• Gill Boden

Saudi Women no longer need a man's permission to decide how they'll give birth.

I’ve seen lots of news reports on the lifting of the driving ban on Saudi women, (and an announcement on January 6th that women must now be notified by text message when their husbands file for a divorce — they previously did not have to be told at all), but it wasn’t until I saw Global Citizen’s newsletter that I realised that Saudi women no longer need a man's permission to decide how they'll give birth. Global Citizen in their newsletter, drew attention to the announcement by the country’s health ministry that women now don't need signed consent for childbirth procedures. Although Saudi Arabia’s male guardianship system gives men complete control over where women work, where they travel, and who they marry, women no longer need men’s permission to make decisions about their maternal health care, and according to the Health Ministry, can ‘choose the details of a natural birth from a wide range of options’.

Global Citizen reported that, ‘in the past, a pregnant woman had to obtain signed consent from a male guardian... before acquiring any details about her pregnancy, including finding out her due date and information about her own pregnancy status. A woman also needed approval from her guardian to choose between having a natural birth or caesarean section.

The decision to change the policy is part of Crown Prince Mohammed bin Salman’s social and economic reform program, Vision 2030’.

Driving a car is a very visible and public manifestation of autonomy but I would argue that control over your own body in childbirth is of even more importance. Some of us in BPPF can remember when women in the UK needed a signature from their husbands for some surgical procedures and so are very aware that rights over our own bodies are hard won and need protecting. In these times of uncertainty the BPPF take heart from policy that supports women’s autonomy through continuity of care teams and schemes that improve outcomes for women through the pregnancy continuum (see ‘Better births’ and ‘Best start’ Scotland). Where we are less confident is when we hear of continuity of care, (CoC), teams being disbanded; The Neighbourhood Midwives being the most recent, as well as birth centre closures. We hear of midwives resigning, because they, ‘can no longer be accountable for that which they are not responsible’: this particular midwife described the parlous situation on her labour ward where staff have been depleted to join CoC teams and how in her view,

'CoC teams are the icing on the cake, when we don’t even have the ingredients for the cake’.

So our vigilance in establishing and protecting women’s human rights has to take account of the context in which choices are made. In any society women can only exercise their autonomy and make decisions about the place and manner of birth when they have real choices available which are both safe and effective and properly resourced.