Many women have experienced and continue to experience perinatal abuse, which consists of violence prior and during pregnancy, obstetric violence and postpartum violence. This phenomenon is quite complicate, since the literature talks about perinatal intimate partner violence (e.g. Silverman et al., 2006; Alhusen et al., 2013; Brown et al., 2008; etc.) and obstetric violence (e.g Diaz-Tello, 2016; Jardim & Modena, 2018; etc), two cases that are conducted in a different operating level of patriarchal power.
The first, perinatal intimate partner violence (IPV), is referring to systematic physical, psychological and sexual abuse of the woman, by a current or former individual with whom they have/had a close personal relationship. The abuse occurs 12 months prior to pregnancy, during pregnancy and up to one year after childbirth (Hahn et al., 2018). The perinatal IPV derives from an individual – in the majority of cases a male (World Health Organization & Pan American Health Organization, 2012) – and it is considered to be behavioral violence, meaning that this particular perpetrator is fully aware of their abusive actions; in other words, the perinatal IPV is intentional.
Obstetric violence, on the other hand, is considered by scholars to be structural (Sadler et al., 2016) and systemic (Diaz-Tello, 2016); it derives from the complete medicalization of the procedure of childbirth and the Western patriarchal idea of a “naturally” weak, disabled, handicapped, dependent female body (Young, 1980) that needs to be tamed “if it challenges its femininity, its condition as object, through a loud and subversive embodied subjectivity” (Cohen Shabot, 2015, pp. 234). This medicalization leads to an unquestionable authority of the medical stuff, resulting to an excessive power over laboring bodies; “. . .the majority of women believed that their experiences and bodily perceptions were not listened to until the attending doctor confirmed that their symptoms were “real”.” (Bellón Sánchez, 2014, pp. 30). Another aspect of the over-medicalized childbirth is that, often, obstetric violence may not be perceived as intentional by the medical authorities, and that is also why it is characterized as structural and systemic. Although some scholars (e.g. Wolf, 2013) argue that obstetric violence must be intentional to be considered “real” violence, the fact that it is recognized as such by the law, either intentional or unintentional, and is described as such by the victims, it maintains its validity and importance, and creates space for further research and social acknowledgment.
It is important to mention that perinatal abuse is a phenomenon not only of the “Third World”. It is globalized and it is deep rooted in the structure of the human societies, therefore it affects women in “Western” countries as well, especially in US for instance (Diaz-Tello, 2016). In fact, Venezuela, which is a developing country, was the first state to legally recognize the term obstetric violence in 2007 (Pérez D’Gregorio, 2010). Argentina and Mexico, also developing countries, followed in 2009 (Vacaflor, 2016) and 2014 (Calvo Aguilar et al., 2019), respectively, although criminalizing obstetric violence has not improved the provided health – care services (Calvo Aguilar et al., 2019).
Cohen Shabot (2015), a white, Western, middle-class woman described her childbirth experience as such: “. . . As my labor went on, I was subjected to numerous medical interventions without my explicit consent, including a catheterization, the artificial rupture of my waters, and repeated painful vaginal examinations. I was told countless times that if labor did not progress quickly, they would need to perform a Caesarean section, otherwise my baby would die. I felt mute, deprived of agency. . . . Today I can say truthfully that I suffered from obstetric violence and that, in more ways than one, this was a traumatic experience” (pp. 231, 232).
Constance, a South African, black, low-income woman described some of her experiences as such: “I screamed because it was burning and she said, the one sister [nurse] ‘No shut your mouth, why are you screaming? You people keep on screaming because you want to… wait now – ^^’Yes, you people keep screaming ^^ because you want to do such things’ (have sex).” (Chadwick, 2017, pp. 500).
Notwithstanding, the consequences of perinatal IPV and obstetric violence are both physical and psychological. The consequences of perinatal IPV can be direct, such as an injury, or indirect such as chronic psychological problems due to increased stress. In their research, Silverman et al (2006), found that women who had experienced abuse prior and/or during pregnancy were at higher risk for vaginal bleeding, kidney infection or urinary tract infection severe nausea, vomiting or dehydration, delivery preterm of a low-birth weight infant and an infant requiring intensive care unit care. Moreover, violence during pregnancy has been also associated with maternal mortality, fetal injury, stillbirth and miscarriage (Devries et al., 2010).
Obstetric violence is very real and it is very important that both the medical personnel and pregnant women are educated and informed of what is about to happen in labor, what are some crucial personal boundaries that permission to cross them is absolutely necessary, how to create a safe space for the women to express their needs and to feel like their needs are listened to. Many more steps need to be walked until patriarchy is uprooted from our bodies.
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