Abstract

MACEDO, João; ANTONIO, Isa; MACEDO, Ermelinda  and  LOPES, Maria de Fátima. The birth plan as a safeguard mechanism the right to self-determination of women in obstetric context in Portugal. Rev. Bioética y Derecho [online]. 2023, n.58, pp.223-242.  Epub Sep 25, 2023. ISSN 1886-5887.  https://dx.doi.org/10.1344/rbd2023.58.39814.

Obstetric violence is a form of violence against women, infringing rights such as health, safety, physical and psychological integrity, and, in the most extreme cases, the right to life. We will address violence during childbirth through insults, lack of information, lack of respect for women's autonomy and self-determination, and violation of informed consent. The practice of medical procedures such as episiotomy, excessive medication, deprivation of movement, Kristeller maneuvers, among others, are potential risk factors for the health and life of the fetus/child. We affirm that obstetric violence is, in many cases, not only violence against the woman, but also against the child. Cases in which the child is born with malformations or diseases resulting from the mistreatment suffered by the mother during childbirth, generate medical responsibility. We refer to works in the area of Law, Bioethics and Reproductive Health and international and national legal texts. We conclude that this type of violence against women is a direct violation of leges artis medicinae and constitutes a form of serious gender discrimination that deserves legal censure by States and the medical profession itself. We affirm that episiotomy is currently classified as a type of female genital mutilation, punishable under criminal law. We maintain that the right to be accompanied during childbirth and to comply with the birth plan drawn up by the woman or partner are two essential mechanisms for mitigating or eliminating obstetric violence.

Keywords : obstetric violence; autonomy; woman's dignity; principles of bioethics; informed consent; birth plan; fetus/child rights.

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