Obstetric violence in a major international reference work on gender and violence
March 29, 2026Patrizia Quattrocchi takes part in a university event in Bari on obstetric violence and interdisciplinary dialogue
April 19, 2026Symbolic Violence and the Regulation of the Feminine
A Genealogy from Jacoba de Settesoli to Contemporary Obstetrics

Author: Dr. Laura Abojer
Head of the Obstetrics Department
Hospital Municipal Materno Infantil de San Isidro,
Province of Buenos Aires, Argentina.
IPOV – International Project on Obstetric Violence
Abstract
This article proposes a genealogical reading of the mechanisms regulating the feminine through an analysis of the figure of Jacoba de Settesoli and her displacement within Franciscan historiography, in dialogue with contemporary practices in the field of obstetrics. Through a theoretical approach that brings together Michel Foucault’s contributions on biopower and Pierre Bourdieu’s concept of symbolic violence, it argues that the silencing of certain forms of female autonomy is not a contingent phenomenon, but rather a structural operation that cuts across different historical dispositifs.
The relative exclusion of Jacoba — a laywoman, autonomous and politically active — from the official narrative makes it possible to identify the criteria of legitimacy that have organized, and continue to organize, the representation of the feminine in the religious field and, by extension, in other institutional spheres. This logic is renewed in the contemporary obstetric field, where obstetric violence is expressed not only in clinical practices, but also in subtle forms of discrediting women’s knowledge and experience regarding their own bodies. In this sense, it can be understood as a form of epistemic injustice, insofar as women are discredited as legitimate subjects of knowledge concerning their own bodily and reproductive experience, as Ester Massó Guijarro has pointed out.
Based on the analysis of a situated discursive scene — a religious speech delivered during the celebration of the “Day of the Unborn Child” here in Argentina — the article examines how certain statements operate as dispositifs for the production of truth that erase maternal historicity and reinforce gender hierarchies. In this regard, it argues that the persistence of these symbolic matrices contributes to the reproduction of inequalities in the field of health, shaping an order in which only certain forms of the feminine are recognized as legitimate.
Recovering figures such as Jacoba de Settesoli allows not only for a critical revision of the historical construction of sanctity and female participation, but also opens questions about contemporary practices, enabling a situated reflection on the ways in which women’s experience around birth is produced, regulated and, in many cases, silenced.
Keywords: symbolic violence; biopower; obstetrics; gender; female autonomy; Jacoba de Settesoli; obstetric violence; IPOV.


Introduction
The ways in which a society narrates birth are not neutral: they condense regimes of truth, gender hierarchies, and dispositifs of power that organize both what can be said and what can be thought. In this sense, the present article begins from a central premise: contemporary modes of regulating the pregnant body cannot be fully understood without attending to the historical matrices that have, over time, shaped the conditions of possibility for female autonomy.
Far from constituting an exclusively medical field, obstetrics is inscribed within a broader web of discursive and institutional practices that intervene in life, producing subjectivities and delimiting legitimate forms of experience. As Michel Foucault has extensively developed, modern power does not operate solely through prohibition, but through the active production of forms of knowledge that regulate bodies and guide conduct.
However, this regulation is also sustained by subtler mechanisms that naturalize hierarchies, as Pierre Bourdieu has pointed out. In the obstetric field, this translates into the delegitimization of women’s knowledge about their own bodies and the construction of models of motherhood associated with obedience.
To understand these continuities, this work proposes a genealogical reading that finds in the figure of Francis of Assisi and, especially, Jacoba de Settesoli, a significant starting point.
1. Jacoba de Settesoli: Female Autonomy and Silencing in the Franciscan Tradition
The figure of Jacoba de Settesoli occupies a singular place in the origins of the Franciscan movement, even though her presence was progressively displaced to the margins of the official narrative. Born into the Roman nobility and widowed at a relatively early stage of her life, Jacoba not only possessed significant material resources, but also a remarkable capacity for action within the social and political fabric of her time. This position enabled her to establish a close relationship with Francis of Assisi, whom she accompanied not only in spiritual terms, but also in logistical, economic, and relational dimensions.
Unlike other female figures associated with early Franciscanism, Jacoba did not conform to the logic of enclosure nor to models of institutionalized religious life. Her participation unfolded in the world, moving through spaces of power, articulating resources and wills in favor of an order still in its early stages and lacking a consolidated structure. In this sense, her role far exceeded that of an occasional benefactor: Jacoba actively intervened in the material sustainability of the Franciscan project and in its insertion into the broader social field.
The recognition granted to her by Francis of Assisi — by naming her “Brother Jacoba” (frate Jacopa) — constitutes an eloquent indication of the singularity of this bond. Far from being anecdotal, this designation can be read as a destabilization of prevailing gender categories, insofar as it enabled a type of spiritual recognition that was not mediated by traditional hierarchies or by the roles assigned to women within the religious field.
However, this very singularity is what later makes her inclusion in institutionalized hagiographic narrative difficult. As Franciscanism consolidated itself as a recognized order, it became necessary to organize its memory according to models of sanctity consistent with ecclesiastical expectations. In this process, certain figures were privileged insofar as they embodied values such as obedience, interiority, and withdrawn life — as in the case of Clare of Assisi — whereas others, whose presence pointed to forms of autonomy, circulation, and relational power, proved more difficult to integrate.
The progressive relegation of Jacoba de Settesoli can thus be understood as the effect of an operation of symbolic regulation that delimits which forms of the feminine are narratable and which must be attenuated or displaced. This is not an explicit exclusion, but rather a silencing that operates through the minimization of her role, her reduction to anecdotal episodes, or her omission from the central narratives. This type of operation not only reorganizes the past, but also contributes to fixing reference models for the present, establishing the limits of what can be recognized as legitimate in terms of female participation.
Within this framework, Jacoba’s figure makes visible a constitutive tension in the Franciscan tradition — and, more broadly, in the religious field — between forms of life that exceed normative schemes and institutional dispositifs that seek to absorb or neutralize those differences. Her displacement from the center of the narrative speaks not only of her own time, but also offers a key for understanding contemporary processes in which certain forms of female protagonism continue, in different ways, to be disauthorized or rendered invisible.
2. Discourse as Dispositif: “The Day of the Unborn Child” and the Erasure of Maternal Experience
The scene of the speech delivered within the celebration of the “Day of the Unborn Child” constitutes a privileged point of condensation from which to observe the contemporary operation of certain dispositifs for the production of meaning around birth. Far from being a mere expression of individual beliefs, the speech is inscribed within a broader web of statements that, through repetition, configure a regime of truth concerning bodies, relationships, and gender hierarchies.
When the priest states that the first voice the baby hears is the father’s, he is not stating a verifiable fact, but instituting a narrative that places the masculine as the origin of speech and, by extension, of law. In this operation, the woman is displaced from her condition as a subject of enunciation and reduced to a biological support: a body that hosts, but does not speak; that enables, but does not found meaning. This configuration not only symbolically rearranges the place of the parents, but also establishes a hierarchy in which male mediation appears as necessary for the new subject’s access to the world of language.
The second statement — that “the circumstances of the pregnancy do not matter because when the baby is born it starts from zero” — deepens this movement through an operation of erasure. By denying relevance to the conditions preceding birth, the historical dimension of maternal experience is deactivated, rendering invisible factors such as violence, inequality, vulnerability, or even desire. Birth is presented as a point of absolute origin, disconnected from any prior web, thus enabling a decontextualized reading that favors the naturalization of the conditions in which that birth takes place.
This double movement — the institution of an original male voice and the erasure of maternal history — can be understood as part of a dispositif in the sense developed by Michel Foucault: a heterogeneous assemblage of discourses, practices, and forms of knowledge that not only describe reality, but produce it, organizing the conditions of possibility for what can be said and what can be seen. In this case, birth is captured as an object of symbolic regulation, and the woman is displaced into a secondary position in which her experience becomes irrelevant to the construction of meaning.
At the same time, the effectiveness of this type of statement lies in its capacity to present itself as self-evident, as truths that require no justification. Here, Pierre Bourdieu’s notion of symbolic violence becomes especially relevant, insofar as it allows us to understand how certain forms of domination are exercised without explicit coercion, through the internalization of schemes that legitimize inequality. The discourse analyzed is not imposed by force, but by its capacity to resonate with deeply rooted symbolic structures that organize perceptions of what is “natural” or “correct.”
In the obstetric field, these symbolic matrices are not harmless. On the contrary, they shape the terrain on which concrete practices unfold, practices that may lead to situations of obstetric violence. The delegitimization of women’s speech, the minimization of their experience, and the subordination of their bodily knowledge to expert knowledge find, in this type of discourse, a symbolic correlate that reinforces and naturalizes them. Thus, what appears to belong to the order of discourse translates into material effects on bodies and experiences.
In this sense, the scene of the “Day of the Unborn Child” not only updates a historical matrix of regulation of the feminine, but also makes visible the ways in which that matrix is reactivated in contemporary contexts, contributing to the reproduction of hierarchies that directly affect the experience of pregnancy, childbirth, and birth.
3. Structural Continuities: From Historical Silencing to Contemporary Obstetric Violence
The temporal distance separating the figure of Jacoba de Settesoli from contemporary obstetric practices might suggest, at first glance, the existence of significant ruptures in the ways of conceiving and regulating the feminine. However, a more careful analysis allows us to identify not so much discontinuities as persistences: recurring ways of ordering, hierarchizing, and legitimizing certain expressions of female experience while others are systematically displaced to the margins.
In Jacoba’s case, her progressive invisibilization in the Franciscan narrative did not result from a lack of relevance, but from the difficulty of inscribing her agency, autonomy, and active participation within a model of femininity compatible with emerging institutional logics. Her figure embodied a form of female presence that could not easily be regulated: she was not enclosed, not passive, and did not mediate her spiritual relationship through prescribed structures. Her displacement from the center of the narrative can therefore be read as an operation of normalization aimed at restoring a symbolic order threatened by that which could not be classified.
This same logic can be recognized, in other forms, in the contemporary obstetric field. Women going through pregnancy and childbirth face not only medical interventions, but also a web of expectations that delimits how they should behave, what they should feel, and, fundamentally, what place they should occupy in relation to knowledge. Those who conform to a model of docility — who delegate, do not question, and adapt to institutional times and decisions — are more easily integrated into the system. By contrast, women who seek to sustain their own voice, express their preferences, or exercise an active role in decision-making are often perceived as disruptive, difficult, or even risky.
In this sense, obstetric violence cannot be reduced to a set of inappropriate practices or individual failures, but must be understood as the effect of a broader rationality that organizes the relationship between knowledge, power, and body. As Michel Foucault has pointed out, modern power acts by producing subjects, shaping conduct, and establishing norms that operate at both institutional and subjective levels. In the realm of birth, this production translates into the configuration of a specific type of patient: collaborative, trusting in expert knowledge, and detached from any claim to autonomy that might disrupt the expected order.
At the same time, this rationality is sustained by mechanisms of legitimation that refer to what Pierre Bourdieu conceptualizes as symbolic violence: forms of domination that do not require direct imposition because they are inscribed in shared schemes of perception that make power relations appear natural. Within this framework, the disauthorization of women’s knowledge regarding their own bodies is not necessarily perceived as an injustice, but rather as a logical consequence of the distribution of competencies between those who “know” and those who “must be assisted.”
The scene of the “Day of the Unborn Child” speech makes it possible to observe how these symbolic matrices continue to produce effects in the present. The displacement of the woman as a subject of enunciation and the erasure of her history are not mere rhetorical resources, but conditions that enable certain practices and exclude others. As in Jacoba’s case, that which does not fit the model — one’s own voice, situated experience, the capacity for intervention — tends to be attenuated, delegitimized, or directly omitted.
From this perspective, the articulation between the historical silencing of Jacoba de Settesoli and contemporary forms of obstetric violence is not metaphorical, but structural. In both cases, these are operations that delimit the margins of acceptable femininity, producing an order in which only certain forms of presence, speech, and action are recognized as legitimate.
Recognizing these continuities does not imply denying historical transformations, but rather making them more complex. It allows us to perceive that, beyond changes in discourse and institutions, deep logics persist in organizing the relationship between gender, power, and knowledge. In this sense, the challenge is not only to make specific practices of violence visible, but to question the frameworks that make them possible, opening the possibility of imagining — and building — forms of care around birth that recognize women as full subjects, bearers of knowledge, and protagonists of their own experience.
Conclusions
The path traced throughout this article allows us to affirm that contemporary forms of obstetric violence cannot be understood solely as deviations from an ideal medical practice, but as the updated expression of historical matrices regulating the feminine. The figure of Jacoba de Settesoli, relegated in the Franciscan narrative despite her effective protagonism, and the discursive scene of the “Day of the Unborn Child,” in which maternal experience is symbolically displaced, do not constitute isolated facts, but moments within the same logic traversing different times and dispositifs.
In both cases, what is at stake is the delimitation of the conditions of legitimacy for female presence: which forms of participation are recognized, what type of speech is authorized, and which experiences may be inscribed in the collective narrative. That which exceeds these frameworks — autonomy, the capacity for intervention, one’s own voice — tends to be displaced to the margins, whether through omission, minimization, or disauthorization.
From this perspective, obstetric violence is not limited to visible practices, but includes a symbolic dimension that acts persistently, configuring subjectivities and naturalizing hierarchies. The difficulty in recognizing women as full subjects in the process of pregnancy, childbirth, and birth is not a contingent problem, but the effect of a rationality that has historically organized the relationship between knowledge, power, and body in asymmetrical terms.
Recovering figures such as Jacoba de Settesoli does not merely imply a gesture of historiographic reparation, but a critical intervention in the present. It makes visible that other forms of the feminine have existed — and still exist — and that their exclusion does not stem from a lack of relevance, but from their disruptive power in the face of established orders.
In this sense, thinking about birth from a perspective that recognizes women as protagonists of their own experience does not simply mean introducing improvements in clinical practice, but questioning the symbolic frameworks that have sustained, and still sustain, their subordination. The challenge is not only to prevent violence, but to transform the conditions that make it possible.

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