinforcing the agency of women and communities to demand better care, while also empowering health workers and managers to implement necessary changes. A vision of respectful maternity care that is meaningful for all women and health providers is essential. However, when mistreatment and abuse are recognized for what they are—a symptom of fractured health systems and locally entrenched power dynamics that work against both patients and providers—only then can the real work of improving quality and ensuring accountability truly begin.
The global movement for respectful maternal care is strategically using legal and policy-based normative standards. However, simply advocating for abstract standards, legal enforcement, or punishment is unlikely to solve the issue of mistreatment and abuse. These standards gain meaning over time through attention to lived experiences and underlying power dynamics. Disrespect and abuse during childbirth are defined as interactions or facility conditions deemed humiliating or undignified by local consensus or experienced as such. Over time, this definition is expected to align with national and human rights standards for quality maternal care. By combining lived experiences with normative frameworks, this approach helps challenge harmful social norms and poor healthcare practices. While research is underway to measure prevalence and test interventions, more is needed to understand the causes and consequences of mistreatment. Developing interventions with clear theories of change and implementation strategies will be key to building a strong global movement for respectful maternal care.
Childbirth can be a traumatic experience for many women. Various studies have found a high prevalence of trauma symptoms following childbirth, with between 1% and 6% of women developing full post-traumatic stress disorder (PTSD) and 35% experiencing some degree of PTSD symptoms postpartum. Women are often traumatized due to the actions or inactions of midwives, nurses, and doctors. Obstetric violence has been defined as “the appropriation of women’s bodies and reproductive processes by healthcare personnel, manifested through dehumanizing treatment, overuse of medication, and the pathologization of natural processes. This results in a loss of autonomy and the ability to make free decisions about their bodies and sexuality, ultimately negatively impacting women's quality of life.” Healthcare professionals may perpetrate obstetric violence due to a lack of technical skills in addressing the emotional and sexual aspects of childbirth, unresolved trauma, or professional burnout.
