Obstetric Violence: Physical And Psychological Aggression In Pregnancy

Prenatal, childbirth or the postpartum obstetric violence, physical and emotional scars, but the cases can and should be reported.

Think of the pregnancy as a health process and help the woman to take over and to have autonomy in your pregnancy. To the obstetrician and gynecologist Alberto Jorge Guimarães, these are essential functions of a health professional in attendance to the pregnant woman. However, the thought that should be agreed between doctors and nurses, is not always what happens in practice.

In Brazil, one in four women suffer some kind of aggression during childbirth, according to oxfordastronomy. The number is pointed to by the search Brazilian women in private and public Spaces, held by the Perseu Abramo Foundation in partnership with SESC. Research shows that many Brazilian pregnant women were subjected to improper procedures, poorly served or suffered some kind of verbal violence in health institutions.

The violence not only cause obstetric injuries, but also emotional and psychological and from a nurse who asks for the woman yelling to the procedures which cause the acceleration of childbirth only by medical interests.

The important thing is not only survive the birth, but having the right ensured an experience of pregnancy prenatal, childbirth and post-partum – – dignified, positive and healthy for the woman and the child.

What Is Obstetric Violence?

“Every act that is against what was agreed between the pregnant woman and doctor during prenatal care or delivery plan can be characterized as violence,” says Dr. Alberto. And it’s not just at time of delivery that the will of the woman must be respected: the expectant mother must have their rights guaranteed also in the prenatal postpartum and abortion.

“Brazil doesn’t have a specific legal provision of obstetric violence, in other countries, such as Argentina and Venezuela. But, the legal provisions currently in force in the country allow you to suppress and punish yourself such cases, “lawyer Tamara Sweet Gonçalves, a master’s degree in Human Rights and a member of CLADEM/Brazil.

Accordingly, and taking into account parameters of human rights and the Ministry of health, obstetric violence can be considered, in a public or private network:

In Pregnancy:

Denial of service;

Offensive comments of any nature;

Scheduling a c-section no clinical indication;

Failure to provide sufficient information so that pregnant women take their decisions;

Overlook quality care.

At Birth:

Refusal of admission to hospital;

Preventing the birth accompanied by a person indicated by the pregnant woman;

Performing medical procedures without the consent of the pregnant woman;

Invasive or unnecessary procedures, especially the application of oxytocin and episiotomy;

Water and food deprivation;

Any kind of verbal action that can humiliate, degrade, abuse, end up endangering or cause insecurity or fear in women;

Prevent or delay the mother’s contact with the child;

Prevent the right to breast-feed the newborn.

On Abortion:

Denial or delay in service;

Threats, coercion or scapegoating of women;

Questions as to the cause of abortion, whether intentional or not;

Conducting invasive medical procedures or without consent and explanation.

Know Your Rights

Regardless of the type of service – if done by professionals of public or private institutions, every woman has the right to prenatal monitoring, which includes examinations and periodic queries. The whole process of gestation, prenatal to postpartum, must have quality care and be carried out by trained health staff.

In addition, it is necessary that the woman is always well informed about the risks, procedures and options for that, as well, can be in control and make their decisions. In this sense, it is extremely important that the doctor provide a warm atmosphere for a woman to feel comfortable and have room to ask questions and clarify any doubt.

This welcoming space and transparency is essential so that the wife can make the best choice about the type of birth, for example. In Brazil, 43% of births are by caesarean, but the average index considered healthy by who is only 15%. In brazilian private network, the statistic is even more expressive: 80% of childbirths are cesarean sections. Good part of Cesarean section are held or scheduled to meet the interests of the doctor or the hospital.

“I am absolutely against the scheduled c-section. If there is no problem in pregnancy, it is important for the baby to be born on the date on which the woman into labor. Choose the date is more aggressive for the child, “says the obstetrician Alberto Jorge Guimaraes. Track of all the information, the woman has the right to choose the type of delivery that consider best, without having to take into account personal interests.

The position in which the woman you want to give birth should also be her decision: the doctor cannot intervene if the best position for the body of the pregnant woman is not lying and Yes squatting, for example. Procedures such as the use of oxytocin to the acceleration of childbirth, episiotomy, immobilisation of the limbs during childbirth and the deprivation of food are also violence against woman.

Episiotomy, cut between the vagina and the anus, is a procedure used by doctors to speed up delivery, and that can lead to future complications for the woman: aches, bruises, infections. According to who guidelines, rates of episiotomies should not exceed 10%. However, in Brazil this number reaches 53.5%, as shown in the survey were born in Brazil.

As well as the scheduling of Cesarean section, episiotomy is often performed only by medical interests, without any notice or consent of the pregnant woman or real clinical need. “This logic [to prioritize the interests of the doctor] needs to be reversed, the welfare of the woman and the child must come first. The woman needs to be empowered and know your rights and your body, so you can really make an informed choice, “says Tamara.

In addition to the procedures which cause physical damage to the body of the woman and the child, the verbal violence also leaves deep marks in pregnant women. Make the woman feel inferior, insecure, humiliated or offended in any way is a form of violence as serious as other.

What To Do In Case Of Obstetric Violence?

Victims of violence at any stage of pregnancy or childbirth, performed in public or private health network, can report the occurrence – and it is very important that you do. The complaints can be carried out by the Ombudsman’s Office of the hospital, the Regional Council of Medicine, to the public prosecutor or public defender of the region. Information and guidance can also be obtained through the Dial 180.

“There was negligence or violence by the doctor or other health care professional? They may be nominally reported. But the hospital and the local Government can be held responsible for the absence of care, neglect or violence at any stage of pregnancy and childbirth. A humanized is not the exception or a choice, it is a right to all women, whether in private or public network, “underscores the lawyer Tamara sweet.


  1. suffered violence during obstetric antenatal care.In a consultation with the doctor, to three months of pregnancy, she complained that he felt pain.The first doctor’s reaction was to say that “the pain was her own baby”. Worried, f. insisted on tests. With the examination, on the strength of the doctor was such that the expectant mother fainted. “My stomach was purple, so he squeezed me,” he says. When he awoke, the doctor gave the verdict: she could not have a healthy baby and suggested that she didn’t continue with the pregnancy.

On the same day, f. switched doctors. The new doctor requested an ultrasound and, thus, she discovered he had a fibroid in the uterus-and also that it would be perfectly possible to have a healthy child. Continued follow-up with the new doctor and, although pregnancy has been complicated due to the fibroid, the child was born healthy.

Didn’t report. More than 20 years later, still gets emotional f. to talk about it and says that few people know what happened. Despite this, she encourages other women report: “no one should have to go through this.”

Awareness Projects

In the fight against violence and obstetric groups have been created to promote the debate and the exchange of information so that women can achieve the autonomy of their pregnancies. Check out some of these designs and stay informed:

  1. GAMMA-Active Maternity support group:Directed by student Ana Cristina Duarte and the psychologist Angelina Pita, the RANGE’s mission is to promote a positive, active and conscious in relation to motherhood. On the site, you will find articles, products and can meet courses that offer information that helps achieve this healthy attitude and conscious.
  2. I assume:the principle is formed by a network of Brazilian women that aims to promote female empowerment, with a focus on sexual and reproductive rights of women. The network produces information material on various points related to pregnancy; publications can be found on the site.
  3. Group good time:Started in 2005, the good time is aimed at pregnant women and couples who go through the process of pregnancy. The Group seeks to offer emotional support, share information and encourage making informed decisions about prenatal procedures, childbirth and postpartum.
  4. Childbirth without fear:led by obstetrician Alberto Jorge Guimarães, childbirth without fear is geared to the concept of Humanized childbirth, and seeks to treat pregnancy as a time of health and a positive experience for the woman.
  5. Sunrise Narratives:the Narratives of birth is an academic research group at the Federal University of Pernambuco. The group, which advocates respect for obstetric care as a norm, is opened and you can follow the exchange of information and publications on labor and birth.
  6. Obstetric Violence:the Facebook page already has more than 5000 followers and uses the space to share information, news and projects that put the obstetric violence on the agenda.
  7. 1:00 pm 4:the 1:00 pm 4 is a project produced by photographer Carla Raiter. The goal is to encourage reflection on the theme, materializing, through photographs, the marks left in women who have suffered some type of violence obstetric.

It is necessary to emphasize that every woman has the right to a dignified, respectful care and quality during the gestation period. Discuss the subject, raise awareness and complaint cases are important ways to combat obstetric violence.