User:ClaraeFranco/sandbox

Short description of my contribution

I have added an entirely new section which was not previously referred to; neither in the "Topics Box", nor in the main Article of Violence Against Women, nor in the rest of Wikipedia. It is 981 words long. The concept of "Obstetric Violence" is fairly new to most people in the developed world, and especially among English speakers. One could still tend to think that the context of "medicalized" birth cannot be a violent one; but evidence from various studies, as well as from international health organizations, legal institutions and NGO's demonstrate that in fact the context of childbirth in the developed world can present violent situations for women. This is a subject that many English speakers in the developed world are not used to hearing, let alone discussing (or that can even be taboo and surrounded by denial); and therefore it will be interesting to see whether some controversies may unfold with other editors concerning this section's content.

I have also contributed with commentaries on the article's Talk Page, as well as on two of my colleagues' Talk Pages in order to make suggestions for the improvement of their own contributions.

My contribution was also enriched by the participation of a Wikipedia editor who suggested another organization that deals with humanized birth in the USA: Young Women United. Thanks to the suggestion, I included an additional line that talks about this organization. ClaraeFranco (talk) 00:04, 17 December 2013 (UTC)

Our group has decided that we would each like to be evaluated individually on our contributions, rather than as one whole group grade.

Clara Franco's Contribution: Obstetric Violence (this is the final version to be graded)

“Obstetric violence” refers to acts categorized as physically or psychologically violent in the context of labor and birth. In most developed and many developing countries, birth takes place in an increasingly medicalized environment, with numerous surgical interventions that women can sometimes be coerced into accepting, or which are done without her consent. Medicalized birthing practices and interventions such as Caesarean sections, episiotomies and hormonal birth induction, which should normally be restricted to only a minority of cases where risks for the mother are clear, are increasingly being used during births that could otherwise take place naturally. Some organizations and scholars consider this a violent act against the woman and her child.

The concept also includes the unjustified use of instruments and maneuvers that have been recognized as risky to the health of the mother and child, or whose benefits and risks have not been sufficiently examined (use of forceps, Kristeller maneuver, vacuum extraction). The World Health Organization warns that “the boom in unnecessary surgeries is jeopardizing women’s health”, that Caesarean sections have reached “epidemic proportions” in many countries (46% in China, 25% and above in many Asian, European and Latin American countries), and that sometimes financial incentives for doctors and hospitals have an influence too.

Concerning episiotomies, the World Health Organization informs that they “carry a greater risk of getting infected, and can cause a higher blood loss, than (natural) tears”, and that “Limiting the use of episiotomy to strict indications has a number of benefits: less posterior perineal trauma, less need for suturing and fewer complications”. England’s National Health Service informs that episiotomies may cause pain and discomfort for the woman for many months after their child’s birth, and the American Congress of Obstetricians and Gynecologists also recommends a restriction on their use. Some sources refer to North American obstetricians and gynecologists, especially between the 1950’s and 1980's, practicing what was called “the husband’s stitch”: placing extra stitches in the woman’s vagina after the episiotomy or natural tearing, supposedly to increase the husband’s future sexual pleasure and often causing long-term pain and discomfort to the woman. However, there is no proof that such a practice was widespread in North America , but mentions of it frequently appear in studies about episiotomy, also in other American countries such as Brazil.

The WHO recently stated that “in normal birth, there should be a valid reason to interfere with the natural process. The aim of care is to achieve a healthy mother and child with the least possible level of intervention compatible with safety”. Practices that should be stopped (in normal labor), according to the WHO:

• Shaving the pubic hair
• Giving an enema to empty the bowels
• Electronic fetal monitoring
• Not letting the woman eat or drink
• Telling the woman to hold her breath and push during the second stage of labor (rather than leaving it to do her own way)
• Stretching and interfering with the entrance to the vagina when the baby is being born
• Episiotomy
• Taking the baby away from its mother at birth
• Getting the woman to lie down on her back during labor and/or delivery

The fight for a more humane and respectful birth

In Latin America, with the increasingly medicalized and surgical context of birth, many organizations propose a rediscovery of natural, unmedicated birth. Different scholars such as O. Fernández have analyzed the link between Post-traumatic Stress Disorder and obstetric violence, as have Olde et al. Various NGO’s around the world have the purpose of defending “the right to a respectful and humane birth”, such as the Canadian organization Humanize Birth, or the Spanish association El Parto es Nuestro (“Birth Is Ours”). In the United States, Young Women United engages in policy and advocacy efforts to improve the access that low income and pregnant people of color have to midwifery care, as well as improve breastfeeding rates in New Mexico communities (Medicaid funding is also available for home births). Other organizations such as The Birth Trauma Association claim to “support women suffering from Post Natal Post Traumatic Stress Disorder (PTSD) or birth trauma”; which rather than being the result of the birth process itself, is caused by “factors such as loss of control, loss of dignity, the hostile or difficult attitudes of the people around them, feelings of not being heard or the absence of informed consent to medical procedures”. The WHO’s Reproductive Health library states that a de-humanized, highly medical context for normal births can “promote the use of unnecessary interventions, neglect women's emotional needs and contribute to a high overall cost of medical services”.

Legal Action Against Obstetric Violence

In Venezuela, as well as in the Mexican states of Veracruz, Chiapas, Guanajuato and Durango, laws have been passed to give women the right to a life free of obstetric violence. Venezuela’s Organic Law on the Right of Women to a Life Free of Violence, approved November 2006, defines on its Article 51 the following acts as forms of obstetric violence:

• Failing to timely and efficiently take care of obstetric emergencies
• Forcing the woman to give birth in a face-up (lithotomy) position and with legs on stirrups, when the means are available for vertical birth,
• Blocking the child’s early attachment to the mother without a justified medical cause, denying the mother the possibility of picking up the child and breastfeeding immediately after birth,
• Altering the natural process of the low-risk birth, by use of induction and acceleration techniques, without obtaining the mother’s voluntary, explicit and informed consent.
• Practicing caesarean sections when the conditions are available for natural birth, without obtaining the mother’s voluntary, explicit and informed consent.

Mexico’s GIRE (Group for Information on Planned Reproduction) has issued a report where it also mentions the “normalization of obstetric violence”, as well as psychological and emotional mistreatment by care providers being common during childbirth. It also mentions forced sterilization as a form of severe violence against women; one which might disproportionally affect indigenous women. Psychological and verbal abuse during childbirth, as well as coercion into accepting surgical intervention, are also documented in Goer’s “Cruelty in Maternity Wards: Fifty Years Later”; published in the Journal of Perinatal Education.

References:

Research Proposal Gender and International Affairs IA039 Elisabeth Prügl Group 5 [1]

This proposal aims to outline our plan to improve the existing entry on Violence Against Women on Wikipedia. We observed that there is a need to improve and expand some existing sections in the entry, as well as incorporate the other related and essential subtopics. Overall, the entry seems to focus the issue in a broad and universal sense. However, while some very important issues related to violence against women (which have gained much media attention in recent years) such as Female Genital Mutilation, or violence against women in the context of mass protests, are absent from this entry, other very specific ones such as Gender-based violence by male college athletes are included, which makes the article appear quite incomplete, random and un-professional. There is, at the right side of the main entry, a more thorough List of Topics, which includes links to many other sub-categorizations of Violence Against Women, but we consider that this one, being the main article on the subject, ought to include at least short and general introductions to topics such as Psychological and Physical Violence Against Women, Violence Against Women in the Context of Activism, and Legal Aspects of violence against women. We also plan to expand the section on “History of violence against women”, which is too short to be a detailed history or mention enough important historical aspects. We also plan to do an introduction on the concept of obstetric violence, which some scholars, especially in the Spanish-speaking world, have recognized as an important source of potential violence, around which there is still much denial and unrecognition.

The entry also appears to have insufficient ‘legitimate’ sources and research-backed approach. This is apparent throughout the entry while it is referring to a very limited number of: 1) United Nations’ treaty bodies such as the United Nations General Assembly, on the Declaration on the Elimination of Violence Against Women and the 48th UNGA Resolution [2] 2) The international human rights instruments such as the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW, which is not even mentioned, and neither is the Convention of Bélem do Pará and the Vienna Declaration and Program of Action and 3) the empirical data and reports of the situation on the ground from the ‘Non-governmental organization ’being used to support the content of the entry. Some of these references were mentioned just in titles, but not in details. We deem that it is necessary for this entry to have more ‘legitimate’ and ‘human rights based’ sources to support the information related to this topic. Therefore, we propose a number of existing subsections to be expanded: history of violence against women and activism, and other subsections to be added as the following:

Emma: “History of violence against women”

The first section, History of violence against women is one of the first ones we would like to revise and expand. Firstly, it is only comprised of 3 paragraphs; one is just a one-sentence paragraph, with a brief theory of why violence against women has consistently existed (women being viewed/treated as property and being subservient to men). One paragraph makes a reference to UN declaration on the subject of violence against women. The last paragraph gives 2 examples (in the US and UK) of when courts ceased to recognize the legal right of a man to use corporal punishment against his wife. There is a lot more to be investigated and to be said about the history of violence against women, for example how and when it has been recognized as a societal problem, and what actions have been taken? Additionally, have other documents on violence against women, like the UN declaration [[3]], been produced? If so, at a national legal level in varying countries, or in regional organizations or associations of countries? Are there different patterns of violence against women in different countries or regions of the world, and how has violence against women been viewed, talked about, or recognized there?

Wipada: Activism

Another section that we would like to expand is the section of ‘activism’. From the existing entry, the information given was not enough for one to comprehend the activism for women’s rights, in this case, violence against women. The first sentence of the paragraph suggests a concept that there is a causal relationship/ correlation between Domestic violence and societal hierarchy based on sexism. However, this was claimed without any reference and that it refers ‘violence against women’ by employing the term ‘domestic violence’ which was not even mentioned anywhere in the page. In addition, there is a need to mention that the activism for the particular issue of violence against women is commonly known to be based on the concept that ‘women rights equal human rights and that the violence against women is considered as violation of human rights'. Also, we need to update some of the terms used in the context of activism that they seem to be out-of-date. We should employ the term ‘human rights defender’ rather than ‘activists.’ In other words, we should introduce the term that the human rights defenders working to improve the rights and situation of women call themselves: Women Human Rights Defenders [[4]] or WHRD (according to the Office of the United Nations High Commissioner for Human Rights: for the human rights defenders, civil society groups and NGOs). Also, the campaign mentioned in this section was just one campaign which is not up-to-date anymore (the recent one would be Event:16 Days of Activism Against Gender Violence Campaign. And lastly, this section also omits the crucial aspects of the activism, which are the work of the human rights defenders and their ‘real’ situations and what they encounter on the ground and there also is a need to expand.

Dilnoza: Female Genital Cutting/Mutilation as a form of Violence against women

In this section there will be examined female genital cutting as a harmful traditional practice that is legally considered as a violation of women’s human rights since 1993 (Vienna Convention). There exist already Wikipedia entry named Female Genital Mutilation that covers definition, history, origins, and oppositions of Female Genital Mutilation. I found, however, that some aspects of that issue (for example little discussion of how FGC is related to Violence Against Women) is missed and would be relevant to shed light on Female Gental Cutting as a form of VAW namely within Wikipedia page Violence against women from gender studies perspective.

Since in the main entry of FGM there is already provided detailed description of terminology and definition of four types of FGM, this section deals mainly with the heat debates over FGC among Western feminists and African (or Outsiders vs. Insiders, Cultural relativists vs. Universalists). It describes the arguments provided by both sides and illustrates the critiques of those arguments. In addition to that, several interventionist approaches set up by international organizations such WHO, UN, and NGOs (such as Tostan) will be described within secttion named Interventionist approaches and the shortages/critiques of those approaches will be defined.

The section is based on the works of Bettina Shell-Duncan, Lisen Dellenborg, Jaqui True, Maria Malstrom, Kwame Anthony Appiah, Martha Nussbaum, Yeal Tamir, Andrew Koppelman, Lori L. Heise, R. Elise, B. Johansen, Nafissatou J., Diop, Glenn Laverack, and Els Leye. Statistics data are taken from WHO and UN reports, and Tostan findings.

While we were working together and were in the process of editing and structuring this Wikipedia page, someone called "skydeepblue" has added several subsections (Honor killings, Dowry violence, Female genital mutilation, Acid throwing,Forced marriage) particularly to Domestic violence section. Therefore within subsection Female Genital mutilation I would suggest to:

1. Along with WHO's technical definition of FGM, to give other academic definion (recommended by scholars: Martha Nussbaum,Andrew Koppelman, Lori L. Heise, Duncan and etc. )

2. to provide data on countries with the bottom rates for FGM;

3. to mention that FGC is spreading beyond the borders of Africa and Middle East due to emigration and globalization (which leads to actually familiarizing the Western world with existence of such practice);

4. due to existence of several misinformation about FGC, there will be subsection on "myths and biases related to FGM";

Camille: ‘Violence against women in the justice system’

We will discuss the different challenges and barriers that women victims of violence face in accessing justice. Among these challenges are : - The lack of criminalization of violent behaviors. We will give several examples of countries where the law does not criminalize Female Genital Mutilation, Rape, Domestic violence. There can also be a law criminalizing the mentioned above violent acts against women, but the legal framework is insufficient and there is in practice no possibility for women victims of such acts to access justice. We will mention for instance the difficulties to file a complaint for rape or other violent behavior; the difficulty to make a case in court (members of the judiciary continue to take evidence of struggle and injury as determinative medical evidence). Other related practical barriers are the delays in investigation and conviction, and the lack of remedies in court despite the possibility of conviction of perpetrators. Crimes against women can also be categorized as minor offences. We will also show examples of legislation allowing better access to justice for women in order to compare and show examples of good practice. Other barriers due for instance to immigration laws in a country. We will mention the case of undocumented women in countries where they would have, in theory, access to justice but in practice don’t for fear of being denounced and deported. We will then discuss discrimination and gender stereotyping as the cause for this lack of access to justice by women victims of violence. We will talk about the role of CEDAW in promoting gender equality and women’s access to justice. Gender stereotyping is often a key factor in failure of states to recognize violation of women’s rights. Influences the treatment of women in justice systems : failure in inquiries in rape by state authorities. State failing to punish violations because of stereotyping. Rejection of evidence based on stereotype. Discriminatory stereotypes affect women regardless of their behavior. It affects victims of violence, who have difficulties to access justice.

Clara Franco: Obstetric Violence

We want to include this part in our contribution because we feel that, especially in English-speaking countries, there is much denial and under-reporting surrounding the issue, challenging its very existence as a form of violence. The increasingly medicalized birthing practices that have prevailed in industrialized countries, and their cultural “trickle-down” into developing countries, can lead to an abuse of birthing practices that should normally be restricted to only a minority of births, such as c-sections, episiotomies, the abuse of medication and birth induction; or the use of instruments and maneuvers that have been recognized as risky to the health of the mother and child (forceps, Kristeller maneuver, vacuum extraction). Various NGO’s around the world have the purpose of defending “the right to a respectful and humane birth”, such as the canadian organization Humanize Birth, or the Spanish association El Parto es Nuestro [[5]]. Different scholars such as O. Fernández have analyzed the link between Posttraumatic Stress Disorder and obstetric violence. Overall, it will be an interesting exercise to analyze the acceptance of the concept of “obstetric violence” among predominantly English-speaking Wikipedia editors. The WHO mentions “obstetric violence” only in a single article about a law recently passed in Mexico, which aims to further the respect for traditional medicine and “women’s right to a life free of obstetric violence, such as unnecessary cesareans”. Venezuela has recently included it as a legal term; in a law that defines obstetric violence as “appropriation of the body and reproductive processes of women by health personnel (...) expressed as dehumanized treatment, an abuse of medication, and to convert the natural processes into pathological ones, bringing with it loss of autonomy and the ability to decide freely about their bodies and sexuality, negatively impacting the quality of life of women”[[6]]. Three Mexican States have also legally defined obstetric violence, along with violence concerning reproductive rights. Cross-cutting issues: rights of indigenous women. Indigenous women are much more likely to suffer different forms of obstetric violence and can also be disproportionately affected by forced sterilizations or other ways of forced contraception.

References

Browne, Angela. “Violence against women by male partners: Prevalence, outcomes, and policy implications.” American Psychologist, Vol 48(10), Oct 1993, 1077-1087.

Bulletin of the World Health Organization: “Mexico’s Midwives Enter the Mainstream”, in World Health Organization Website, http://www.who.int/bulletin/volumes/86/4/08-010408/en/, Visited October 2013.

Christian E. Molidor. Gender differences of psychological abuse in high school dating relationships. Child and Adolescent Social work journal. Vol.13 N1, February 1996. in http://link.springer.com/article/10.1007%2FBF01876596#page-1.

Ellsberg, Mary , and Lori Heise. "Researching Violence Against Women."A PRACTICAL GUIDE FOR RESEARCHERS AND ACTIVISTS 1 (2005): 1-244. http://www.path.org/publications/files/GBV_rvaw_complete.pdf (accessed October 20, 2013).

Fernández I, O. “PTSD And Obstetric Violence”, in Midwifery Today - International Midwife, vol. 105, pp. 48-68, 2013.

Garcia-Moreno, Claudia and Henrica AFM Jansen , Mary Ellsberg , Lori Heise , Charlotte H Watts. “Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence.” The Lancet, Volume 368, Issue 9543, 7–13 October 2006, Pages 1260–1269.

GIRE, Group for Information in Informed Reproduction. “Omission and Indifference: Reproductive Rights in Mexico”, Yearly Report.

Goer, H. (2010). “Cruelty in maternity wards: Fifty years later”. Journal of Perinatal Education, 19(3), 33–42.

Krug , Etienne G and James A Mercy , Linda L Dahlberg , Anthony B Zwi. “The world report on violence and health.” The Lancet, Volume 360, Issue 9339, 5 October 2002, Pages 1083–1088.

Johanson, R., Newburn, M., & Macfarlane, A. (2002). “Has the medicalisation of childbirth gone too far?” BMJ (Clinical Research Ed.), 324(7342), 892-895.

Pérez D’Gregorio, Rogelio. “Obstetric Violence: A New Legal Term Introduced in Venezuela”, in International Journal of Gynecology and Obstetrics, Vol. 111, No. 3, pp. 201-202, 2010.

Venis, Sarah and Richard Horton. “Violence against women: a global burden.” The Lancet, Volume 359, Issue 9313, 6 April 2002.

Villegas Poljack, Asia. “Obstetric Violence and Forced Sterilization Facing Medical Discourse”, in Venezuelan Magazine of Women’s Studies, vol. 14 No. 32, pp. 125-146, 2009.

External links

Organizations

[7]

United Nations Population Fund “Organic Law on Women’s Right to a Life Free of Violence”

[8]

World Health Organization Gender. Gender-based violence. http://www.who.int/gender/violence/gbv/en/

UNFPA

[[9]]

Women Human Rights Defenders [[10]]