This is an introduction to filing formal complaints after experiencing Obstetric Violence. It is a living document. Updates will be ongoing. Please remember:
There is not one “right” way to speak up or take action. It can be a messy, imperfect process.
It can feel frustrating, traumatizing, and challenging to speak up. Try to build your support network before you begin the process, if possible.
This is peer support information only, not professional medical or legal advice. Please take what is useful for your unique situation and leave the rest.
If you are considering legal action to seek redress for harm to yourself or your baby, please consult with a lawyer as soon as possible. There may be limitation periods or other important considerations to keep in mind.
See our Canada-Wide Complaints Directory resource (under construction) for links and contact information for complaints destinations organized by province and territory.
Your Story Matters
It can be difficult to speak up in any way after experiencing Obstetric Violence. Most people never provide feedback or file a formal complaint. Even fewer pursue legal action.
There are so many reasons why people are not able to speak up, or choose not to do so, and they are all valid. Coming forward is not always safe or possible for everyone.
If you have decided that filing a complaint is the right choice for you, please know that there are many people standing behind you who have endured similar mistreatment and were not able to come forward. Your story is so important!
Tell Your Story
It may be difficult or even traumatizing to recall your experience. Take breaks to care for yourself and seek support from friends and loved ones, or professionals, if you can.
If writing or dictating text feels too difficult, consider using a voice recorder app to speak your story first, or a cell phone video to film yourself telling your story. This way, the details will be preserved and you can come back to it at a later time when you feel ready.
Be sure to back-up or email yourself a copy of the file so it doesn’t get lost.
Write down, speak, or record as much as you can remember as soon as possible. Include important dates, approximate times, thoughts, feelings, direct quotes from your care team, and other details. Ask any witnesses to do the same, if possible.
You do not need to know the name of the individual(s) in order to provide feedback or file a complaint.
Try to establish a rough timeline of your experience:
- Who was involved?
- Who did/said what?
- What happened?
- Where?
- When?
- Why?
If you had a loved one, birthworker, or support person present for your experience, they may be able to help you recall details and vouch for your version of events in your complaint.
Try to include every detail that you remember in this first version of your story.
View Section 4 of the following external resource for excellent writing tips and cost/benefit analysis of different actions to take after Obstetric Violence: Birth Rights: A resource for everyday people to defend human rights in labor and birth by Birth Rights Bar Association and the National Advocates for Pregnant Women (USA).
Get Legal Advice
Obstetric Violence is still an emerging field of law in Canada, and it will take many of us coming forward with our experiences to push the area forward.
Many medical malpractice lawyers and personal injury lawyers are experienced with birth injury, medical negligence and disability cases. They may be able to help you recover damages if your situation fits into their area of expertise. Even if you don't see cases like yours reflected in their website testimonials, reach out to explore your options. Some lawyers may be able to refer you to someone else who can help.
Many lawyers offer free 30 minute consultations, and if you have a strong case, some will take it on contingency. In other words, you do not pay the lawyer up front, but they take a percentage of the money if you win.
If you have experienced Obstetric Violence, you may have grounds for a civil lawsuit, human rights complaint, or another legal remedy. There may be important deadlines and limitation periods for taking legal action, so please don't wait to seek professional advice.
What About Police?
Some lawyers with experience in this practice area recommend filing a police report about Obstetric Violence.
This can be especially important if what occurred was illegal, and/or if you are considering exploring the option of legal action. If you have been the victim of a crime, police may be well-positioned to receive your report.
However, Police are well known for responding poorly to reports of gender-based violence and sexial assault in the past, and have earned an indisputable reputation for being unsafe to many - inlcuding Black and Indigenous communities, queer and trans folks, and people experiencing a mental health crisis to name a few.
We acknowledge that policing is a harmful institution and that it may be traumatizing, unsafe, and unhelpful to go through the process of filing a report. However, in some instances, it could be helpful to bolster your legal case, or to help your concerns be taken more seriously.
Going to the police with your Obstetric Violence experience is a personal decision. Please weigh the pros and cons for your own unique situation and make an informed choice.
Get Your Medical Records
You do not require a copy of your records in order to file a complaint, however, if you file a formal complaint or take legal action, the investigators at the regulatory colleges and your healthcare provider's lawyers will obtain a copy of your records and use them to defend their member/client from accountability.
Medical records can be helpful for piecing together your story before filing a complaint. Sometimes what’s written down is just as useful as what is left out of your chart.
Your medical information belongs to you and you have a right to have a copy.
Primary Care Records: Contact your OB/GYN’s office, midwifery clinic, Nurse Practitioner or doctor’s office to request a copy of your file.
Hospital Records: Contact the patient health records department of your hospital to request a copy of your file. Be very specific about requesting ALL of your records between the dates that your experience occurred. (search "hospital name" + "patient records" to find the contact info)
There is generally a fee associated with getting a copy of your hospital records. If cost is a barrier, and if you have a family doctor, their office can fax a requisition to obtain a free copy. Another option is to work with the hospital Patient Relations department to have the fee waived.
Hospital Complaints
Most medium-to-large hospitals have a dedicated Patient Relations Department. These departments are one place where you can share your experience to make sure it stays in their internal records.
They can bring together the different care providers and departments involved in your complaint, set up in-person meetings, follow up calls, or a medical chart review with someone who can explain the documents to you, and can act as a liaison between you and the healthcare team.
Remember, Patient Relations teams work for the hospital. They are not impartial mediators, or “patient advocates”. They are not accountable to anyone outside their institution.
The job of Patient Relations is to smooth things over so patients who have been harmed do not attempt to hold them accountable by escalating their complaint to regulatory bodies, going public with their experience, or taking legal action.
The fear of bad press or litigation can be a powerful motivator for hospitals to make internal changes. Don’t be afraid to make some noise if it feels like the right choice for you!
Potential Questions to Ask:
- How are complaints about Obstetric Violence logged, tracked, and addressed at your hospital?
- How are you taking tangible steps to change the institutional culture that allowed my negative experience to occur?
- How are topics like Obstetric Violence, informed consent, anti-racism and anti-oppression, and trauma-informed care being integrated into informal discussions and/or mandatory training to prevent experiences like mine from repeating?
- Who is leading these trainings? Why have they been chosen?
- Are you committed to learning from folks with lived experience of Obstetric Violence and the growing body of international research on the subject?
- Beyond trainings, how will you foster an environment in which staff members can speak up about harmful culture, policies and behaviours in the workplace without fear of retribution?
- What changes will be made as a result of my feedback?
- What is the timeline for these changes to be implemented?
- How will you remain accountable for following through with these commitments?
- How will the hospital assist me to access supports necessary for my healing and recovery? (ie: paying for cost of trauma therapy, pelvic floor physio, etc.)
Escalate!
When filing a hospital complaint by email, consider cc’ing many contacts from the hospital, not just the Patient Relations department. For example, include the Chief of Obstetrics, Nursing Managers, perinatal social work, risk management, other department heads, and the hospital CEO. This contact info can often be found online.
Regulatory bodies that oversee your care provider’s profession also need to hear about the Obstetric Violence you’ve experienced! These complaints generally need to be submitted by mail in order to be valid. If the results of your complaints investigation are unsatisfactory, consider filing an appeal.
Although they do not officially receive or investigate complaints, professional associations like the Society of Obstetricians and Gynaecologists of Canada (SOGC) or the Canadian Association of Midwives can be contacted as well, if only to ensure that Obstetric Violence remains on their radar.
In 2016, the President of the SOGC was quoted in a CBC investigation claiming to have never heard complaints of disrespectful and abusive care during childbirth happening here in Canada. Make sure the folks who need to hear these complaints the most receive your story!
Consider forwarding your complaint to contacts outside the immediate circle of those involved, like your MP and MPP/MLA, ministers of health, ministers of women’s and children’s issues, opposition health care critics, local media outlets and advocacy groups.
So many experiences of mistreatment and neglect, particularly in the past few years, were exacerbated by budget cuts, non-evidence-based policies, and unsafe staffing ratios caused by chronic underfunding and devaluing of essential healthcare workers. The politicians who made these policies and cut healthcare spending should hear about the impact it's had on everyday people.
Contact the heads of the department at the schools where your healthcare providers were educated, or other schools in your area, to ask how they are incorporating Obstetric Violence awareness and prevention into their curriculum so future students will be better equipped to provide proper care.
Many medical, nursing, and midwifery schools still need to update their course content to include learning about Obstetric Violence, anti-racism, anti-oppression, implicit bias, and trauma-informed care.
Without external pressure, changes to education are less likely to happen quickly.
Birth Centres
Obstetric Violence occurs across care settings with all types of care providers. Even with midwives at free-standing birth centres. Visit your birth centre's website to find details about their feedback and complaints process. Consider contact the board of directors and clinical director to share your feedback. Growth and improvement can happen through open communication and feedback.
Regulatory Colleges
Each regulated healthcare profession is overseen by a self-regulating body, or “college”. The college is responsible for receiving and investigating complaints about its members.
College websites include directories of all registered members of the profession and list their past workplaces, schools, and any disciplinary decisions that have occurred as a result of complaints from patients or employers.
If you know their name, try looking-up your healthcare provider in the directory to see their education and employment history and whether they have been disciplined or cautioned by the college in the past.
Even if no concrete action is taken as a result of your individual complaint, when you submit a formal complaint to a regulatory college, it stays on file and must be taken into account if/when future complaints are made about the same healthcare provider.
When there is no documentation to back up allegations, it’s much easier for the college to deny a pattern of misconduct. By filing a complaint, you are ensuring your experience stays on record, paving the way for others to come forward.
Check out our resource, a Canada-wide list of regulatory bodies and other agencies that receive complaints, organized by province and territory. This resource is still under construction and your feedback is welcomed and encouraged: obstetricjustice@gmail.com
Divest From Outcome
Keep in mind as you go through this process, that you cannot know or control the outcome of your complaint.
Your complaint alone will not put an end to Obstetric Violence.
You might not receive an apology or feel a sense of closure or justice. Those who harmed you may not face any consequences, or commit to changing their behaviour in the future.
Whether or not it has the outcome we all hope for, your complaint is still an essential part of a wider, long term effort to push for changes in the system and better care for all. Nothing will change unless we speak up.
More coming soon
Thank you for your patience!
Your feedback can help make this resource better. please reach out: obstetricjustice@gmail.com
Sources & Resources
Birth Rights: A resource for everyday people to defend human rights during labor and birth by Birth Rights Bar Association and the National Advocates for Pregnant Women, 2019 (USA)
Accountability Toolkit: A guide to filing a formal grievance after a difficult childbirth by Improving Birth (USA)
WHO recommendations: intrapartum care for a positive childbirth experience by the World Health Organization, 2018
Why Parents Don't File a Complaint after Abuse by Birth Trauma Ontario, 2019
Obstetric Justice Reading List compiled by Kate Macdonald