This was one of the first intentions announced by the Ministry of Equality in proposing future reform of the abortion law. The department, led by Irene Montero, advocated the inclusion of obstetric violence as a form of violence against women, but a norm approved by the Council of Ministers this week eventually rejected the term. Yes, most of the measures of the first drafts reviewed by the Ministry have been retained, but there are no traces of these two words, which caused so much controversy, and that the texts were named seven times at that time.
This was one of the issues that led to more disagreements between the government partners since the start of the negotiations. Finally, the chapter, which originally dealt with gynecological-maternal violence, ends with the title “Protection and guarantee of sexual and reproductive rights in the field of gynecology and obstetrics.” Sources at Equality acknowledge that this is not the wording they wanted to appear in, but they suggest that they are a “small part” of the coalition and that neither the Ministry of Health nor the Ministry of Justice has accepted the term positively. “The text has been processed and agreed upon by the ministries,” they respond from Carolina Darias’s portfolio.
The idea of equality was fundamentally translated into law, something that some international organizations have recognized for some time, warning of its impact. ოფლიWorld Health Organization Speaks of “disrespectful, abusive or negligent childbirth” as a “violation of women’s rights”. And in 2019 the UN He called obstetric violence a “widespread and systematic” phenomenon. A year later, the Committee on the Elimination of Discrimination against Women (CEDAW) condemned Spain for a case in 2009 in which it demanded that administrations provide more training for professionals and data that would allow it to ‘inspire the situation.
The declaration of equality did not take long to stir up a wave of support, but also strong opposition. The medical associations said in a statement that the term appeared to be “particularly offensive” and that “it does not fit into the reality of pregnancy, childbirth and postpartum care and criminalizes the actions of professionals.” The Spanish Society of Gynecology and Obstetrics (SEGO) also took a stand against the concept, which it described as “inappropriate, biased and unfair”, but acknowledged that “it made it possible to highlight the unpleasant experiences of many women and put it in public debate.” There is room for improvement in the “certain obstetric practice” care scenario.
As negotiations took place in the government, the public statements of the Ministry of Equality on this issue were no longer so strong. Asked about this a month ago, Minister Irene Montero assured that the purpose of the regulation was to “promote that good practice” is “the only practice” in gynecological consultation and childbirth and affirmed the recognition of obstetric violence in legislation. “Do not try to criminalize anyone,” with a clear indication of resistance from doctors. “If it is not named, it will not cease to exist,” he added, as a prelude to what awaited the law.
Anyway, the text that the government has given the green light to, that the process has just begun and can still be changed, did not ignore the reality that the term is going to name. In fact, the gynecology-obstetrics rights chapter calls on administrations to promote services based on free, prior and informed consent, in which interventionism is reduced, avoids “unnecessary or inappropriate” practices, and provides “clear and sufficient”. tion for women and a “guarantee” of not “unnecessary” separation from their babies.
In practice, it provides for the obligation to conduct research and periodically collect data depending on what is happening in hospitals. The Sexual and Reproductive Health Strategy will have a specific chapter and the Territorial Health Council will have to approve a common protocol against obstetric violence (“Guarantee of sexual and reproductive rights in the field of gynecology and obstetrics”, the text reads). Communities will have to encourage hospitals to adopt specific protocols. “This is a historic step forward” because “she unequivocally recognizes the need for public policy,” which will develop what CEDAW recommends to Spain, said Tony Morillas, director of the Women’s Institute, who has played a key role in the rule. .
The fact that the concept is ultimately left behind in the text provokes all sorts of reactions. “As much as we want to close our eyes, it exists, and it’s not what we invented. Franco, secretary of the Spanish Federation of Midwifery Associations, stressed that, nevertheless, the document shows “the intention to improve all these processes. “
For Virginia Murialdo, an anthropologist and activist for El Parto es Nuestro, the resignation is “important” because the term “expresses that it is a systemic and structural problem, as the United Nations says, and it is not an isolated case.” Among the testimonies given by the association are “unjustified practice without consent or prior information”, such as an episiotomy, overdose of drugs or so-called. Crystal maneuver that discourages WHO. But there are also “degrading” attitudes and comments or “actions that do not respect the privacy of women,” she explains.
“The term focuses a lot on a particular practice, but deep down there is a reality that goes much further and is related to the fact that the experience is not well-groomed. We are talking about women whose express consent is not. For certain actions and very fixed systems that do not allow them to carry out the process as they wish, or are infantilized in decision making. “It all makes them feel disturbed during the obstetric process,” Franco said.
Gynecologist Isabel Serrano believes the good news is that the concept has finally disappeared, as she believes that talking about obstetric violence and, above all, its generalization “could lead to more problems than we want to avoid, such as mistrust of health professionals.” The expert points out that the sector has made “great efforts” in recent years, which has “grown into tangible progress”.
Beatrice Julia agrees with him, a gynecologist at Severo Ochoa University Hospital in Leganés, who notes abortion law reform, but disagrees with Igwald on the issue: “Violence deliberately causes harm,” she laments. “The expert points to the delicate nature of the gynecological field, where ‘the best results are needed’ and professionals’ can not act even in emergencies for fear of being accused of obstetric violence for practices such as having an episiotomy,” he says.
Julia also points to the “burden of day-to-day care”, which many times “does not allow us to make explanations the way we want them to.” For his part, Serrano acknowledges that women are sometimes “inadequately treated” and “should work to prevent this from happening,” but acknowledges that “there is no majority” and limits it to cases of crime. But not to obstetric violence.
These are not two equivalent realities for gynecologist Miriam Al Adib, author of several books, including Let’s talk about us. “There are cases when there is a medical error and there is childbirth, which can be traumatic because they are complicated, but in some it is a dehumanized treatment in which women are passive subjects,” said the expert, who claims to be self-critical. “It does not mean that we are professionals abusers”, but “socially and medically there is still this paradigm that we need to improve.”
In fact, he believes that the progress of recent years has come about precisely because of his misrecognition. “Two decades ago, something incredible was done. For example, unnecessary separation of mother and baby was systematic after a caesarean section and a woman could be fine until the next day without it. And so on. The steps taken are very positive because we were able to celebrate “And we have established some practices that were considered normal,” al-Adib added.
Source: El Diario
