In Ruling by Inter-American Court of Human Rights, New Legal Protections for Pregnant Women

A recent ruling by the Inter-American Court of Human Rights will set new standards to protect women and other pregnant people—during pregnancy, childbirth and postpartum—from obstetric violence across Latin America and the Caribbean. The ruling came in a case involving a pregnant Argentinian woman whose death resulted from inadequate medical treatment.

The ruling, in Britez Arce et. al. v. Argentina, marks the first time the Court applied the concept of obstetric violence.

“Women have the right to live a life free of obstetric violence and States have the obligation to prevent it, punish it and refrain from practicing it, as well as to ensure that their agents act accordingly,” specifies the Court’s ruling. The ruling, dated November 16 and announced by the Court January 18, also states that “States have the obligation to provide adequate, specialized and differentiated health services during pregnancy, childbirth and within a reasonable period after childbirth, to guarantee the mother’s right to health and prevent maternal mortality and morbidity” under international law. 

Specifically, the ruling recognizes obstetric violence as a form of gender-based violence under the Belem do Para Convention in the Americas—a legally binding international treaty criminalizing all forms of violence against women, including sexual violence—and requires member States to adopt policies to ensure that these forms of violence do not occur. 

The Center for Reproductive Rights filed an amicus brief in the case—the only party to do so—requesting that the Court adopt standards concerning the definition of obstetric violence and States’ duties in cases when obstetric violence occurs. The Court adopted most of the Center’s recommendations in its ruling. 

“This case is significant: for the first time in its contentious jurisdiction, the Court has recognized obstetric violence as a concept of international law and as a form of violence against women. With this ruling, the Court sets new standards that will benefit pregnant women and other pregnant people across the entire region,” said Maria Fernanda Vanegas, the Center’s director of advocacy and external relations. “The court’s ruling clearly aligns with one of the Center’s strategic objectives: to build stronger legal protections for maternal health.” 

Court Finds Argentina Responsible for the Death of Cristina Britez Arce 

During her pregnancy, Cristina Britez Arce presented several risk factors that were not adequately addressed by the health system and that ultimately led to her death.

In June 1992, when she was more than 40 weeks pregnant, she went to the Ramón Sardá Public Hospital in Buenos Aires, where an ultrasound was performed that indicated that the fetus had died. She was immediately hospitalized to undergo an induced labor. However, the risk factors of her pregnancy and various previous health conditions that she presented were not adequately taken into consideration. She was subjected to great suffering and distress and died due to “non-traumatic cardiorespiratory arrest” at age 38.

In its ruling, the Court ordered restitution for Britez Arce’s family and declared Argentina responsible for violating her rights to life, humane treatment and health, and the rights of her son and daughter to humane treatment, a fair trial, family protection, children’s rights and judicial protection. Argentina was also ordered to carry out awareness campaigns towards preventing obstetric violence and to train health providers to promote dignified treatment for pregnant persons. 

Court’s Ruling Has Far-Reaching Impact Across the Region 

The Inter-American Court of Human Rights is the highest judicial body for human rights in the Americas, and the standards set by its ruling will benefit millions of pregnant people throughout the entire region.   

Based on the American Convention on Human Rights, the Court’s rulings are understood as binding to all States under its jurisdiction—including highly populated countries such as Brazil, Mexico, Colombia, Argentina, and many others throughout Latin America and the Caribbean. The rulings have been traditionally used as a binding interpretation by the Inter-American Commission of Human Rights when deciding on cases and elaborating reports on the whole Americas region, under the Organization of American States (OAS) charter. 

In its ruling in Britez Arce et. al. v. Argentina, the Court also provided its definition of obstetric violence: “The Court finds that obstetric violence is a form of gender-based violence (…), exercised by health care providers against pregnant women, during access to health services that take place during pregnancy, childbirth and postpartum, which is expressed mostly, but not exclusively, in a dehumanizing, disrespectful, abusive or negligent treatment of pregnant women; in the denial of treatment and full information on the state of health and applicable treatments; in forced or coerced medical interventions; and in the tendency to pathologize natural reproductive processes, among other threatening manifestations in the context of health care during pregnancy, childbirth and postpartum.” 

• Press release from the Inter-American Court of Human Rights (available in English, Spanish and Portuguese), 01.18.23 
• Ruling by the Inter-American Court of Human Rights in Britez Arce et. al. v. Argentina (Spanish), 11.16.22
• Amicus brief filed by the Center for Reproductive Rights (Spanish), 06.03.22