International human rights standards require states to guarantee women's access to quality care throughout pregnancy. Human rights mechanisms have also clarified that states must ensure adequate standards of care and respect for women's rights, dignity and autonomy during childbirth and in maternal health care settings.
Women's right to sexual and reproductive health is an essential part of their right to health. The right to the enjoyment of the highest attainable standard of physical and mental is enshrined in Articles 12 of the International Covenant on Economic, Social and Cultural Rights. States must also guarantee the availability, accessibility, acceptability and quality of all health facilities, goods, information and services related to women's sexual and reproductive health and must ensure they are evidence-based, scientifically and medically appropriate, and up to date.
Despite these obligations in recent years, violation of women's rights during facility-based childbirth has gained global attention. The World Health Organization (WHO) reacted to the growing concerns by issuing a statement in 2015 condemning "outright physical abuse, profound humiliation and verbal abuse, coercive or unconsented medical procedures (including sterilization), lack of confidentiality, failure to get fully informed consent, refusal to give pain medication, gross violations of privacy, refusal of admission to health facilities, neglecting women during childbirth to suffer life -threatening, avoidable complications, and detention of women and their newborns in facilities after childbirth due to an inability to pay."
In 2018, the Special Rapporteur on violence against women published a report, "A human rights-based approach to mistreatment and violence against women in reproductive health services, with a focus on childbirth and obstetric violence." It addresses human rights abuses experienced by women during facility-based childbirth. The report states unequivocally that: "Women and girls have long experienced mistreatment or even violence when delivering children in healthcare facilities around the world."
IN 2019, the Parliamentary Assembly of the Council of Europe issued Resolution 2306 (2019) on Obstetrical and gynecological violence. According to the resolution, in the privacy of medical consultation or childbirth, women are victims of practices that are violent or that can be perceived as such. These include inappropriate or non-consensual acts, such as episiotomies and vaginal palpation carried out without consent, fundal pressure or painful interventions without anesthetic.
In light of these considerations, as well as due to the research done by Slovak NGOs supported by the growing debate and women's voices indicating that there are also violations of women's rights in the provision of healthcare in childbirth in childbirth Slovakia. The Public Defender of Rights decided to prepare her report on the violation of women's rights in reproductive health services, focusing on childbirth.
The right to health is a fundamental right guaranteed by Article 40 of the Constitution of the Slovak Republic. The right to health is also closely linked to the enjoyment of other human rights, which are enshrined in the national legislation of the Slovak Republic (especially in the Constitution and in laws) and international conventions; the Slovak Republic is bound.
In her report, the Public Defender of Rights applied a human rights-based approach to the different forms of mistreatment women experience during childbirth in facility care. Given that an integral part of effective monitoring of human rights constitutes data collection, the Public Defender of Rights decided to carry out an online survey to define, quantify, and better understand the causes of possible violations of women's rights in healthcare provision during childbirth. This online survey takes the form of a mapping study to obtain a basic overview of the occurrence of a given phenomenon. The anonymous online questionnaire collected 3 164 statements from women about their experience of childbirth.
Through the mapping study and other resources, the Public Defender of Rights has been able to identify manifestations of violations of women's rights during facility-based childbirth in Slovakia. These include violations of the right to dignity and respect for physical integrity, lack of informed consent, the right to enjoy the benefits of scientific progress and its applications and the right to respect for private and family life.
The report provides recommendations on addressing the structural problems and root causes of violations of women's rights during facility-based childbirth. The research shows the need to provide specific training for students of medical universities on the protection of human rights connected to childbirth.