Beyond the term "obstetric violence": A conceptual architecture for obstetric gynaecological violence and perinatal care violence.

Over the past two decades, "obstetric violence" has become a central concept in research, policy and law on reproductive health care. Debate has focused almost entirely on whether "violence" is the appropriate word, while "obstetric" has gone largely unexamined. This article argues that "violence" is justified, but that "obstetric violence" is conceptually insufficient: it confines the phenomenon to the moment of birth, frames as relational what is structural and institutional, and names one clinical specialty within a field of care that involves several. The field uses at least four overlapping labels - obstetric violence, obstetric and gynaecological violence, mistreatment and disrespect, and abuse - with no account of how they relate, making the phenomenon difficult to define and measure. Using four criteria - construct validity, operationalisability, socio-legal usability, and professional acceptability - the article proposes a two-level framework. Obstetric gynaecological violence is proposed as the macro-category, covering violations of physical and psychological integrity occurring within reproductive health care across the reproductive life course. Perinatal care violence is proposed as its subcategory for pregnancy, labour and birth, and the six weeks following birth. Both terms name a context and a phase of care rather than a profession, and neither displaces the term codified in existing legislation.