Dariela Aquique

HAVANA TIMES — Unfortunately, there are still situations in which women become the targets of violence. Obstetric violence is one case in point. I didn’t make up the term – it has a legal definition and some constitutions already acknowledge the practice as a form of violence.

Obstetric violence describes a situation in which any form of labor is considered pathological, when a woman is automatically transformed into a patient and routine medical and pharmacological procedures are conducted without allowing her to make decisions regarding her own body.

In this connection, international scientific studies reveal that the routine practice of episiotomies is not justified. It is worth mentioning that there’s been a statistically significant reduction in this practice in several countries since the eighties.

On the basis of research on assisted labor, the World Health Organization suggests that such practices ought to be eliminated, considering them harmful and inefficacious.

It also recommends that a family member ought to have free access to the labor and post-natal processes.

Insulting words or phrases addressed to women during labor, such as “spread ‘em”, or “it didn’t hurt when you were doing it”, are another form of violence.

The paper El nacimiento en Cuba: análisis de la experiencia del parto medicalizado desde una perspectiva antropologica (“Birth in Cuba: A Study on the Experience of Assisted Labor from an Anthropological Perspective”), written by Dailys García-Jorda, Zoe Diaz-Bernal and Marlen Acosta Alamo, has yielded highly important data on obstetric violence in Cuba.

The authors conducted their study in three hospitals in Havana, interviewing and observing 36 women in labor, ten relatives and nine obstetricians. The study yielded results as interesting as:

1- Many of the women interviewed followed instructions, submitted to and allowed the exploration of their bodies in the presence of medical personnel from other hospital areas.

2- In this context, they became patients referred to on the basis of their assigned cubicle or bed. They were often addressed as “love, kiddo and cutie”, rarely as “Ma’am.”

3- Contact between obstetricians and the women in labor or their relatives was scarce. Generally, the specialists merely gathered the required information from the clinical record and gave instructions. They didn’t introduce or identify themselves, nor did they explain anything about the process (unless they were asked).

4- Medical examinations and observations were constant prior to labor and conducted by several medical professionals, obstetricians, residents, students and nurses that surrounded the woman.

5- “I’ve had enough”, was the most common complaint the women voiced. It was addressed only by some of the staff, when these were present.

6- What the doctors said suggested the wards are designed to meet the needs of medical professionals, not the expectant mothers.

7- An episiotomy was conducted on 29 of 36 women interviewed. The obstetricians declared it was a routine procedure. They spoke of the risks involved. However, there was no agreement as to being a necessary procedure.

8- The examination of the uterus and the suture of the episiotomy were very traumatic for the majority of the women in the study. These women complained of sharp pains and that not enough anesthetic had been administered.

9- The hospital decided when and who was to accompany the expectant mother at the time of birth.

The authors of the study believe we must seek alternatives based on non-hegemonic labor assistance models.

Despite what the official discourse claims, women in Cuba continue to be the victims of different forms of violence in practice. It’s been proven.