The Human Rights in Childbirth conference runs 2 – 5 February in Mumbai.

Day 1 of the Human Rights in Childbirth conference in Mumbai was an eye-opening and sobering experience. In a world where relatively privileged women spend months meticulously charting their perfect birth plans, it is important to be reminded of all the women who don’t have access to institutionalized medical care in childbirth, or who have access to hospitals that provide only suboptimal care.

Throughout the day, presentations by researchers, journalists, and former patients painted a bleak picture of maternal care for the underprivileged. While Manju Kamacharya, in her study on women’s birthing choices in a Nepalese village, cited financial constraints as one of the drivers for home delivery, a few researchers pointed to more sinister and unexpected reasons.

Most disturbing was the theme of violence and abuse in the delivery room, with virtually every speaker reporting data that showed women were beaten, slapped, or pinched in the delivery room if they cried or were deemed difficult in any way. They are also routinely subjected to patriarchal insults during childbirth (a common refrain is something along the lines of: “You weren’t crying so much when you were in the act of getting pregnant – why are you crying so much now?”). Nalini Visvanathan’s research showed that fear of abusive hospital staff was the most common reason cited by her target population for avoiding institutional care, despite heavy government incentives to use public hospitals. The personal accounts of these experiences illustrate a shocking lack of empathy and basic care among hospital staff.

Another disturbing trend can be summarized as an access issue. Even if women do manage to travel from villages to reach the nearest public birthing facility, they report problems with access. Many times, they are turned away for not having proper documentation. Frequently, hospital staff extort families for money, not allowing women who are in labor to enter the hospital or be seen by medical staff unless they pay a “fee.” Scarier still are the reports of babies being withheld from parents unless they can pay a bribe. It is no surprise that rural women are rejecting institutional births in favor of traditional methods at home, despite enormous government incentives to get them into hospitals.

The silver lining in this depressing day was, of course, the incredible people who have recognized this problem and are working to solve it. We were impressed with the efforts of Regina Tames, a human rights lawyer from Mexico, who has been instrumental in devising a term and legal definition for this trend in her country: obstetric violence. She is seeking to influence policy by providing pro bono legal support to affected women, but also by engaging the medical and government communities on how a definition and statement of women’s rights in the delivery room should be recognized.