In an editorial published online on October 6, 2010 in the International Journal of Gynecology and Obstetrics, Dr. Rogelio Pérez D’Gregorio, President of the Society of Obstetrics and Gynecology of Venezuela described the specific mentions of the term “obstetric violence” as it appears in the Organic Law on the Right of Women to Be Free from Violence, enacted in Venezuela on March 16, 2007.
The law defines obstetric violence as “…the appropriation of the body and reproductive processes of women by health personnel, which is expressed as dehumanized treatment, an abuse of medication, and to convert the natural processes into pathological ones, bringing with it loss of autonomy and the ability to decide freely about their bodies and sexuality, negatively impacting the quality of life of women.”
Dr. Pérez D’Gregorio highlights two phrases for consideration, the first of which is “health personnel.” In Venezuela, this includes obstetricians, residents, medical students, nurses and technicians. Midwives are not included because, as Pérez D’Gregorio notes, “midwifery does not exist in obstetric practice in Venezuela, where all deliveries are attended by physicians in an institution.”
In addition, the phrase “the appropriation of the body and reproductive processes of women by health personnel” is, according to Pérez D’Gregorio, “contrary to good obstetric practice, whereby medication should only be used when it is indicated, the natural processes should be respected, and instrumental or surgical procedures should be performed only when the indication follows evidence-based medicine.”
The following acts executed by care providers are considered obstetric violence:
(1) Untimely and ineffective attention of obstetric emergencies; (2) Forcing the woman to give birth in a supine position, with legs raised, when the necessary means to perform a vertical delivery are available; (3) Impeding the early attachment of the child with his/her mother without a medical cause thus preventing the early attachment and blocking the possibility of holding, nursing or breast-feeding immediately after birth; (4) Altering the natural process of low-risk delivery by using acceleration techniques, without obtaining voluntary, expressed and informed consent of the woman; (5) Performing delivery via cesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman.
In these cases, the person or persons responsible are subject to a fine of two hundred and fifty (250 TU) to five hundred tax units (500 TU) and the court will submit a copy of the sentence to the professional body or union responsible for disciplinary actions.
Sounds like a good start for legislation in the US.