Obstetric Violence and Maternal-Infant Microbiota at the 2025 SEMiPyP Congress

We are pleased to share that Serena Brigidi presented the IPOV Project (International Platform on Obstetric Violence) at the 2025 SEMiPyP Congress, offering an anthropological perspective on the impact of obstetric violence and the importance of respectful childbirth care in the lives of mothers and babies.

Her presentation highlighted how obstetric violence not only affects physical health but also profoundly influences the subjective, emotional, and social experiences of mothers. This perspective complements the scientific sessions by emphasizing how cultural and social contexts shape biological processes during childbirth and the long-term health of mothers and babies.

The IPOV Project, part of the HORIZON-MSCA-2022-Staff Exchange (2024-2028), aims to raise awareness and advocate for the prevention of obstetric violence through research and international collaboration.

In addition to this essential presentation, the congress highlighted key sessions on:

• Human Milk Microbiota and its role in newborn health
• Mastitis and Breastfeeding Complications
• Vaginal Microbiota and Reproductive Health
• Vertical Transmission of Microbiota from mother to child
• Probiotics for Vaginal Infections during pregnancy

This growing body of research reinforces the need to protect physiological processes that support maternal and infant health.

Abstract

Gynaecological-obstetric violence (GOV) is defined as a form of structural, symbolic, and gender-based violence that affects women in their sexual and reproductive health (SRH) processes (Šimonović, 2019). This type of violence can manifest throughout the entire sexual and reproductive life cycle, from menarche and fertility to pregnancy, childbirth, postpartum, breastfeeding, menopause, and climacteric. These experiences range between the physiological and the pathological, revealing a continuum that challenges traditional risk categories associated with age or social class and invites the consideration of SRH from an intersectional perspective that embraces its complexity.

GOV, besides its structural dimension, is distinguished by its intergenerational and transnational nature. Hierarchical power structures, consolidated and reproduced across generations of women (grandmothers, mothers, daughters, granddaughters), have contributed to the normalisation of violence in their SRH processes (Brigidi et al., 2023). Among the various forms of violence affecting women, the brutality, carnalisation, and objectification often experienced before, during, and after childbirth (Brigidi, 2024) stand out. These experiences, which frame women and their babies as fragile and vulnerable subjects, have been the most studied and linked to obstetric violence (OV).

To understand OV, it is essential to analyse its manifestations across three domains – physical, emotional, and spiritual – and three key stages: gestation, childbirth, and postpartum (Brigidi et al., 2023). This form of violence is characterised by the denial of women’s agency in key physiological processes and in decisions related to their SRH, manifesting through practices such as direct or indirect physical injuries, medical interventions without clear clinical evidence, and dehumanising treatment. These dynamics reflect a hierarchical, patriarchal, and colonial structure that permeates biomedical systems.

OV can be perpetrated within the biomedical system by medical professionals, nurses, and various healthcare specialities, as well as by administrative and cleaning staff. One of its primary complexities lies in the fact that those who perpetrate this violence can also be victims of various forms of violence, such as institutional, gender-based, and obstetric violence. The suffering subjects, therefore, include women, their children, partners, and the wider family and social environment. Moreover, echoing the famous phrase by Michel Odent, “To change the world, we must first change the way babies are born”, the collective is also affected: what kind of society can we build if the majority of people are born in a violent context? How can we generate collective reparation?

Therefore, it can be affirmed that the impact of Obstetric Gender Violence (OGV) is not limited solely to women but also reflects the precarious working conditions faced by healthcare professionals. However, this does not exempt them from responsibility for discriminatory or racist attitudes, particularly towards migrant women (Brigidi, 2024; Llamas & Brigidi, 2022). These women often encounter additional barriers, such as lack of access to information in their language or culturally appropriate care (Barata, 2023; Davis, 2019).

In Spain, progress has been made towards recognising obstetric violence as a form of gender-based violence, with examples such as regulations in Catalonia (2021), the Basque Country (2022), and the Valencian Community (2022). Likewise, within the healthcare field, initiatives such as the working group on OGV of the Societat Catalana de Obstetrícia i Ginecologia (SCOG) and the Associació Catalana de Llevadores stand out. However, it is important to highlight that the genealogy of the concept of OGV lies in the activism, theory, and legislation developed by women in Latin America, who were the first to conceptualise and legislate on this specific form of violence (Quattrocchi & Magnone, 2020).

Although various countries have normative frameworks, real transformation requires significant changes in healthcare training, including specialties such as paediatrics, anaesthesiology, and comprehensive care for women’s sexual and reproductive health (SRH). It is also crucial to raise public awareness and promote care models that respect traditional knowledge, avoiding unnecessary medicalisation and the epistemic violence that has characterised the hospital-centric model.

The consolidation of “obstetric power” (Arguedas, 2019), along with the social control exercised over bodies — particularly non-normative ones — and a pathologising approach to women’s life cycles have perpetuated OGV. Furthermore, the absence of a clear consensus on its definition (Brigidi et al., 2024) and the predominance of quantitative methodologies for its evaluation have limited the understanding of the phenomenon, maintaining a paternalistic and universalist perspective.

Addressing OGV requires overcoming these limitations by integrating qualitative tools that allow exploration of subjectivity and the intersections shaping this issue, while also reflecting on prevention (Guaita-Fernández et al., 2014). Specific prevention measures regarding OGV are essential. Academic production, feminist critiques, and activism have worked for decades to raise awareness, investigate, and eradicate violence in SRH processes. An example is the IPOV project, International Platform on Obstetric Violence (HORIZON-MSCA-2022-Staff Exchange 2024-2028), which aims to make obstetric violence visible and promote respectful maternity and childbirth care.

To this end, an innovative, international, interdisciplinary, intersectoral, and transcultural interactive digital platform will be developed to connect academic research with public policies, healthcare professionals’ training, women’s perspectives, and societal involvement on this topic. This space will be dedicated to producing, sharing, and transferring knowledge, systematising and exchanging good practices, acquiring skills, and designing innovative training programmes with a gender perspective on respectful maternity and childbirth care.

In conclusion, integrating intersectional approaches, promoting transformative differential healthcare training, and fostering prevention strategies based on inclusion and respect are essential actions to prevent OGV and advance towards equitable health systems.

Download all the studies presented at the congress:

Download studies (PDF)

Bibliography

– Guaita-Fernández P, Martín Martín JM, Ribeiro-Navarrete S, Puertas R. Analysing the efficiency of public policies on gender-based violence: A literature review. Sustainable Technology and Entrepreneurship. 2024; 3(3): 100066. https://www.sciencedirect.com/science/article/pii/S2773032823000299

– Šimonović D. A human rights-based approach to mistreatment and violence against women in Reproductive Health Services with a focus on childbirth and obstetric violence. New York, NY: UN; 2019. https://digitallibrary.un.org/record/3823698?v=pdf

– Boletín Oficial del Estado. Organic Law 1/2023, of February 28, amending Organic Law 2/2010, of March 3, on sexual and reproductive health and voluntary termination of pregnancy. Available at: https://www.boe.es/buscar/act.php?id=BOE-A-2023-5364

– Autonomous Community of Catalonia. Law 17/2020, of December 22, amending Law 5/2008 on women’s right to eradicate gender-based violence. Available at: https://www.boe.es/diario_boe/txt.php?id=BOE-A-2021-464

– Autonomous Community of the Valencian Community. Law 10/2014, of December 29, on Health of the Valencian Community. https://www.gva.es/en/inicio/procedimientos?id_proc=G21561

– Autonomous Community of the Basque Country. Law 1/2022, of March 3, second codification of the Law for the Equality of Women and Men. In Boletín Oficial del Estado. https://www.boe.es/buscar/doc.php?id=BOE-A-2022-4849

– Quattrocchi P, Magnone N (Eds.). Obstetric violence in Latin America: Conceptualization, experiences, measurement, and strategies (1st ed.). Remedios de Escalada: De la UNLa – Universidad Nacional de Lanús; 2020. Available at: https://doi.org/978-987-4937-50-6

– Arguedas G. Obstetric violence: A conceptual proposal based on the Costa Rican experience. Cuadernos Intercambio sobre Centroamérica y el Caribe. 2014; 11(1): 145-69. https://www.redalyc.org/pdf/4769/476947241008.pdf

– Llamas E, Brigidi S. Cultures and Sexual and Reproductive Rights of Migrant Women in Catalonia: Towards care centered on a comprehensive and gender-based perspective in the Catalan health system. Revista (Con)textos. 2022; 10(1): 115-32. https://dialnet.unirioja.es/servlet/articulo?codigo=8393869

– Brigidi S. Intersectional obstetric stratification. Revista (Con)textos. 2022; 10: 93-113. https://raco.cat/index.php/contextos/article/view/400648

– Davis DA. Obstetric racism: The racial politics of pregnancy, labor, and birthing. Medical Anthropology. 2019; 38(7): 560-73. https://pubmed.ncbi.nlm.nih.gov/30521376/

– Barata C. Body broken in Half: tackling an Afro-Brazilian migrant’s experience of Obstetric violence and racism in Portugal through art making. Revista (Con)textos. 2022; 10(1): 65-84. https://repositorio.ulisboa.pt/handle/10451/52229

Key Sessions on Microbiota and Maternal-Infant Health: Pregnancy, Childbirth, and Breastfeeding

In addition to the presentation Prevention of Obstetric Violence – IPOV Project by S. Brigidi, we also recommend attending the following sessions for their relevance in understanding the microbiota in pregnancy, childbirth, breastfeeding, and reproductive health:

• Human Milk Microbiota – L. Fernández Álvarez, A. Aragón Ramírez, R. Jurado Escober, N. Hernández Sampio, J. Jara Pérez, B. Orgaz Martín, J.M. Rodríguez Gómez. An essential session to delve into the composition and function of human milk as a vehicle for beneficial microbiota for the newborn.
• National Consensus on Mastitis – J.M. Moreno Villares. Addressing the latest recommendations on the prevention, diagnosis, and treatment of mastitis, one of the main complications during breastfeeding.
• The Vagina and Its Microbiota: Contribution to Reproductive Health – E. Suárez. A key presentation to understand the role of vaginal microbiota in gynecological health and its influence on fertility and pregnancy.
• Mother/Child Microbiota: Type of Breastfeeding – B. Espín. An analysis on how the type of breastfeeding influences the baby’s microbiota and its long-term health impact.
• Vertical Transmission of the Microbiome: Microbial Heritage – M.C. Collado. Exploring how maternal microbiota is transmitted to the baby during pregnancy, childbirth, and breastfeeding, with fundamental implications for infant health.
• Use of Probiotics in Vaginal Infections – M. Sánchez-Prieto, F. Losa, H. Losa Puig, R. Sánchez-Borrego. A review of current evidence on the use of probiotics as a tool to prevent and treat vaginal infections, especially relevant during pregnancy.

These sessions offer a comprehensive view of the role of microbiota in maternal and infant health and the importance of protecting the physiological processes that support it.