The Right to Be Accompanied at Birth: New Laws in Argentina and Uruguay

In the last several years, the Buenos Aires city congress and the national congresses in Argentina and Uruguay have approved similar civil laws stating that women have the right to be accompanied during labour and delivery. This is an important example of how parliamentarians in a number of countries are recognising that evidence-based practices in health care can become rights.

The Uruguayan law, passed in August 2001, states that during labour and delivery every woman has the right to be accompanied by a person of her choice, or if no such person is available, she has the right to be accompanied by a person specially trained to provide her with emotional and other support. It instructs every health care facility, both public and private, and all health professionals to inform every pregnant woman of this right and encourage this practice. ¹

The Buenos Aires city law, passed in July 2003, states that every woman has the right to be accompanied by a person of her choice during labour, delivery and her hospital stay, that providers in health care institutions must inform every pregnant woman of this right, and that health facilities must ensure the implementation of this policy by training their staff and ensuring that physical and organisational structures are adequate to do so. ² In August 2004, the Argentinean national congress followed suit and approved a law that gives every woman the right to be accompanied by the person of her choice during labour, delivery and the post-partum period. ³

These legislative measures were a result of promotion in the Latin American region of evidence-based practices during labour and delivery by the Latin American Center for Perinatology (Pan American Health Organization/WHO) in Montevideo. Since 1997 the Center has promoted the use of evidence-based practices in maternal and newborn care in Latin America through a monthly e-mail newsletter disseminated to more than 3,000 professionals in the region and in conferences and regional scientific meetings. ⁴ The Center also developed a course to provide professionals with the skills to perform critical reviews of the literature to help them to identify best practices of care. However, although more than 1,000 professionals from almost every country in the region have taken this course, the increase in knowledge did not lead to a discernible increase in implementation of the best practices in maternal and perinatal care, e.g. in lower episiotomy rates, as expected. ^{5 6 7}

The passage of laws such as the one on the right to be accompanied at birth, that defend a person's right to the best practice in health care, might be a relevant strategy in some instances for promoting evidence-based practices, since patients then have the right to ask for them. In addition, the support of a law might empower health care providers to address the resistance that they may face from both colleagues and patients when they try to implement best practices. In addition, it could help to protect health care providers against litigation.

Food distribution centre, Bajo Flores, Buenos Aries, 2003