The Portugal Parliament voted on July 17, 2026, to strip the term "obstetric violence" from national healthcare law, replacing it with the phrase "inadequate, disrespectful, or non-consented practices." The decision reverses a landmark statute passed approximately 16 months earlier in March 2025 that had made Portugal the first European Union member state to explicitly recognize obstetric violence in its legal framework. Women's advocacy groups are now preparing to escalate the matter to international human rights bodies, calling the move a legislative retreat that erases recognition of thousands of documented incidents.
Why This Matters
• Legal terminology changed: "Obstetric violence" removed from Law 33/2025; replaced by softer language regarding "inadequate practices."
• International appeal: Women's rights groups will petition CEDAW (UN Committee on the Elimination of Discrimination Against Women) and Portugal's Ombudsman for Justice, Luísa Neto.
• High-stakes disagreement: Medical associations celebrate the change; patient advocacy organizations condemn it as silencing victims.
Medical Establishment vs. Women's Rights Groups
The Associação Portuguesa pelos Direitos da Mulher na Gravidez e Parto (APDMGP) issued a sharp rebuke following the July 17 vote, announcing it would continue using the term "obstetric violence" in all institutional documents, communications, and awareness campaigns. The organization stated that "it is impossible to transform, prevent, or eradicate a reality one refuses to name."
The association emphasized that the qualifier "obstetric" does not target a specific professional class, but rather the systemic delivery of sexual and reproductive healthcare. Scientific literature, it argued, describes obstetric violence as a structural phenomenon linked to institutional practices, power imbalances, and gender inequalities that produce physical, psychological, and emotional harm—whether or not there is deliberate intent to cause injury.
On the opposing side, the Ordem dos Médicos (Portuguese Medical Association) and its regional branches have lobbied intensely for the removal of the term, describing it as scientifically inadequate, legally fragile, and a source of distrust between patients and healthcare providers. Medical groups claim the expression stigmatizes doctors, undermines clinical autonomy, and encourages defensive medicine, where practitioners prioritize legal protection over patient-centered decisions. They also note that the World Health Organization (WHO) avoids the term, preferring to discuss "mistreatment, disrespect, and abuse" during childbirth.
What This Means for Residents
For pregnant women and families navigating Portugal's public healthcare system, the legislative shift creates uncertainty about how complaints will be classified, investigated, and addressed. The original Law 33/2025, enacted in March 2025, had established a Multidisciplinary Commission for Rights in Pregnancy and Childbirth and outlined protections against obstetric violence, defining it as physical and verbal actions by healthcare professionals that result in dehumanizing treatment, excessive medicalization, or disregard for consent.
The revised text maintains protections against unauthorized procedures and disrespectful treatment but eliminates the specific legal category of "obstetric violence." It also repeals the article mandating the eradication of routine episiotomies (surgical cuts during delivery) and removes the sanctions regime tied to the original law. Healthcare facilities must still follow clinical criteria and Direção-Geral da Saúde (DGS) standards, but the enforcement mechanism has been weakened.
Practical implications include:
• Reporting channels: Complaints about mistreatment during childbirth will now be framed under the broader term of "inadequate practices." Residents can still file formal complaints through the same channels: the DGS (Direção-Geral da Saúde) Patient Rights division and the Ombudsman's office (Provedoria de Justiça). When filing, document specific incidents with dates, names of personnel involved, and detailed descriptions of what occurred. Use terminology such as "non-consensual procedure," "lack of informed consent," "disrespectful treatment," or "inadequate care" to align with the new legal framework.
• Institutional accountability: Without explicit legal recognition of obstetric violence, hospitals may face less pressure to track and address systemic patterns of abuse. However, the DGS still maintains oversight authority and can impose penalties for violations of consent protocols and clinical standards.
• Educational impact: The original law required inclusion of obstetric violence content in sex education curricula and healthcare professional training programs; it remains unclear whether this mandate survives under the new terminology. Residents should inquire directly with their hospital's patient services department about how staff training has been adapted to reflect the legislative changes.
The Data Behind the Debate
Portugal has some of the highest rates of contested obstetric interventions in Europe. A study published in The Lancet Regional Health – Europe found that 45.3% of Portuguese women undergoing spontaneous vaginal birth were subjected to episiotomy, more than double the European average of 20.1%. The Kristeller maneuver (abdominal pressure to accelerate delivery), explicitly discouraged by the WHO, was applied to 50% of surveyed women—above the European average of 41%.
Additional findings from the "Experiências de Parto em Portugal" survey (7,555 responses, 2015–2019) revealed:
• 2 out of 3 women lacked freedom of movement during labor.
• 41% were not involved in decisions about their own bodies.
• 3 out of 4 women underwent vaginal exams without consent.
• During the COVID-19 pandemic, 62.2% faced restrictions on having a support person present, and the same percentage were not consulted about instrument use during delivery.
The Observatório de Violência Obstétrica (OVO) logged 1,005 formal complaints over five years through April 2025, documenting unauthorized episiotomies, forced labor inductions, unconsented cesarean sections, verbal abuse, and denial of birthing companionship. The APDMGP says complaints continue to arrive regularly, underscoring ongoing systemic issues.
Impact on Expats & International Families
For expatriates and international families giving birth in Portugal, the July 2026 legislative change highlights persistent gaps in patient-centered maternity care in both public and private sectors. English-speaking residents or those unfamiliar with Portuguese healthcare culture may face additional vulnerability if consent procedures are not clearly communicated or if systemic practices prioritize institutional convenience over individual autonomy.
Both SNS and private facility considerations: While the legislation applies to the Serviço Nacional de Saúde (SNS), many expats utilize private hospitals and clinics. Private providers are not bound by the same statutory framework but must still comply with Portuguese civil law regarding informed consent and contractual obligations. Private facilities often operate under their own patient charters; expats should request these documents in advance and clarify the facility's policies on episiotomy, instrumental delivery, and companion presence during labor. Private clinics may offer more personalized approaches to birth plans, but standards vary significantly. Compare institutional practices and read patient reviews before selecting a provider.
Prospective parents should:
• Request written birth plans and discuss preferences explicitly with medical teams in advance—specify your wishes regarding episiotomy, instrumental assistance, and companion presence.
• Clarify consent protocols for episiotomies, instrumental deliveries, and cesarean sections, ideally in writing and in English if you are not fluent in Portuguese.
• Ask whether your hospital/clinic maintains lower intervention rates; request data on episiotomy and Kristeller maneuver usage.
• Identify hospitals with lower intervention rates and stronger patient-rights track records through patient support networks and online resources.
• Document any incidents of non-consensual procedures or disrespectful treatment for potential complaints to the DGS or Ombudsman, keeping records of dates, times, personnel names, and detailed descriptions.
• If language barriers exist, arrange for a qualified interpreter (not a family member) during all clinical consultations to ensure informed consent is genuinely obtained.
Whether labeled "obstetric violence" or "inadequate practices," the underlying reality—documented by over 1,000 formal complaints and multiple academic studies—remains unchanged. The legislative tug-of-war over terminology may ultimately matter less than whether Portugal strengthens institutional accountability, consent protocols, and patient empowerment across its maternity services.
