Health

“Gender bias in medicine kills”

Interviews

OBSTETRIC VIOLENCE


Francisca Fernández Guillén regrets that “all possible stereotypes regarding the role of women are concentrated in obstetric care” and denounces the “excessive pathologization and excessive interventionism”. She is a founding member of the Obstetric Violence Observatory of Spain.

The WHO defines obstetric violence “as a specific form of violence exercised by health professionals -predominantly doctors and nursing staff- towards pregnant women, in labor and postpartum, and that constitutes a violation of the reproductive and sexual rights of women”. In the words of the lawyer Francisca Fernandez Guillen this practice differs “from what is pure medical negligence, in that there is a intended to limit women’s ability to make decisions and it is accompanied, many times, by psychological abuse or humiliating treatment”. In his opinion “all possible stereotypes regarding the role of women are concentrated in obstetric care”.

Fernández Guillén has two decades of experience in the legal defense of patients and users, especially in childbirth care. In March 2020, he signed a historic victory at the UN by getting, for the first time, an international court to condemn a State for the ill-treatment received by a pregnant woman and her newborn, classifying it as a form of gender-based violence. . Although on July 14 the UN Committee for the Elimination of Discrimination against Women once again held Spain responsible for exercising obstetric violence, “the majority of professional associations deny the existence of this problem,” laments the lawyer. At the other extreme, together with the recognition of the medical associations of Catalonia, “the midwives’ associations unanimously recognize that this problem is structural and systematic”.

There are four cases that the lawyer has been forced to submit to the UN, but there are around four hundred complaints that have passed through her hands. “All the mothers in the cases that I have handled, of course, wanted the best for their babies; what happens is that they think -and this has been corroborated by the experts in the different trials-, that what has been done to them did not serve the purpose of safeguarding their own health and that of their babies, but other interests“.

The bibliography in this regard refers to “inappropriate or non-consensual acts, such as episiotomies without consent, painful interventions without anesthetics, forcing to give birth in a certain position or providing excessive, unnecessary or iatrogenic medicalization that could generate serious complications. This violence can also be psychological, such as giving the user a childish, paternalistic, authoritarian, derogatory, humiliating treatment, with verbal insults, depersonalized or humiliating”. (SESPAS, 2020. Authors: Javier Rodríguez Mir and Alejandra Martínez Gandolf)

Francisca Fernandez points out that, “in conjunction with routine episiotomy”, “convenience induction of labor” is particularly abused: Many children are born prematurely to adapt the birth to the doctor’s agenda, especially in the private one, but also in the public one”.

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