of violence as “that exercised by health care personnel on the body and the reproductive processes of women, expressed in a dehumanizing treatment, an abuse of the medicalization and the pathologizing of the natural processes.”102 81. The Court, therefore, finds that obstetric violence is a form of gender-based violence, “prohibited by inter-American human rights treaties, including the Convention of Belém do Pará,”103 caused by those responsible for the care of women at health institutions, which takes place during pregnancy, childbirth and post-partum and which is mostly, but not exclusively, expressed in a dehumanized, disrespectful, abusive or negligent treatment; in the denial of treatment and of complete information on their state of health and the applicable treatments; in forced or coercive medical procedures, and in the tendency to pathologize the natural reproductive processes, among other threatening manifestations in the context of health care during pregnancy, childbirth and post-partum. B.2 Analysis of this specific case 82. The Court finds that, during her pregnancy, Ms. Brítez Arce presented various risk factors that were not treated adequately by the health system; among them, her age, an important weight gain, a history of arterial hypertension during a previous pregnancy and a blood pressure of 130/90 at one of the checkups.104 These circumstances imposed a special duty of protection that obligated her physicians to provide a diligent and augmented care, especially because it was a high-risk pregnancy and the possibility that she might suffer a pre-eclampsia, which is obstetric violence in Law 19,580/17 as “[a]ny act, omission and pattern of conduct of health personnel in the reproductive processes of a woman that affects her autonomy to freely decide on her body or the abuse of invasive techniques and proceedings.” Venezuela was the first country to adopt the term “obstetric violence” in its laws. The Organic Law on the right of women to a life free of violence, adopted in 2007, defines obstetric violence as “the appropriation of the body and reproductive processes of women by health personnel, which is expressed in a dehumanizing treatment, in an abuse of the medicalization and pathologicalization of the natural processes, bringing with it the loss of autonomy and capacity to freely decide on their bodies and sexuality, negatively impacting on the quality of life of women.” This definition is found in Article 6(c) of Law 26,485 of 2009 “Law of the Integral Protection to prevent, punish and eradicate violence against women in environments in which they develop interpersonal relationships” that, in turn, remits to Law 25,929 of 2004. Article 2 of that law defines the rights of women who are pregnant, in labor and during postpartum. The latter norm is known as the “Law of Humanized Birth” and establishes in its Article 2 that “[e]very woman, who is pregnant, in labor, childbirth and post-partum has the following rights: a) To be informed on the distinct medical procedures that may take place during those processes so that she can freely choose when there are different alternatives; b) To be treated with respect and in an individualized and personalized manner that ensures privacy during the entire process of care and have her cultural patterns taken into consideration; c) To be considered, in her situation of giving birth, as a healthy person so that her participation, as a protagonist in the delivery, be facilitated; d) To natural childbirth, respectful of the biological and psychological moments, avoiding invasive practices and the provision of medication that is not justified by the medical condition of the parturient or the fetus; e) To be informed on the evolution of the childbirth, the status of her son or daughter and, in general, that she is made aware of the different acts of the professionals; f) To not be subjected to any examination or procedure the purpose of which is research, except by her written consent using the protocol of the Committee of Bio-ethics; g) To be accompanied by a person of her confidence and her choice during labor, childbirth and post-partum; h) To have at her side her son or daughter during her stay in the health institution, as long as the new-born does not require special care;. i) To be informed, since pregnancy, on the benefits of maternal lactancy and to receive support to breast-feed; j) To receive advice and information on taking care of herself and the baby; k) To be specifically informed about the adverse effects of tobacco, alcohol and drugs on the baby and on herself.” 102 Inter-American Commission on Human Rights. Violence and discrimination against women and girls: Best practices and challenges in Latin America and the Caribbean, OAS/Ser.L/V/II. Doc. 233, November 14, 2019, para. 182. 103 According to the World Health Organization, among the criteria for the diagnosis of preeclampsia and eclampsia is the beginning of a new episode of hypertension during pregnancy, characterized by mild to moderate hypertension (diastolic blood pressure of 90 mm Hg or more). Cf. World Health Organization. WHO Recommendations for Prevention and Treatment of Pre-eclampsia and Eclampsia, 104 24

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