The topic of human rights in childbirth has never been so important, and today I am sharing a couple of resources in this area which offer interesting perspectives from obstetricians.
The first is a freely available Reproductive Health article by Amali Lokugamage and Sithira Pathberiya called Human rights in childbirth, narratives and restorative justice: a review. It offers an overview of the debate, with a focus on the implications of the Montgomery v. Lanarkshire  legal ruling in the UK and proposes that a restorative justice approach might be beneficial in relation to childbirth. The authors discuss the importance of storytelling as an important aspect of restorative justice processes, and argue that these “may be suitable in addressing the concerns in health care where patients feel they have not received the care they should have” (Lokugamage and Pathberiya 2017).
“The key objectives of the process would be to repair the harm suffered by the victim; person at fault becomes aware of that his actions are unacceptable and the effect his actions are having on the victims and community; acknowledging responsibility for actions; participate in reparation decision making moving forward; participation of community; and victim brought to understand the position of the other parties. A successful RJ program in a hospital setting would aim to understand the aetiological factors which produce negative outcomes such as stress, lack of resources (time, training) as well as engage with patients and community in humanistic way to understand their concerns.” (Lokugamage and Pathberiya 2017)
The second resource that I’d like to share today is an article in The Conversation, written by Neal Shah, Despite differences in culture, US and India fall short in childbirth in similar ways. This is also a great article, because it gives another perspective on the issues:
“A large part of the challenge is that many women may not know what they deserve when it comes to the experience of having a baby.
An impoverished Indian woman who treks to civil hospital, only to give birth through an avoidable episiotomy, with minimal labor support, on a dirty metal cot, in a room crowded with other patients, may see that as normal. She may even expect it.
Of course, an American woman who labors in a clean, private room, within a state of the art hospital, only to receive an avoidable c-section will often see that as normal as well. In both cases, as long as the baby is healthy, women are almost always grateful.
Those of us in the birth community could do better in helping women understand what they deserve, and in developing systems of care that deliver on this promise. But first we have to be willing to link the ideas of appropriateness and justice, of patient experience and dignity. In other words we have to be willing to see childbirth through the lens of human rights.” (Shah 2016).
It’s so good to see these conversations happening, and happening more often.