When a United Nations committee ruled that Nahia Alkorta had suffered obstetric violence while giving birth to her first child, it was the culmination of a 10-year quest for justice.
Alkorta was diagnosed with post-traumatic stress disorder after being treated at a hospital in northern Spain in 2012 and turned to the UN after failing in Spanish courts.
The United Nations Committee on the Elimination of Discrimination Against Women (CEDAW) found in July that she had been subjected to a series of unjustified procedures amounting to obstetric violence, including a cesarean section without her consent, which left her arms immobilized and her partner from childbirth room was excluded.
“Since the verdict, more than 100 women have contacted me and said this has happened to them,” Alkorta, now 36 and a mother of three, said in an interview with AFP.
“It’s not talked about because of the pain it causes, because of the shame. There’s a notion that this is just the way it is,” she said.
The CEDAW decision described obstetric violence as “violence suffered by women during childbirth in medical facilities,” adding that it was a “common and systemic phenomenon.”
It said Spain should compensate Alkorta for physical and psychological harm and ensure that women’s reproductive rights are protected by the health and justice systems.
The verdict came as activists across Europe are raising awareness of obstetric violence, which often goes unrecognized.
Some national medical associations in Europe even object to the term itself, saying it cannot be applied to their practices.
But Alkorta argues, “Women tell a different story.”
– ‘at your mercy’ –
Alkorta suffered from nightmares, insomnia and flashbacks after an ordeal that began when her water broke at 38 weeks.
At her local public hospital in San Sebastian, in Spain’s Basque Country, she was given the drug oxytocin despite being in labor and for no medical reason, she said. The staff’s responses to her questions became increasingly aggressive, she recalled.
The day after she was admitted, the gynecologists decided to deliver the baby via caesarean section without obtaining her consent and despite a midwife telling her her labor was progressing, she said.
“When I asked for a clear explanation, they just said they would take the baby out and it would be over in 40 minutes,” Alkorta, who lives in the Basque city of Zizurkil, told AFP.
With her arms tied, a protocol some hospitals follow for cesarean births, and her husband locked out of the room, she trembled with fear. “I felt completely at their mercy,” she told AFP news agency. Alkorta was unable to hold her son, who was healthy, for the first few hours of his life.
There is a lack of comprehensive data measuring obstetric violence in Europe, but advocacy groups say women are routinely denied informed consent, subjected to rude and degrading behavior by medical staff and, in some cases, to dangerous practices.
A recent petition in Serbia, ‘Stop Midwifery’, collected 70,000 signatures in five days, urging the state to cover the cost of someone accompanying a woman in the delivery room – currently some Serbian public hospitals require the extra person to be paid, even if it is the woman’s partner.
“Many mothers in Serbia would like to forget the day they were born because they have experienced various forms of violence at the hands of medical workers,” the petition says, which lists insults, humiliation, shouting, neglect and medical errors among the problems.
Some countries in Europe, including Spain and Italy, have set up obstetric violence observatories, but campaigners say legal cases are rare.
“We are approached by many mothers who have suffered a traumatic birth, but almost nobody files a complaint,” Nina Gelkova of the Bulgarian campaign group Rodilnitsa told AFP.
“The state does not recognize that such a problem exists.”
– approval and respect –
Remarks submitted by Spain to CEDAW in the Alkorta case warned that there was no such thing as “a la carte birth” and supported the domestic courts’ findings that the hospital was not at fault.
Alkorta counters that what she’s fighting for shouldn’t be a luxury.
“I wasn’t looking for an a la carte birth, I was looking for humane treatment,” she told AFP.
“I’m not against legitimate interventions, I think they save many lives – but they should always be done with consent and respect.”
Attorney Francisca Fernandez Guillen, who has worked with Alkorta since the beginning of her legal career, explained that medical professionals and even a woman’s own relatives can downplay traumatic experiences during childbirth.
“Sometimes even the woman’s partner or family advises to just ‘forget’ what happened,” Fernandez told AFP.
However, some medical professionals believe attitudes are changing.
Daniel Morillas, vice-president of the Spanish Federation of Midwives’ Associations (FAME), told AFP that in the 16 years he’s been working as a midwife, he’s noticed a growing awareness of mothers’ rights and her role as an “active participant”. at birth, although he admits there is still a long way to go.
“The first thing we have to do to combat obstetric violence is to recognize that it exists,” he told AFP.
“Many doctors and midwives have already realized it’s happening and are trying to change things.”
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