gms | German Medical Science

Background: Obstetric violence was classified as gender-based violence by the Parliamentary Assembly of the Council of Europe (PACE). They highlighted the importance for and responsibility of all Council of Europe member States to contribute to the application and dissemination of good practice defined by the World Health Organization (WHO). PACE calls to fight discrimination in healthcare services to encourage healthcare provision that values human rights and dignity.

Black US-American feminists have developed the concept of Birth Justice (BJ) to reveal structural injustice and violence in maternity care. BJ is part of a wider context of Reproductive Justice. It aims to analyse and dismantle human-rights-based and intersectional aspects within reproductive inequalities.

Aim/Research question: The presentation focuses on the political and theoretical framework of Birth Justice and its relevance for midwifery research first, followed by a critical appraisal of studies in German speaking and European countries respectively to highlight the need for future research.

Methods: The presentation includes different topics, each of which requires an appropriate literature search. For the topic BJ some relevant publications were identified during a webinar “Understanding Systemic Racism in Maternity Care” followed by a reference list search. A systematic literature search regarding quantitative birth outcomes in a childbearing population with migrant background was undertaken. A critical literature search was undertaken to identify studies focusing on maternity care experiences in German speaking and European countries.

Results: Individual experiences of pregnant and childbearing people are shaped by varied interdependence of several characteristics such as sexual identity, race/ethnicity/citizenship/descendance, class, social circumstances, age, disabilities, and sexual orientation. These experiences interfere with their satisfaction with care provision as well as health outcomes, and therefore their future healthcare decisions. This in turn can lead to ongoing healthcare inequalities.

Studies in German speaking and European countries including intersectional perspectives sufficiently and appropriately are not available yet. Quantitative studies in German speaking countries evaluating perinatal outcomes in a childbearing population with migrant background are limited and biased as data regarding migrant background is limited. Qualitative studies analysing the experience of marginalised minorities in maternity healthcare provision are limited in quantity and quality. Experience with discrimination was not specifically researched yet.

Relevance: Considering the importance of intersectional perspectives and the significance of discrimination awareness and sensitivity within maternity care provision and midwifery research it appears crucial to discuss the need for future research.

Conclusion/Recommendations: For human-rights-based, respectful maternity care to become reality and to minimise health inequalities, healthcare practitioners need reliable data concerning with the experience of marginalised minorities within maternity care provision. Future studies should consider intersectional perspectives and need thoughtful planning.

Ethics and conflicts of interest: A vote on ethics was not necessary. The research was financed by own resources. There are no conflicts of interest.