by Courtroom Mama
Like birth, the law is a subject swathed in a constant fog of confusion and misinformation. Previously, I was convinced that this was a trick of the legal profession to keep themselves employed and maintain the scarcity of legal expertise. Now that I’ve been inducted into the club, I realize that the truth is that the answers are, in fact, murky and often unsatisfactory. An area that seems to come up perennially is the question of “rights” in birth – does the provider have a right to do x? does a woman have a right to do/refuse y? I love to be able to tell people what they want to hear, but anyone who followed Jill’s coverage of the New Jersey c-section case knows that there is a chasm between rights and reality.
For example, the Convention to Eliminate All Forms of Discrimination Against Women (CEDAW) has been a hot topic lately. It is an international human rights document that commits the nations that ratify it to ending discrimination against women—and the United States is the only democracy that has refused to sign on. The end to discrimination against women is a noble end that makes my feminist heart quake with glee; I personally think we should sign on without reservation. But if we take off the rose colored glasses for a moment, we see that among the ranks of the signatories, we find Mexico, where a femicide in Ciudad Juárez raged with total impunity for over a decade, finally escalating into a breakdown of law and order within the last few years. Or Afghanistan, where girls attend schools despite threats from the Taliban. In short, laws without implementation, whether through lack of will or resources, do nothing to rectify wrongs.
As Jill reported here back in November, as a part of its 2007 Ley Organica sobre el Derecho de las Mujeres a una Vida Libre de Violencia (Organic Law on the Right of Women to a Life Free of Violence) Venezuela coined the term “obstetric violence.” There was a collective huzzah from birth activists in the U.S., because we lack a term (and thus a construct) for this idea, and the notion that such a law exists lights a way forward. What it means for birthing women in Venezuela, however, is another thing entirely.
As noted in the International Journal of Gynecology and Obstetrics editorial on the law, there are some practical problems with implementation. The author notes, for example, that the mandate to end “[u]ntimely and ineffective attention of obstetric emergencies” can be difficult or impossible to carry out against a backdrop of “overcrowded public hospitals that have a high population of patients to attend, a deficient number of health personnel, scant supplies, as well as an inappropriate infrastructure.”
Lack of hospital beds is the least of Venezuela’s infrastructural worries around the law. Amnesty International calls the law “a valuable tool to strengthen women’s access to their rights,” but admonishes that implementation has been “far from satisfactory.” As one report by the Immigration and Refugee Board of Canada points out, the number of specialized courts in the nation is “insufficient” to process sexual violence cases. According to AI’s 2010 “State of the World’s Human Rights” report, there were 12,000 complaints of violence against women between January and August, only half of which could be dealt with. The report also describes other serious concerns, such as attacks on human rights defenders and repression of political dissent. As for the culture of obstetrical practice in Venezuela, three years after the implementation of the law (which states that “obstetrical violence” includes “[p]erforming delivery via cesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman”) the cesarean rate is approximately one-in-three overall, and as high as 90% in some practices (click even if just to see a Trotskyite playing This Little Piggy).
In short, laws can only help where the rule of law prevails: rights without a form of redress are just empty promises. We still have a long way to go toward the attainment of gender equality in the U.S. and worldwide, and even longer until that equality is three-dimensional and not just on paper.
Photo credit: Amnesty International