ABSTRACT
The World Health Organization, together with other leading maternal health organisations, and obstetric violence activists and researchers actively encourage the use of evidence-based care to tackle abuse during childbirth and obstetric violence. This chapter questions whether their application will always support the fight against abuse during pregnancy and childbirth. It draws from women’s lived experiences of obstetric-related care to show how evidence-based guidelines are applied in a way that silences and excludes some women from care, and it reveals some of the unique harms women experience because of their exclusion. The chapter exposes the anomaly that while evidence-based guidelines are said to be developed for women’s benefit, a woman cannot use the law to compel a healthcare provider to comply with guidelines when she wants access to those benefits, or to compel a healthcare provider to disregard guidelines when she does not want access to benefits. Finally, it demonstrates that evidence-based guidelines may facilitate obstetric violence by omission. This underscores an overlooked concern that even the most well-developed evidence-based guidelines may leave some women behind. An obstetric violence perspective helps to clarify the harm experiences and it supports demands for more respectful application of guidelines.
