“Hospitals have some procedures that seem dehumanising to me”: Experiences of abortion-related obstetric violence in Brazil, Chile and Ecuador

abstract

Abortion-related obstetric violence is an under-documented global phenomenon that seems more frequent in settings that legally restrict abortion. Seeking to document and critically assess this phenomenon, we analyse testimonies of obstetric violence shared by abortion seekers in Latin America. Data were collected through the communication channels of Women Help Women (WHW), a feminist non-profit organisation that supports self-managed abortion where access is restricted. We conducted in-depth review of 20 cases of women from Brazil, Chile and Ecuador who reported being subjected to several forms of obstetric violence while seeking abortion and post-abortion care in formal health facilities. This obstetric violence included denial of care and failure to meet standards of care, criminalisation, gaslighting, physical violence, and discrimination. We show how abortion-related obstetric violence is used as a means to punish and control feminised subjects that contradict social and legal mandates regarding abortion and gender. We also highlight the role of modern legal and medical systems in reproducing oppressive structures that deny people proper care.

keywords:

• abortion
• obstetric violence
• reproductive health
• reproductive justice
• testimonies

Notes

1 We recognise that people with diverse gender identities (cis women, trans and non-binary people) have abortions and are exposed to obstetric violence and we strive to use neutral language that acknowledges this diversity. However, in this text we mainly refer to cis women’s experiences regarding abortion-related obstetric violence, thus using the term ‘women’ to refer to them. We believe that abortion-related obstetric violence affects trans and non-binary people in specific ways, which might be even more brutal because of their generally more marginalised identities and material conditions in a heteropatriarchal society. Nonetheless, we do not have enough data to describe obstetric violence experienced by people other than cis women.

2 The Venezuelan law defines obstetric violence as “ … the appropriation of women’s bodies and reproductive processes by health personnel, which is expressed by a dehumanising treatment, an abuse of medicalisation and a pathologisation of natural processes, resulting in a loss of autonomy and ability to decide freely about their bodies and sexuality, negatively impacting their quality of life” (República Bolivariana de Venezuela 2007).

3 While we recognise the value of the concept of obstetric racism to highlight the centrality of racism in the production of violence and mistreatment experienced by Black women in pregnancy and childbirth (Davis 2018), in this article we opted for the broader category of discrimination because not all of our research participants identify as Black, and nor are the forms of mistreatment they suffered clearly connected with racism.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Sara Larrea

SARA LARREA is a feminist sociologist who holds a Master’s in Public Health and is a doctoral candidate at Universitat Pompeu Fabra (Barcelona). Since 2004 her activist and research work has focused on understanding and improving abortion access and experiences in legally restrictive settings, particularly in Latin America and the Caribbean. She has collaborated with several organisations providing abortion support and access across the region, and was a founding member of Salud Mujeres (Ecuador, 2008) and a member of Women Help Women since its inception in 2014. In the latter, she served as a Research Coordinator between 2017 and 2020. Email: [email protected]

Mariana Prandini Assis

MARIANA PRANDINI ASSIS is an assistant professor at the Faculty of Social Sciences, Federal University of Goiás, Brazil. She is interested in the ways in which rights discourse and legal strategies shape and impact social and gender justice struggles. Her current research project examines how feminist activism on self-managed abortion is productive of a new transnational normative order, sustained by both a creative use of human rights language and a commitment to direct action driven by an ethics of care. She has an LLB from the Federal University of Minas Gerais, and an MPhil and a PhD in Politics from the New School for Social Research. Email: [email protected]

Camila Ochoa Mendoza

CAMILA OCHOA MENDOZA is an activist and researcher interested in reproductive justice, specifically abortion. Through her work she contributes to the destigmatisation of abortion, and addresses the intersecting systemic barriers to abortion access and quality of care. Camila is currently engaged in youth-led initiatives around sexual and reproductive health and rights in Europe, and is the producer of the podcast ‘Abortion, with love’. She has an MSc in Global Studies from Gothenburg University (Sweden). Email: [email protected]