Constructing Obstetric Violence in Law: Venezuela’s Feminist Definition and Its Role in Shaping Uruguay’s Framework

This post examines the foundational process behind Venezuela’s groundbreaking 2007 definition of obstetric violence and its influence on legal developments in Uruguay. By tracing the origins of Latin America’s first legal definition of obstetric violence, it becomes possible to understand the feminist discourses and perspectives that shaped Venezuelan legislation and inspired similar frameworks across the region.

Venezuela as a Regional Pioneer

In 2007, Venezuela became the first country to legally define obstetric violence through its Organic Law on Women's Right to a Violence-Free Life (Law No. 38,668), as “the appropriation of women's bodies and reproductive processes by healthcare personnel, which manifests as dehumanizing treatment, overuse of medicalization, and the pathologizing of natural processes, leading to a loss of autonomy and the ability to freely decide about their bodies and sexuality, negatively impacting women's quality of life”. This groundbreaking legislation established the foundation for similar laws across Latin America. Argentina followed suit in 2009 with Law 26,485 for Comprehensive Protection of Women, adopting the Venezuelan model, as later confirmed by the 2012 reports issued by the Follow-up Mechanism to the Belém do Pará Convention (MESECVI).

Although both the Venezuelan and Argentine definitions informed the research conducted by Diana González, a co-author of Uruguay’s former 2016 Bill on Gender-Based Violence Against Women which provided a definition of obstetric violence, the definition eventually incorporated into Uruguay’s proposal did not emerge from an extended national debate. Instead, it largely reproduced the wording used by MESECVI, which quotes the Venezuelan definition. As a result, the Uruguayan proposal reflects a direct definitional lineage from Venezuela, a path also followed in Argentina, as noted in MESECVI reports.

The Venezuelan definition became the template that influenced legal frameworks across Latin America, illustrating how pioneering legislation can drive regional change. In Uruguay, the definition of obstetric violence originally proposed in the 2016 bill was: “Any action, omission, or pattern of conduct by healthcare personnel aimed at appropriating a woman’s body and reproductive processes, affecting her autonomy to freely decide about her body, and expressed through dehumanizing treatment, overuse of medicalization, and the pathologizing of natural processes.” However, after consideration by the parliamentary committee, the definition was narrowed and ultimately worded as follows: “Any action, omission, or pattern of conduct by healthcare personnel in a woman’s reproductive processes that affects her autonomy to freely decide about her body, or the overuse of invasive techniques and procedures.” The phrases “appropriation of the body,” “dehumanizing treatment,” “overuse of medicalization,” and “the pathologizing of natural processes” were discarded as these were considered “neologisms” likely to prompt resistance from healthcare teams to the law. Although the definition was subject to several revisions during parliamentary discussions, there was no meaningful examination from parliamentarians, of the reasons for adopting one definition over another. Therefore, understanding how the Venezuelan definition was constructed is essential for developing an understanding of the discourses and perspectives that informed at least the definition that was originally proposed in the Uruguayan law.

Professor Marbella Camacaro: A Key Figure in Defining Obstetric Violence

In the development of the Venezuelan legal definition of obstetric violence, several factors converged around the work of Professor Marbella Camacaro, who emerged as a central figure in the process. With more than 35 years of academic experience at the Faculty of Health Sciences, University of Carabobo (Aragua), she brought significant medical and scholarly expertise to the debate. Alongside this, her lifelong feminist activism and personal motivations played a crucial role in this process. The origins of obstetric violence as a legal category were shaped by a deeply personal experience: her daughter, a medical student completing her obstetrics rotation, witnessed disturbing treatment of women in delivery rooms, an experience that profoundly influenced Camacaro’s research direction.

The traumatic experience of her daughter’s first obstetrics shifts, during which a resident aggressively berated both students and a 15-year-old patient in crisis, prompted a process of careful documentation. In 1996, her daughter began secretly recording incidents in a small notebook, working quietly at night to document experiences without challenging medical authority. Camacaro described this work as “almost subversively”, reflecting how power structures within obstetric services resist scrutiny and critique.

From Personal Experience to Public Policy

In 1997, Camacaro helped establish what is recognised as Latin America’s first public respectful birth room in Turmero. This pioneering facility challenged the dominant hospital paradigm by positioning women as central actors in their own pregnancy and birth experience. The project reflected her medical expertise and feminist commitment, and became a practical expression of principles that would later come to inform the legal conceptualisation of obstetric violence.

In 1997 the Women’s Institute of Aragua was founded to promote women’s rights and influence public policy on gender. As its Executive Secretary, Professor Camacaro helped to ensure that the Turmero birth room was accessible to users of the public healthcare system, a crucial distinction from private alternatives available only in Caracas. During its period of operation, the facility represented a significant paradigm shift: women were empowered, accompanied by their chosen support person, and treated with dignity throughout the childbirth process. Although the facility has since closed, it marked an important step in translating feminist and human rights perspectives into public maternity care practices.

The Emblematic Book: Giving Voice to Women's Experiences

In 2000, Camacaro published The Birth Experience: Women’s Process or Medical Act, a groundbreaking work that, together with her earlier institutional and activist efforts, became the foundation for the legal definition of obstetric violence in Venezuela. It was one of the first books in Latin America to centre women’s own accounts of childbirth experiences, rather than privileging the voices of medical professionals. It juxtaposed hospital births shaped by dominant obstetric paradigm with respectful birth experiences at the Turmero facility, highlighting the contrast between medicalised control and dignified, women-centred care.

The book gained ministerial endorsement and became instrumental in legislative discussions during National Assembly deliberations. Camacaro explains: “From that is what I construct the category, through women’s voices. I emphasise that, it should be clear that it’s not just a theoretical definition, but one taken from women’s voices, which is the great value it has.”

Legislative Success: The Moment of Historical Change

Several factors came together to make this groundbreaking legislation possible. Feminist movements held an unprecedented level of political influence at the time, and the Health Minister was a university professor, which contributed academic legitimacy to the initiative. Years of research provided a solid evidentiary base, and a cross-party women’s coalition aligned around shared goals

The definition was incorporated into the Organic Law as a specific form of gender violence, which gave it a higher legal status than ordinary legislation. Medical associations did not initially object, as Professor Camacaro states: “they didn’t become aware, when they found out, it was already a fact.” Reflecting on this process, Camacaro observed: “I never, never thought that could happen, that categorisation that blurs medical power. I never believed in my life that I would be a protagonist of such a thing in my country, much less in Latin America.”

Legacy and Impact: Twenty Years of Transformation

The law on gender-based violence against women brought obstetric violence into public discourse, making visible what had previously been silenced and unacknowledged. It also served as a reference point for legislation in Argentina, Brazil, and other Latin American countries. According to Camacaro, medical professionals “are more careful now” and students recognise obstetrics as “one of the most violent services”.

Reflecting on its legacy twenty years later, Camacaro’s acknowledges both achievements and limitations.  Although in practice the law is not applied according to Camacaro, she also argues that its greatest strength lies in transforming private experiences into public political issues: “The great strength of this was making public something that is personal, making political a reality exclusive to women in the national and international public agenda. That is for me one of the great strengths.”

This analysis reveals that Venezuela’s legal definition was fundamentally influenced by feminist discourse and epistemic justice perspectives, grounded in women’s testimonies. Understanding this origin is crucial for comprehending Uruguay’s legal framework, which drew almost directly from the pioneering Venezuelan model. Although this perspective informed the original Uruguayan definition, parliamentary debate stripped it of much of its epistemic-justice content, leaving a final definition that was more technical and less grounded in women’s lived experiences.

The text published here is based on a chapter from the author’s master’s thesis, titled “Incorporation of Obstetric Violence into Uruguay’s Legislative Agenda: Processes, Perspectives, and Discourses”, presented this year as the culmination of her master’s degree in Public Policy and Feminisms at the University of José C. Paz (UNPAZ - Buenos Aires).

The quotes and information that emerge from this post are part of the interviews conducted with Marbella Camacaro and Diana González for the aforementioned research.

Romina Gallardo Duarte, Assistant Professor, University of the Republic and co-lead of the Law and Human Rights Working Group, International Platform on Obstetric Violence.