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María Hidalgo Rudilla

A Hidden Form of Gender-Based and Institutional Abuse

Obstetric violence (OV) is a specific form of violence that merges gender-based and institutional abuse, manifesting in various forms of mistreatment and disrespectful care during pregnancy, childbirth, and postpartum. This type of violence, whether through action or omission, results in harm to women in both public and private health services.

OV is characterised by a range of abusive practices that strip women of their autonomy to make informed decisions about their bodies, sexuality, and reproductive health. It also reflects a significant lack of quality and compassionate care. This violence is not only inflicted by individual healthcare providers—sometimes intentionally, but often as part of routine practices—but also by health systems as a whole, particularly when the conditions in healthcare facilities fall far below accepted standards.

The manifestations of OV are varied and include the overuse of medical interventions, such as unnecessary C-sections, episiotomies, and other procedures even in low-risk births. Women may also experience physical and verbal abuse, including infantilisation, discrimination, and coercive or unconsented medical procedures. Other forms of OV include breaches of confidentiality, failure to obtain fully informed consent, denial of pain relief, and violations of privacy.

Recognising the severity of this issue, international bodies such as the United Nations (2019), the Council of Europe (2021), the European Parliament (2019, 2024), and the European Commission (2024) have defined obstetric violence as a violation of human rights, categorising it as both gender-based and institutional violence.

It is important to note that most instances of OV are not intentional. Rather, they are perpetuated through normalised routines and a risk-based approach to pregnancy and childbirth. OV is deeply structural and intersectional, rooted in societal norms, health inequities, gender stereotypes, professional hierarchies, and the power dynamics between women and healthcare practitioners.

Crucially, all women, regardless of their economic status, level of education, or socio-cultural background, are at risk of experiencing obstetric violence. This pervasive issue demands urgent attention and action to ensure that all women receive the respectful and compassionate care they deserve during one of the most critical periods of their lives.