responsible for high indices of maternal mortality.105 Nonetheless, Ms. Brítez Arce did not obtain the specialized and diligent medical treatment that she required as a pregnant woman and the risk factors shown in her clinical history. In addition, she was not given specific information on the state of her health; in particular, on the risk of pre-eclampsia and its implication of the high likelihood of maternal mortality. Nor, in spite of her clinical history, did they offer her recommendations on how to prevent or treat the hypertension, which indicates that there was no guarantee of access to precise and timely information on the state of her health. 83. The Court also finds that, on June 1, 1992, Cristina Brítez Arce, 40 months pregnant, went to the Sardá Hospital where she had undergone medical checkups regarding her pregnancy, complaining of lower back pain, fever and a scant loss of liquid from her genitals. She was admitted and was informed that the fetus had died. It was decided to induce birth, a process that lasted from 1:45 p.m. to 5:15 p.m., at which time she was transferred to the maternity ward, where she died. There is nothing in the file that shows that Ms. Brítez Arce had received adequate information on the procedure to be followed once she learned that the fetus had died. The Court’s attention is also called to the fact that Ms. Brítez Arce remained in labor with a dead fetus for more than three hours, two of them seated in a chair. Although the Court is not called upon to establish whether this course of action of the physicians was adequate or whether medical reasons required inducing labor, the Court finds that, in view of the evidence available in the file of the case, the situation described indicates that the victim was submitted to a state of stress, anxiety and anguish.106 Therefore, as indicated in the expert opinion presented by the Catholic University of Córdoba, Ms. Brítez Arce “should have been stabilized and evaluated before being submitted to another stress such as induced birth, holding her dead son at her breast.” Instead, the procedure of the medical staff that performed the obstetric emergency “exposed the patient to a risk that a posteriori was harmfully transformed, to death.”107 84. The Court recalls that women are in a situation of special vulnerability during or immediately after natural or caesarian childbirth.108 The state of anxiety, anguish and stress to which Ms. Brítez Arce was subjected, in addition to her vulnerability, made her a victim of dehumanizing treatment. On this matter, the Court notes that the expert opinion of the Catholic University of Córdoba stated that “the patient was ignored while the dead fetus was being diagnosed.”109 85. Thus, the diagnosis, the decision to subject Ms. Brítez Arce to an induced labor, the lack of complete information on possible alternative treatments and their implications; and the wait of two hours in a chair while the procedure was being carried out subjected the victim to stress, anxiety and anguish that, added to her special vulnerability, resulted in dehumanizing care and the denial of full information on the state of her health and alternatives of treatment, which constitute obstetric violence. 105 According to the Special Rapporteur on the right of everyone to the highest attainable standard of physical and mental health, “[a]round 80 per cent of maternal deaths are due to obstetric complications, mainly […] preeclampsia and eclampsia […].” (Emphasis added). Special Rapporteur on the right of everyone to the highest attainable standard of physical and mental health, UN Doc. A/61/338, September 13, 2006, para. 7. After confirmation that the fetus was dead, blood was taken from Ms. Brítez Arce and it was noted on her medical record that she had hyperglycemia. According to the expert opinion of the Catholic University of Córdoba, this condition “may be due to stress suffered by the patient upon receiving news of the death of her son. Physicians, in their studies on glycemia and stress, say that what most raises the level of glycemia is the death of a close family member […]. The patient was subjected to great stress (the news of the death of her son). Why didn’t they wait for the result before subjecting her to another stress, such as labor. Expert opinion of the Catholic University of Córdoba of March 13, 1998 (evidence file, f. 110). 106 107 Expert opinion of the Catholic University of Córdoba of March 13, 1998 (evidence file, f. 121). 108 Cf. Case of I.V. v. Bolivia, supra, para. 183. 109 Expert opinion of the Catholic University of Córdoba of March 13, 1998 (evidence file, f. 120). 25