Mother’s Advocate supports a woman’s right to give birth upright, instead of in a flat-lying position, as it’s much easier and more healthy for both mom and her baby. This week, Jill Arnold, founder of TheUnnecesarean.com, invites us to learn from Latin American activism for women’s birth rights — the fight for “El Parto Vertical,”or vertical birth.
In recent years, a variety of organizations, coalitions and advocacy groups in Latin American countries — spanning from Mexico to Argentina — have worked to confront the rampant overuse of unnecessary and unwanted obstetric interventions, while improving labor conditions and accessibility for women.
In Venezuela, women are faced with 80 percent cesarean rates in private clinics or 30 percent in public hospitals. Women who are permitted to give birth vaginally often experience the routine use of a forced lithotomy or supine position (laying on the back with knees bent, positioned above the hips, and spread apart through the use of stirrups). In reaction, the Organic Law on the Right of Women to Be Free from Violence, enacted in Venezuela in 2007, includes forced supine position as “obstetric violence,” alongside episiotomies and unnecessary cesarean sections.
The demand for vertical births is also growing in neighboring Ecuador and Peru. Peruvian-based activists in the Sociedad Peruana de Estimulacion Prenatal y Postnatal (SPEPP) argue that allowing women to labor in the position of their choice is a human rights issue. Their Facebook page, A FAVOR DEL PARTO HUMANIZADO!! – PARTO VERTICAL!!, currently boasts more than 2,200 members. According to obstetrician Pedro Luna of Ecuador, “Horizontal birth is an occidental practice brought by the conquistadors with zero medical logic.”
Indeed, supine position is not native to Latin America, and indigenous women are often reluctant and feel violated by the hospital birth process. A recent video by UN in Action explains, “For indigenous peoples, giving birth is a private and intimate family ritual. Midwives and family members are always there to give support and comfort. Modern medicine is not only unfamiliar, but also frightening.” Marta Mendoza Parissi, the former director of the Instituto Veracruzano de las Mujeres in Mexico, calls for an end to this kind of obstetric violence — stating that failure to respect the customs and traditions of indigenous women to give birth in a vertical or squatting position is in violation of the 2007 General Law on Women’s Access to a Life Free of Violence (Spanish).
Hope for the Future
The Mexican Secretaría de Salud (Department of Health) created a department in 2002 to shift existing paradigms in health care with regards to traditional medicine, particularly among Mexico’s diverse mestizo and indigenous populations. The department’s director, Alejandro Almaguer González, was quoted in June 2010 touting the benefits of vertical birth, and praising a vertical midwifery practice in Coetzala, Puebla, which won a quality award in 2007 for its zero maternal mortality rate. Almaguer González claims that vertical birth in hospitals could help reduce maternal mortality, as 80 percent of maternal deaths occur in indigenous and rural populations, often as a result of resistance to medical care.
Whether established as an option to provide indigenous women with culturally-sensitive choices in a hospital, or because coerced positions for perceived obstetric benefit are considered to be an act of violence against women, “parto vertical” has become a rallying cry in recent years in two hemispheres – inspiring new ways of thinking about and advocating for upright birth.
Jill Arnold is the founder of TheUnnecesarean.com, a patient advocacy blog that focuses on the overuse of the cesarean section, informed consent and transparency in maternity care.
What position did you birth your baby in, and why? Did your care provider support your decision and pushing wishes?