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Join HRiC’s Key Stakeholder Advisory Group

HRiC is forming a global network of lawyers, researchers and advocates dedicated to improving maternity care - everywhere. Join us! Human Rights in Childbirth (HRiC) is developing a new strategy to inform our advocacy and strategic direction over the next three...

Terms of Reference: Key Stakeholder Advisory Group (KSAG)

Human Rights in Childbirth (HRiC) is developing a new strategy to inform our advocacy and strategic direction over the next three years. Our goal is to develop a sustainable network of key stakeholders in order to make full use of, and build on, our collective skills...

Forced Sterilisation during Caesarean and Informed Consent – the case of I.V. vs Bolivia

I.V. vs. Bolivia was the first time the Inter-American Court of Human Rights analysed the foundations of the right to informed consent.

Shared Decision Making in Maternity Care

In this article HRiC outlines its opinion on shared decision making and how it relates to human rights, specifically in maternity care.

Report on Rights Violations in Maternity Care During COVID-19

Since the beginning of the COVID-19 pandemic, HRiC has been collecting reports of disproportionate human rights violations in maternity care. The first set of rights violations have been published in a report (available below) and sent to the United Nations. , The...

Contribute to our Second Report on Violations in Maternity Care during COVID-19

Help us document what is happening taken in maternity care services in your country - send us a submission by Friday, 10 July 2020.The COVID pandemic is having an enormous impact on maternity care around the world. Minute by minute, day by day, practices and norms are...

HRiC informs European Parliament Action on Maternity Care during COVID-19

HRiC has been working with a Member of European Parliament to bring light to some of the problems women throughout Europe and the world are facing in maternity care during the COVID-19 pandemic.

Report Rights Violations during COVID-19

Help us document what is happening taken in maternity care services in your country - send us a submission by Friday, 24 April.The COVID pandemic is having an enormous impact on maternity care around the world. Minute by minute, day by day, practices and norms are...

Midwifing Us Through the Epidemic

Now is the time to press our governments and policy makers to support midwifery care in communities as part of policies to address climate change or Green New Deals that are being prepared around the world – to make sure we are well-prepared for the next emergency or pandemic. We ignore midwifery models of care, essential midwifery skills, community and home birth at our peril – future generations will depend on them as part of crisis response.

Communications Volunteer Position

HRiC is seeking a communications volunteer – apply by 30 April 2019!

Obstetric Violence and the UN Special Rapporteur for the Right to Health

Obstetric Violence and the UN Special Rapporteur for the Right to Health

The role of a UN Human Rights Special Rapporteur is to visit countries around the world and meet with a variety of stakeholders to get a sense of the state of human rights issues in each one. They engage with governments, organizations, and civil society to hear about the strengths and areas for improvement, then prepare a detailed report on their findings. Their final report has the power to launch issues into the national spotlight and spark real policy change.

The Special Rapporteur for the Right to Health held a Country Visit to Canada in November 2018.

I became a patient advocate sort of by accident. My own experience of obstetric violence that led me to this work left me completely traumatized and struggling to function. On paper, the birth of my child appeared perfectly uneventful; the kind of birth for which many hope. I had a “normal” vaginal delivery following an induction at 41 weeks. There were no instruments required, I had minimal tearing, delayed cord clamping, and immediate skin-to-skin with my beautiful healthy baby. Despite the positive physical outcome, some of the treatment I’d received left me in a very dark place. When I returned home from the hospital, I was unable to separate vivid flashbacks of the non-consensual procedures and cruel attitude of hospital staff from my previous experiences of violence and abuse. Well-meaning friends, family, and professionals to whom I reached out to for help in those early days implied that a healthy baby was all that mattered; that I was selfish and ungrateful for expecting more support from my healthcare providers, even at such a vulnerable time. I was told to make peace and move on, not to complain because it was unlikely to change anything. Instead of quietly making peace with the trauma, I began to connect with others in my community and online who’d been through similar experiences who had never spoken up, or had tried to speak up but felt silenced, gaslit, and dismissed. There are so many of us.

Knowing that these problems are widespread not just in childbirth, but in other forms of reproductive healthcare as well, I created a website called The Reproductive Justice Story Project. The project centres on a story-sharing platform, the Community Story Blog, which serves as a public body of evidence to expose mistreatment and abuse in reproductive healthcare, first in my home province of Ontario, and now across Canada. Many folks have already written in to share their personal experiences not just of obstetric violence and birth trauma, but disrespect, discrimination, threats, and coercion from healthcare providers during prenatal and postpartum care, abortion care, pregnancy and infant loss, and much more. It is the hope that sharing these stories loudly and publicly will be one small way to help hold harmful systems accountable and influence change in policy and in the culture of reproductive healthcare.

When the UN Special Rapporteur on the Right to Health, Dainius Pūras of Lithuania, visited Canada this past November, Human Rights in Childbirth reached out to suggest that I try to share my work on obstetric violence with him during the mission.

The role of a UN Human Rights Special Rapporteur is to visit countries around the world and meet with a variety of stakeholders to get a sense of the state of human rights issues in each one. They engage with governments, organizations, and civil society to hear about the strengths and areas for improvement, then prepare a detailed report on their findings. Their final report has the power to launch issues into the national spotlight and spark real policy change. I was grateful for the tip about the Special Rapporteur’s visit, and emailed the office right away using every bit of advice I’d been offered from Human Rights in Childbirth. It was pretty short notice and their trip had already begun, so I was incredibly lucky to receive an invitation to give a brief presentation in Ottawa a few days later. I crowdfunded a last-minute plane ticket from Toronto for myself and my nursing toddler and stayed with a family friend in the city so I could give my presentation.

The meeting was hosted at the offices of Action Canada for Sexual Health and Rights, an organization doing invaluable work around sexual and reproductive rights here in Canada and globally. I arrived early and sat in the conference room anxiously looking over my notes; I am very new to advocacy work and this was my first opportunity to speak for a group of this nature. The other presenters arrived one-by-one and took their place around the conference table. They all looked like experts: well-spoken, well-dressed, and all from such well-established organizations. I felt like I’d snuck in somewhere that I didn’t belong! When it came my turn to speak, I managed to silence my imposter syndrome long enough to get through my presentation. I shared the final report from the patient feedback survey I conducted earlier this year as a case study in mistreatment and abuse in childbirth, and spent my few allotted minutes highlighting, specifically, the issue of obstetric violence in Canada.

Obstetric violence is truly a reproductive justice issue, and therefore, a human rights issue. It impacts women, trans, two-spirit, and gender non-conforming folks across demographic lines, but has a disproportionate impact on people experiencing marginalization and vulnerable life circumstances. The Special Rapporteur seemed to echo these sentiments in his preliminary findings at the end of his visit on November 16, 2018:

“I observed and discussed many additional issues related to the in-focus themes of my visit on which I will elaborate further in my report. For example, I received information about additional challenges including, inter alia, criminalization of both sex work and of HIV non-disclosure; access to contraceptives and abortion services, access to HIV medication, remaining practices of obstetric violence and forced sterilization amongst indigenous women, and the situation of vulnerability of incarcerated women, among whom indigenous and Afro-Canadian women are disproportionately represented.”

The final report on this mission will be released in June 2019. It will likely elaborate further on issues including obstetric & reproductive violence based on the presentations given by other organizations doing this important work across the country. These issues and the ways they intersect with social determinants of health have profound implications on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, and I hope this report will be a step towards meaningful change here in Canada.

HRIC Seeking Masters Student for Research on the Kristeller Maneuver

HRIC Seeking Masters Student for Research on the Kristeller Maneuver

The Kristeller Maneuver, or fundal pressure, is an emergency obstetric maneuver that is used routinely in many parts of the world. A research team is currently being assembled to complete a project on the prevalence of the Kristeller and women’s experiences of it. This is the perfect opportunity for a Masters student who is looking for a research topic for his/her thesis project, with the supervision and assistance of experienced midwifery and obstetrics researchers.

This is a project where the chosen student would be given the opportunity to acquire the following skills:

 

1. Survey development, including assessing the validity of the survey and cultural appropriateness (language, health system) using a novel and important method.

2. Analysis of quantitative data, including cleaning data, developing a conceptual model, descriptive statistics and regression equations (likely logistic regression).

3. Drafting scientific publications

The chosen candidate will be the lead researcher for the majority of the following research steps; for items that are currently outside the skill set of the chosen candidate, we will work to find people who can do them.

Steps:

1. Development of a study protocol

2. Ethics approval at your university

3. Survey validation: cognitive interviews with women to assess the intelligibility of the survey.

4. Program the survey

5. Ensure that we have a functional backend that will give us a usable dataset (file, format, etc).

6. Launch the survey: Recruitment, managing the team, advertising and promotion

7. Data cleaning

8. Data analysis

If you are interested in participating, please send a short letter of motivation and CV to Dr. Nicholas Rubashkin, nick@humanrightsinchildbirth.org by January 10th 2019.

Nicholas Rubashkin

HRiC President

Nicholas Rubashkin obtained his MD and MA (Anthropology) from Stanford University. He is an obstetrician who was born at home on a remote island in the state of Maine.

He is currently a PhD candidate in Global Health Sciences at the University California San Francisco (UCSF) where his dissertation research will focus on the global cesarean epidemic. He is also a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at UCSF.