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The battle of a Galician victim of obstetric violence: recognized by the UN but without compensation in Spain
In February 2020, the UN Committee for the Elimination of Discrimination against Women (CEDAW) issued its first resolution on obstetric violence. He did so to recognize as a victim a Galician woman, Susana FM, who had given birth in September 2009 in a hospital of the Servizo Galego de Saúde (Sergas) in Lugo, in a birth surrounded by “numerous interventions without having received explanations to the respect and without being allowed to comment”. Two years after the UN notified her conclusions, the affected party has decided to continue with her claims because the State has not provided her with the reparation that this committee included as the first of its recommendations and considers that she has not complied with the rest.
After 12 years of battle -first in the administrative and judicial channels, in which he was unsuccessful, and then before the UN-, he says that he does not want Spain to act “as if nothing had happened”. He has filed an administrative complaint with the Ministry of Justice to demand compliance with the CEDAW resolution, but he assures that he will go to the Supreme Court if he does not receive a response. “It seems that these are childhood dreams or expectations of mine, but what I am talking about is the violation of fundamental rights, especially informed consent, physical and moral integrity and privacy,” he highlights. He describes as “curious” the position of the Government, which is, in fact, negotiating a reform of the Abortion Law to include obstetric violence as a form of gender violence.
The UN recommendations are five: provide “appropriate reparation, including financial compensation” to the victim for damage to their physical and psychological health; that Spain provide “adequate obstetric care,” including information at each stage of labor and requiring the mother’s free and informed consent for treatment; do studies on obstetric violence; train obstetric and health workers; and ensure that there are “effective resources” in the event that women’s rights are violated and training is given in the field of Justice.
The report with which the Ministry of Justice responded to the CEDAW resolution considers that Spain has complied with these recommendations. He recounts a series of measures, among which he cites that reform of the Abortion Law to include obstetric violence, the commitment to carry out studies in this field and the current training plans on gender violence aimed at judges, prosecutors and security forces. of security. Susana FM, who is a lawyer, replies that these training resources do not specifically address obstetric violence. Regarding her reparation, she points out that the State’s response is to refer to the fact that the Spanish Justice did not agree with her claims. In the document signed by the general director of International Legal Cooperation and Human Rights, the ministry says that it “respectfully disagrees” with this specific resolution.
The affected party explains that she allowed two years to pass before resuming her claims because the resolution came shortly after a change of government in Spain and just before the pandemic broke out. “But there comes a time when what are you going to do, frame the resolution in your living room?” she notes. Next September her daughter will be 13 years old and she assures that before the end of the year, if there is no response from the ministry, she will go to the Supreme Court and present an patrimonial claim against the Administration of Justice. If she doesn’t agree with him, she says, she may end up ordered to pay the costs.
Susana FM believes that there is still ignorance about obstetric violence in Spain. He assures that he has found himself in his litigation with the “misunderstanding at the social, judicial and political level” and that he has the impression that “there is no understanding of where the problem is.” A study published last year in the scientific journal Women and Birth concludes that it is a daily reality and that up to two out of three mothers have suffered it during childbirth. The most reported practices in the research are repeated vaginal examinations, feelings of insecurity and guilt, acceleration of labor and the Kristeller maneuver, discouraged by the World Health Organization and which consists of putting pressure on the mother’s abdomen to try to drop the baby
The events that started this process and led CEDAW to consider that several articles of the Convention on the Elimination of All Forms of Discrimination against Women had been violated began on September 26, 2009. Susana was in week 39 and six days of her pregnancy, waiting for an imminent delivery, and went to the hospital -the old Xeral-Calde de Lugo- with contractions. She was not yet in the active phase of labor, but she wanted to receive “guidance” on how to act, indicates the resolution, which includes the woman’s story. However, she was admitted and had the first of the 10 vaginal examinations that were going to be performed in total in the following 40 hours, which was how long it took her to give birth. She was taken to a room that her partner was not allowed to access.
In the seventh vaginal exam, at 1:40 on day 28, when she had been hospitalized for 36 hours, it was determined that she had entered the active phase of labor. After her eighth scan, an hour and a half after her, the sanitaros gave her intravenous oxytocin to induce labor, something to which the woman points out that she did not give her consent and, therefore, she did not was informed of adverse effects. She then had increased pain, seizures, vomiting, chills, and fever, and the fetal monitoring records became “worrying.” Shortly before 6:00 in the morning she was taken to the delivery room. She asked to get up to give birth, but she criticizes that she was not allowed and that “without explanation or information” they made her a cut in the vagina -what is known as an episiotomy- with scissors and they extracted their daughter with a suction cup.
Within seconds of being born, the baby was taken away by staff and told that she would not be able to see her until noon the next day. The girl had a fever, caused by the bacteria E. coli, and was taken to the neonatal unit, where she stayed for seven days. At that time she was only able to accompany her for 15 minutes every three hours. Susana FM attributes the contamination to the numerous vaginal examinations that were performed on her and in which she believes that the bacteria could have been dragged to the pockets of water. She also assures that she was not allowed to breastfeed the baby because “the mothers bothered with the bell.”
Susana FM had post-traumatic stress disorder and had to go to psychological therapy. She emphasizes that the girl’s separation from her parents after her birth made it difficult for her to form a bond and she points out that the treatment she received from her made her feel “unauthorized, without self-esteem.” The woman also underwent physiotherapy treatment to recover from the episiotomy.
The first complaints filed by Susana FM were with the hospital where she was treated and with the Sergas patient care service, but she received no response. She later filed a claim for financial liability with the public administration, which was dismissed by the Ministry of Health. She then went to the contentious-administrative route and filed a lawsuit, but a Court of Santiago first and the Superior Court of Justice of Galicia later dismissed it. Finally, she went to the Constitutional Court, which dismissed the case without going to the bottom of the matter, considering that it had “no constitutional significance.”
The CEDAW resolution did agree with the woman and points out that there was “an alternative” to the situation she experienced. The Spanish administrative and judicial authorities, says the document, “applied stereotyped and, therefore, discriminatory notions” both when they considered that it is the doctor who decides whether to perform the episiotomy, and when they affirmed “without providing explanations” that it is “perfectly understandable that the father could not be present at the instrumental delivery”. Also, he adds, by “assuming that psychological injuries” are “a matter of mere perception.” However, they did show “empathy” with the father when he stated that he was deprived of coital intercourse for two years.