How have these media from Chile, Cuba and Mexico made obstetric violence in the region visible?

Although obstetric violence is a widespread problem that continues to affect thousands of women in Latin America, journalists say the issue remains invisible in most traditional media due to factors ranging from the difficulty of covering it to the lack of official figures.

However, some recent investigative reports in the region have stood out for helping to reveal this hidden reality. Journalists from countries such as Chile, Cuba and Mexico have reported, through hard data and shocking testimonies, that obstetric violence is a problem. Additionally, they have managed to make victims visible and have even managed to get reactions from health authorities.

The World Health Organization (WHO) defines obstetric violence as being experienced by women during pregnancy or childbirth. It includes physical abuse, humiliation, verbal abuse or non-consensual medical procedures.

The three reports detailed below are examples of how journalism in Latin America is covering obstetric violence, the approaches that can be taken to the problem and the strategies to obtain data, testimonies and impact.

Revealing a hidden reality

In May 2022, Chilean President Gabriel Boric delivered a public apology to an HIV-positive woman who was sterilized without her consent after giving birth in a public hospital. In a Peaceful Solution Agreement promoted by the Inter-American Commission on Human Rights (IACHR), the Chilean State accepted its international responsibility for the violation of human rights and committed to repairing the damages to the woman.

"How many people like you don't we know about?" Boric said at the event.

Chilean journalist Rocío Larraguibel interviews a woman for a TV report.

The team led by Larraguibel (right) asked women outside hospitals if they had undergone unauthorized sterilizations or if they knew of anyone in that situation. (Photo: Screenshot of Meganoticias)

At the same time that the president apologized, a team from the investigation division of channel Meganoticias led by Rocío Larraguibel was struggling to obtain official information on sterilizations in public hospitals in Chile, both through the Transparency Law and with the Ministry of Health. For months, the channel had been investigating cases of foreign women who had been sterilized without their consent.

Although the issue was very present in media, Larraguibel said the Ministry of Health did not respond to Meganoticias and very few hospitals responded to requests for information. Given these results, the team decided to investigate directly with the victims. It was enough to stand outside a hospital and ask women who came for postpartum consultation if they had undergone unauthorized sterilization or if they knew of anyone in that situation.

“Most of them knew someone who it had happened to,” Larraguibel told LatAm Journalism Review (LJR). “It's like a reality that is evident but was hidden. You just had to go out and ask what was happening.”

The result of that investigation, which took more than six months, was the report “They were sterilized against their will: Women denounce public hospitals”, broadcast in August 2022. The project reported that dozens of women in Chile had been subjected to sterilization procedures at the time of delivery or in situations of great pain. Many of them are immigrants who do not speak Spanish and who have been victims of obstetric violence allegedly due to racism and xenophobia, according to the report.

Larraguibel said that one of the main reasons why the topic of obstetric violence is not so present in traditional media in Chile is because of the difficulty of covering medical negligence, which normally happens in a confidential space and is difficult to prove with official figures and testimonies.

However, through the report, the Meganoticias team managed to present the issue as a widespread problem that represents a real threat to the human rights of women and their children.

“There is a kind of birth control through this practice that should not happen. It is wrong, it is immoral. This type of reporting serves to make visible these realities that are more hidden. There are so many important and urgent issues, but for them [the affected women] this is also urgent and important,” Larraguibel said. “I think there is work there that the media or independent journalists can take on and reveal through their publications.”

After the broadcast of the report, the Ministry of Health established a discussion table with institutions to work on a stricter protocol so that public hospitals allow women to decide whether or not they want to have more children. In addition, Larraguibel said Chilean health authorities contacted Meganoticias to try to reach the victims of forced sterilization and medical personnel mentioned in the story.

Due to the quality of the interviews and data management, “They were sterilized against their will” obtained an honorable mention at the 2023 Roche Awards. In addition, it won the Audiovisual Excellence Journalism award from Alberto Hurtado University.

As a result of the report, Meganoticias received more testimonies from Chilean women who say they were victims of obstetric violence, so the team is currently preparing a second installment.

“[Obstetric violence] is the most invisible kind of gender violence that we women suffer and this same invisibility is what has led to it being seen as natural that the birth process has to be painful, when it does not necessarily have to be that way,” Larraguibel said. "That was what we wanted to make visible, that women also have the right to be treated as bodies with autonomy and not simply as an inert body that is there to give birth without having to be consulted."

The first figures about an alarming problem

A team of female journalists in Cuba carried out a pioneering collaborative journalism project on the birth experiences of hundreds of Cuban women in recent decades that also points to alarming obstetric violence.

Partos Rotos” (Broken Births), published in June 2022, is an investigation that reports, among other things, that hundreds of Cuban mothers remember their births as traumatic episodes in which they were violated and mistreated.

The project arose from a report by journalist Claudia Padrón published in 2020 about alleged medical malpractice in women's births due to cuts in health budgets in Cuba. Based on the report, hundreds of women shared similar experiences on social networks, so Padrón saw the opportunity to expand her investigation.

Collage of women with their children that illustrates the Cuban journalistic collaborative project "Broken Births"

Although the data reported by "Partos Rotos" are not statistically representative, the project revealed the first figures on obstetric violence in Cuba. (Photo: Screenshot of "Partos Rotos")

“The majority of the [women] who dared to write narrated quite negative experiences. And as a result of that I had the idea of ​​doing a larger project where it would be shown that these were not anecdotal cases, but rather that we were talking about a structural and systemic problem,” Padrón told LJR.

The journalist brought together a group of Cuban colleagues who worked both inside and outside the island to carry out “Broken Births.” The team faced the challenge of investigating a sensitive issue that involved the Cuban health system – an entity that the regime most proudly promotes on the international level – in a country where practicing independent journalism is prohibited.

The journalists developed an online questionnaire that, although it was extensive, was answered by 514 women. The questionnaire was distributed privately to women who had shared their testimony on social networks to prevent the authorities from learning about the investigation. In addition, they recruited a team of volunteer interviewers in various parts of Cuba to administer the questionnaire to their family and friends.

Padrón and her team chose some of the stories shared in the questionnaires for in-depth interviews, most of which were conducted by phone or through audio messages.

The result was captured on the website partoscuba.info, which includes six installments of data journalism, testimonies, illustrated stories and a podcast series. For their meticulous work and good use of journalistic and social science tools, the team won the 2023 Roche Award in the Written Journalism category. In addition, the work was chosen as one of the best investigations in Latin America in 2022 by the Global Investigative Journalism Network (GIJN).

However, the most notable impact of the project is that it achieved what few independent journalistic works achieve in Cuba: a reaction from the State.

A few weeks after the publication of “Broken Births,” the issue was taken up by some official Cuban media in which doctors recognized bad practices. In August 2022, the Ministry of Health published a guide on recommended birth practices to avoid obstetric violence and announced a respectful birth pilot project that would be implemented in some hospitals.

“The institutions had to recognize that obstetric violence was indeed a problem and that they were going to implement a group of measures to change birth practices so that women would have better experiences,” Padrón said.

The journalist attributes this reaction of the State to the impact that “Broken Births” had internationally and to the fact that, she said, health and education are two of the issues that the Cuban regime is most interested in highlighting abroad.

“Cuba has low infant mortality statistics. There is not much transparency, but at least that is how the image is exported to the world,” she said. “So, suddenly women began to tell about the mistakes they had experienced in the delivery rooms, whether due to the attitude of the professionals or the lack of resources [...], many small problems were being revealed, which, when added up, revealed a quite chaotic overview of the health system.”

The “Broken Births” team monitored the implementation of the pilot program and in a new installment of the investigation, published in August 2023, reported that the plan was not being implementedThe project's website was then blocked from being accessible in Cuba.

Although the population sample that responded to the “Broken Births” questionnaire is not representative, its authors say that the project revealed the first figures on obstetric violence in Cuba.

“Yes, they are the first numbers on it, because there was nothing before,” Padrón said. "In terms of data, there is only the Health Statistical Yearbook, where you can see the number of cesarean sections that are performed in the year, maternal deaths, infant deaths, but in Cuba the indicators of maternal and child care and quality of care are not measured.”

Journalism and art for humanized childbirth

One of the main challenges when covering obstetric violence, according to journalists who have investigated the topic, is approaching victims. The authors of “They were sterilized against their will” and “Broken Births” agree that having women journalists interview women who have suffered obstetric violence tends to lead to a natural trust.

However, a report on the subject carried out by male journalists in Mexico also managed to create that empathy and lead to social impact. “Humanized childbirth: An urgent need in Coahuila,” from the independent media outlet Red Es Poder, managed to establish that hospitals in the Mexican state of Coahuila far exceed the numbers of cesarean sections recommended by the WHO. Likewise, the investigation reported lack of investment of public resources to combat obstetric violence.

Woman painting on a canvas during a painting intervention in Coahuila, Mexico.

Red Es Poder carried out an art installation in a public space in Torreon, Mexico, to expand the reach of its investigation. (Photo: Screenshot from Red Es Poder's Instagram)

Jorge Espejel, one of the authors along with his colleague Gerardo Pineda, said that they managed to build bridges of trust with the victims who gave them their testimonies thanks to the fact that they trained on the subject with experts and had the guidance of Silka Guerrero, an activist and motherhood coach.

“Obviously, we did encounter that resistance, which is natural and perfectly understood,” Espejel told LJR. “Normally, Red Es Poder has followed issues that have to do with combating gender violence and making visible the movements that are suddenly taking shape here in the region and that also helped.”

As a strategy to expand the scope of its investigation, which was published in February 2023, Red Es Poder organized an artistic installation in a public space in the city of Torreón, in which artists and women made paintings alluding to motherhood. In addition, Espejel and Pineda offered a talk about their report, in which Guerrero and one of the women who gave testimony for the investigation were present.

“The idea of ​​holding subsequent events with different narratives is so that the topic does not die so soon and also to reach another audience that may not be willing to go through a half-hour reading,” Espejel said. “We are exploring new or alternative narratives so that the message reaches more people and to find a way to communicate things with more diversity.”

The journalist said that both the report and the artistic installation opened a channel for more women to approach Guerrero’s organization that focuses on pregnancy and childbirth.

The report also found that some private hospitals in Coahuila offer obstetric packages to women from the beginning of their pregnancy that include the practice of cesarean sections and that some women in Coahuila voluntarily choose to undergo a cesarean section to avoid the pain of natural childbirth, without knowing that the WHO considers it a risky practice when it is not medically necessary.

“That is why we believe that it is important to disseminate this type of information because in the end the more mothers are aware of what a cesarean section entails and what a humanized birth entails, the greater the chances will be that they will demand respect for their reproductive rights in public and private health institutions,” Espejel said.

Advice for covering obstetric violence

Larraguibel, Padrón and Espejel shared some key points that they believe journalists should consider when covering issues related to obstetric violence in Latin America.

1. Train in reproductive rights

The Meganoticias team had the guidance of a lawyer specialized in reproductive rights to help it understand the legal dimension of the issue, and to determine the extent to which they could intervene and investigate.

2. Address the issue from a gender perspective

Larraguibel said that taking a gender perspective (meaning, in this case, investigating while taking into account the conditions of inequality between genders) offers tools that facilitate conversation with victims. This includes the correct way to talk to them and always making it clear that what they experienced is not their fault.

Padrón added that it must be kept in mind that women who have suffered obstetric violence may have ongoing trauma, so they should be treated with greater care.

3. Get familiar with medical terms

Covering obstetric violence involves managing highly specialized medical terminology and knowledge. For this reason, Padrón advises training on technical language so that when telling the stories, you are precise and understandable.

4. Put aside prejudices

Espejel said that it is important for journalists who wish to cover obstetric violence, especially men, to put aside all sexist and gender prejudices. Instead, Larraguibel said, it is advisable to try to connect with the pain and grief of the victims to address the issue.

5. Base the investigation on hard data

Although the testimonies give strength and meaning to the narrative, Espejel said that it is important to outline a hypothesis based on hard data at the beginning of the investigation. That way it is easier to structure the story.

Translated by Teresa Mioli
Republishing Guidelines