CEDAW/C/75/D/138/2018 caused by the medical interventions occasioned by the 10 vaginal examinations carried out in her case, was due to structural discrimination based on gender stereotypes regarding sexuality, maternity and childbirth. The author also maintains that these stereotypes were perpetuated in the administrative and judicial proceedings. The Committee notes that, according to the author, this situation constitutes a violation of her rights to high-quality health services free from violence and discrimination, to personal autonomy and to physical and psychological integrity, in violation of articles 2, 5 and 12 of the Convention. 7.3 In this regard, the Committee notes not only the academic articles and reports on the subject of obstetric violence mentioned by the author 4 but also the recent report of the Special Rapporteur on violence against women, its causes and consequences submitted to the General Assembly on a human rights-based approach to mistreatment and violence against women in reproductive health services with a focus on childbirth and obstetric violence. 25 In her report, the Special Rapporteur defines “obstetric violence” as the violence experienced by women during facility -based childbirth and affirms that “this form of violence has been shown to be widespread and systema tic in nature”. 26 The Special Rapporteur explains that the root cause of obstetric violence include labour conditions, resource limitations and power dynamics in the provider patient relationship, which are compounded by gender stereotypes on the role of women. 27 Of particular relevance for the present communication is the Special Rapporteur’s assertion that an episiotomy “may have adverse physical and psychological effects on the mother, can lead to death and may amount to gender-based violence and torture and inhuman and degrading treatment”. 28 7.4 The Committee notes that, in the context of an individual communication in which rights are alleged to have been violated following judicial decisions, its task is to examine such decisions in the light of the Con vention and to determine whether the authorities of the State party complied with their obligations thereunder. Thus, in the present communication, the Committee must assess the State party ’s compliance with its obligation to exercise due diligence in the administrative and judicial proceedings initiated because of the acts that are the subject of the author ’s complaint and with a view to ending gender stereotypes. In this regard, the Committee notes that, according to the State party, the domestic courts c arried out a thorough assessment of the evidence. The Committee also notes that, according to the author, in spite of the various items of evidence and reports that demonstrated the cause -andeffect relationship between the health service’s actions and the harmful outcome, the administrative and judicial authorities gave credence only to the hospital reports and made assumptions based on stereotypes. In this connection, the Committee notes that the Administrative Court observed that “because those with technical knowledge offer different conclusions, these doubts and difficulties have been passed on to the judge, ” and that the High Court of Justice acknowledged not only that the judge had made little mention of the reports provided by the author and failed t o give them due weight but also that the lack of a report by a legal expert made analysis difficult. The Committee also notes that, according to the clinical obstetrical and gynaecological report provided by the author, the actions of the health -care personnel did not comply with lex artis, 29 fewer vaginal examinations should have been performed, the clinical documentation did not justify the use of oxytocin and the author did not give consent for the episiotomy as required under the Patient Autonomy Act. The Committee notes that the information provided by the parties in the present case, as a whole, __________________ 25 26 27 28 29 12/14 A/74/137. Ibid., paras. 4 and 12. Ibid., paras. 40 and 49. Ibid., para. 25. Standard operating procedure for the application of a medical treatment. 20-04882