Translating international health policies into lived realities: Maternal health, social support programs, and obstetric violence in highland Peru

Abstract

This article examines women's experiences of pregnancy and childbirth in highland Peru and illuminates how international maternal health policies can perpetuate and reinforce social inequalities through what is now increasingly termed obstetric violence, including coercion, neglect, and physical and verbal abuse. Data were collected through in-depth, semi-structured interviews with mothers, obstetricians, midwives, and social workers and community-based, participatory action research workshops. In recounting their experiences, women continually referenced confusion around medical interventions, issues of coercion, neglect, abuse, and punishment, and structural obligations to utilize biomedical services. Analyzing these experiences through the lens of obstetric violence allows for a contextualization of individual women's experiences of violence in the healthcare setting within the broader context of everyday assaults on economically disenfranchised, indigenous women's personhood. Although women have increasing access to biomedical care as a result of international maternal health policies, this research demonstrates that how this care is delivered also deserves scrutiny.