Extending the concept of "obstetric violence" to post-partum experiences: cautions regarding the "first ever" pill for post-partum depression.

Abstract

The growing identification of "obstetric violence," first in Latin America and subsequently far more widely around the world and in supra-national human rights forums' jurisprudence, has been a pivotal site for contesting the power asymmetries encoded into the biomedical paradigm and examining reproductive governance. A key aspect of deploying "obstetric violence," as opposed to the discourses of "disrespect and abuse" or, in the United States, the more common "obstetric mistreatment" has been to challenge the treatment of pregnancy and childbirth as a medical condition or event, as opposed to a natural process. Until now, little attention has been paid to post-partum obstetric violence beyond egregious acts such as detentions in health facilities for non-payment of fees. We argue here for expanding consideration of the post-partum period gure to include pharmaceuticalization, with a focus on the US context. Rapidly increasing diagnoses of PPD, especially among women of color, and newly available pharmaceutical solutions, may appear as a solution to lack of access. However, the biomedical framing shifts attention from the socio-political causes of emotional distress-with significant consequences for individual women and public health. Taking the recent approval of the 'first-ever' pill for post-partum depression, zuranolone (brand name Zurzuvae) as a case example, we argue here that the reduction of reproductive subjects' experiences to biochemical disorders, and the lowering of regulatory standards for the pharmaceutical industry, threaten to perpetuate a subtle but damaging form of obstetric violence, which warrants concern.