For a few weeks now, the Ministry of Equality and the Women’s Institute have been discussing the proposal to reform the sexual and reproductive health law to, among other things, make some modifications regarding the voluntary interruption of pregnancy and incorporate into it the obstetric violence. Well, in the coming weeks I am going to address some issues along these lines, to whose study I have dedicated the last years of my life and which may perhaps be useful in the public debate that this reform project has been generating. Sometimes these issues become as interesting as they are complicated to understand, so I will try to raise it in a simple way and very briefly with the socio-legal foundations that I consider relevant in the discussion.
The first thing – and what will be addressed in this column – is to talk about what sexual and reproductive rights are, what relationship they have with obstetric violence and whether or not it is appropriate for obstetric violence to be incorporated into the sexual health law and reproductive. So let’s go!
Sexual and reproductive health according to World Health Organization (WHO) it is a state of physical, emotional, mental and social well-being in relation to all aspects of sexuality and reproduction, not simply the absence of disease. It is guaranteed from the effectiveness of the right to health (art 12 International Covenant on Economic, Social and Cultural Rights) which is materialized in this case more specifically in sexual rights (the possibility of having pleasant sexual experiences free from all coercion and discrimination , have access to counseling and care services related to sexuality, not to be violated or genitally mutilated, etc.) and reproductive (the possibility of choosing whether to have children, access contraception services, access abortion services insurance, the right not to be forcibly sterilized, to menstruate in dignity conditions, to have safe pregnancy, delivery and postpartum care, etc.). In other words, sexual and reproductive health cannot be guaranteed without the realization of sexual and reproductive rights.
The WHO on several occasions has referred to the existence of mistreatment during pregnancy and childbirth by health personnel and has issued guidelines interceding for its prevention and eradication (in 2014) as well as a positive birth experience (in 2019).
The demand for the elimination of obstetric violence such as those dehumanizing treatments that are given by health personnel to women in pregnancy, childbirth and postpartum – on whose definition I will not stop, but they can deepen it by here– It is part of the fight for sexual and reproductive rights and thus the legal framework that has incorporated it has been developing. It is also a type of gender violence that violates the rights of women to their privacy, dignity, freedom of choice and above all to a life free of violence. And, given its seriousness, it is necessary to make it visible and give it special legal treatment as has been done at the time with other violations of sexual and reproductive rights such as forced sterilization or female genital mutilation.
The United Nations Special Rapporteur on torture It has said on several occasions that abuses and ill-treatment in the field of health care constitute inhuman and degrading treatment that can cause enormous suffering and are considered acts of torture.
The United Nations Special Rapporteur on violence against women presented in 2019 the report “Human rights-based approach to abuse and violence against women in reproductive health services, with special emphasis on delivery care and obstetric violence”, in which for the first time within the framework of international human rights law, these painful and violent practices suffered by women in a generalized and systematic way in the world are recognized and given this name.
Last year the United Nations Committee for the Elimination of Discrimination against Women issued an opinion condemning the mistreatment suffered by a woman during her childbirth. It is the first time that CEDAW has adopted a decision related to obstetric violence and the State on which this reproach fell was Spain. This implies not only financial reparation for the victim but also a series of public policies that Spain must implement to stop this violence.
So the conclusion is simple, the modification that the Ministry of Equality intends to make to the law on sexual and reproductive health and voluntary interruption of pregnancy, is not an institutional whim of the Government, far from it. It would not be the first time that obstetric violence would have legal recognition; countries like Venezuela, Argentina and Mexico have already done so. Recognizing obstetric violence is in absolute accordance with the legal framework of international human rights law, with compliance with international obligations and the binding recommendations made by the United Nations to Spain. The inclusion of obstetric violence in the sexual and reproductive health law is a moral and legal obligation of Spain and is also the result of social and feminist struggles for human rights and for the right to health.