Spain responsible for obstetric violence - UN women's rights committee finds

GENEVA (14 July 2022) - A woman in Spain who underwent premature labour induction and a caesarean section without her consent was subjected to obstetric violence, the UN Committee on the Elimination of Discrimination against Women (CEDAW) has found.

The Committee published its Views today after reviewing a complaint filed by a Spanish national, N.A.E., who has been suffering lasting physical and mental trauma as a result of her experience during childbirth.

She informed the Committee that she went to a public hospital in Donostia, Spain, at 38 weeks of pregnancy because her water had broken. The hospital ignored the 24-hour waiting period protocol, did not provide her with information on alternative options, and induced her labour prematurely without her consent. She underwent multiple digital vaginal examinations and was not allowed to eat. She then suffered a caesarean section, without any medical justification, while her arms were tied down and without the presence of her husband. The caesarean was performed by a group of medical residents undergoing training supervised by their tutors and without N.A.E.’s prior consent.

When her baby boy was born, she could not even touch him as her arms were still strapped. The baby was taken away from her immediately to the paediatrician, and she had no opportunity to have skin-to-skin contact with her newborn. She had to see her primary care physician about symptoms of anxiety related to her childbirth experience. She was later diagnosed with post-partum post-traumatic stress disorder.

She brought her case to courts in Spain but has encountered gender stereotypes and discrimination throughout the administrative and judicial process. During the proceedings in Spain, she was told that it was the doctor who should decide whether to perform a caesarean section and that the psychological harm she had suffered was simply a matter of perception.

The Committee considered that N.A.E was a victim of obstetric violence, a particular type of violence against women during facility-based childbirth, which has been shown to be widespread, systematic in nature and ingrained in health systems.

“If doctors and nurses had followed all applicable standards and protocols, it might be possible that the victim would have given birth naturally without having to go through all these procedures that left her physically and mentally traumatised,” said Committee member Hiroko Akizuki.

“States parties have an obligation to take all appropriate measures to modify or abolish not only existing laws and regulations but also customs and practices that constitute obstetric violence,” Akizuki added. 

The Committee urged Spain to provide N.A.E. with appropriate reparation for the damage that she has suffered to her physical and psychological health.

The Committee also requested that Spain respect women’s autonomy and ability to make informed decisions about their reproductive health by providing them with complete information at every stage of childbirth and by requiring that their free, prior and informed consent be obtained for any invasive treatment during childbirth.

The experts on women’s rights also requested that Spain provide obstetricians and other health workers with adequate professional training on women's reproductive health rights. In addition, Spain was also asked to provide specific training for judicial and law enforcement officials, as well as to develop, publicise and implement a charter of patients’ rights.

ENDS