Deputy Cristina Rodrigues (ex-PAN) is already known in the Portuguese media for giving voice to controversial issues and in this case, she brings up a new subject: obstetric violence.
In Portugal, this is a topic where there is still little clarification, with many female voices stating that the problem exists in the country but without sufficient data and discussion around the subject.
Problems like the use of force or physical restrictions, threatening or offensive language effecting a woman's self-esteem or the use of procedures not authorised by the woman or not recommended by the WHO are the basis of the bill.
The bill 912/XIV/2 sent to the parliament is available at: https://www.parlamento.pt/ActividadeParlamentar/Paginas/DetalheIniciativa.aspx?BID=121036
What is obstetric violence?
Obstetric violence happens anytime a person in labour or giving and experiences mistreatment or the disrespect of their rights, including being forced into procedures against their will by health professionals.
Rather, respectful maternal care is supposed to include: providing safe and timely care, nurturing positive interactions between midwives and women, protecting confidentiality, maintaining an active role in the birth process, obtaining women's consent before performing procedures and providing information about these procedures.
However, in a survey undertaken by the Portuguese Association for the Women's Rights in Pregnancy in 2015, found that more than 40 percent of women said they were not consulted about the interventions or exams performed during labour and delivery and/or had no information about delivery options.
More than 10 percent of women reported that their experience negatively influenced their self-esteem; 43.8 percent of them said they did not have the birth they wanted; and the data also revealed that 18 percent of the women surveyed were not allowed to have their partner present at the birth.
One of the biggest issues that the deputy spoke about was a high recourse to episiotomy, which occurred in more than 60 percent of cases and was usually applied without consent and without a reasonable reason.
Episiotomy is a surgical procedure that consists of an incision in the perineum, the region between the anus and the vagina, to facilitate the passage of the baby, which “aims to minimise the development of lacerations that, in the final analysis, can affect urinary and defecation disorders”, according to the President of the Portuguese Society of Obstetrics and Maternal-Fetal Medicine, Nuno Clode, in an opinion piece in Observador.
However, this method which is undertaken routinely has already been criticised by WHO. “Although WHO has considered that the routine or liberal use of episiotomy is not recommended for women in situations of vaginal birth, doctors are still doing it many times”, reads the petition.
In turn, the “UN considers that obstetric violence has a widespread and systematic nature. WHO has already issued guidelines to establish global standards of care for healthy pregnant women and to reduce unnecessary medical measures, such as those that are not being fully complied within Portugal”, says the deputy.
“All in all, we find that violence against women in childbirth is so normalised that it is not yet considered violence against women”, she highlighted.
Criminalization of obstetric violence in Portugal
A petition, which has so far already been signed by almost 5,000 people, will be used to reinforce the draft in parliament that establishes a change to the criminal code.
"Whoever subjects a woman, during labour, childbirth or puerperium, to physical or psychological violence that causes her pain, damage or unnecessary suffering or limits her power of choice and decision, is punishable with a prison sentence of up to one year or with penalty of a fine," says the draft.
In the case of mutilation, the bill provides for an even more severe penalty: "A prison sentence of up to two years or a fine of up to 240 days” for interventions carried out by a doctor or other legally authorised person that result in the genital mutilation of a female, in breach of the leges artis, thus creating a danger of life or danger of serious harm to the body or health”.