The Order of Nurses (OE) has voiced concerns regarding a newly enacted law intended to uphold women’s rights in preconception, pregnancy, childbirth, and postpartum care. The organization acknowledges the law’s good intentions but emphasizes that it cannot be effectively implemented without consulting those actively engaged in the field.
“The law’s ambiguity, combined with a lack of technical criteria and the establishment of a punitive framework, could lead to insecurity, distancing, and defensive practices,” stated OE president Luís Filipe Barreira in a formal statement. He further commented, “The dignity of care begins with respecting those who provide it.”
Barreira also argues that genuine humanization cannot be achieved without additional professionals, improved conditions, and “effective value” given to healthcare teams.
The legislation in question emerged from a final draft presented by the Health Commission and received approval during the last plenary session dedicated to voting before the dissolution of the parliament. The law includes measures for information dissemination and protection against obstetric violence, as well as the establishment of a multidisciplinary commission to safeguard pregnancy and childbirth rights.
Among its various provisions, the law calls for the elimination of routine episiotomies—a surgical incision made in the perineum during childbirth to widen the vaginal opening.
According to the legislation, routine episiotomies and other unwarranted repeated practices will result in financial penalties and sanctions for hospitals that fail to comply with the World Health Organization’s recommendations and the standards set by the National Directorate of Health. Additionally, disciplinary investigations may be conducted on health professionals involved.
The OE criticizes the new legislation for “technical and conceptual weaknesses,” arguing that these shortcomings jeopardize not only its practical effectiveness but also “the safety and dignity of healthcare professionals,” particularly Specialist Nurses in Maternal and Obstetric Health (EE-ESMO).
The OE further notes that the concept of “obstetric violence,” as defined in the law—which is inspired by foreign legislation without appropriate Portuguese technical and scientific context—is “extremely vague.”
“The lack of clear technical criteria could lead to subjective interpretations, even when professionals act ethically and safely,” the OE warns, predicting that the result will be “a climate of fear,” affecting the relationship with patients and encouraging “defensive clinical practices” that do not enhance care quality.
Regarding the ban on routine episiotomies, the OE opposes any practices lacking in scientific basis but insists that the concept of “routine” must be distinctly defined.
“Without this clarity, there is a real risk of penalizing justified clinical decisions made in consultation with the woman, undermining the safety and trust in professionals,” Barreira adds.
The OE also finds the replacement of the term “birth plan” with “birth design” inappropriate, arguing, “This linguistic change departs from a woman-centered approach, diminishing her role and contradicting the law’s stated principles of self-determination and dignity.”
The new legislation has also faced criticism from the Order of Doctors (OM), which has called for its repeal, arguing that it is poorly constructed and that healthcare professionals were not consulted on a subject that is technical and scientific in nature.
In comments to Lusa, Carlos Cortes, head of the doctors’ association, viewed the law as the result of “a process conducted in obscurity without dialogue and communication,” highlighting the absence of input from the OM, scientific societies, specialty colleges, and other civil society entities.
