OBSTETRIC VIOLENCE: CLINICIANS ARE STILL MAKING CHOICES WITHOUT INFORMED CONSENT
While the pro-choice movement is strong when it comes to preventing pregnancy from coming to full term, what about “my body my choice” when it comes time to actually give birth?
Obstetric violence is the place where institutional violence meets violence against pregnant people during pregnancy, childbirth, and postpartum. It occurs in both public medical practice, like your general public hospital, and private medical practices. (Side note, private hospitals can further complicate things, since they can refuse service to anyone based on their own personal biases). Obstetric violence is often overlooked, and normalized. There are few, if any, policies in place to eradicate it, therefore it is up to us to identify it, call it out, and educate one another!
THIS IS WHAT IT CAN LOOK LIKE
-Overbearing medical staff, e.g. “Once Kari came out of the bathroom to find a nurse waiting right outside the door. ‘The doctor said if you go to the bathroom again and take [the fetal monitoring strip] off, you’re having a C-section, [the nurse] warned.” This is real. Read more here.
-Discrimination of care because of race, HIV status, gender, ethnicity, education and/or income level. “African-American and Latina women are about 2.5 times more likely to get delayed prenatal care than a white woman,” says Rachel Ward, a senior director of research at Amnesty International, who co-authored a report titled “ Deadly Delivery: The Maternal Health Care Crisis in the USA .” More here.
-Verbal put downs, denial of pain or a mother’s thoughts and feelings about the care they are receiving, and or prior knowledge of their own health. “There was the new mother in Nebraska with a history of hypertension who couldn't get her doctors to believe she was having a heart attack until she had another one.” Also, real. More here.
-Lack of informed consent about the procedures they are being told are necessary and mandatory, like the episiotomy new mother Kimberly Turbin probably didn’t need, but her doctor insisted.
-Forced procedures, like being told you have to lie down on your back to deliver, even when evidence proves this is not the best position from which to birth.
-Lack of informed consent or performing procedures without consent at all, like pitocin postpartum.
-Overall neglect, or rude and/or dehumanizing treatment, like not being allowed to see family, drink water, or go to the bathroom, or being left for hours without check-ins from nurses or other support.
MORE EXAMPLES FROM RECENT CASES COMING TO LIGHT
- Shalon Irvings dying three weeks after giving birth.
- Erica Garner dying of peripartum cardiomyopathy.
- This woman’s baby was shoved back inside her causing permanent damage
- She was dropped from her provider for refusing surgery
WHY THIS MATTERS:
Well if it isn’t obvious enough….
Out of hospital births make up only 1.36% of births in this country, according to data by the CDC. Obstetric violence can result in lifelong health complications, physical and psychological trauma, and infant and/or mother mortality. It can also just plain ole put a damper on your whole birth experience...which is kinduva a big deal. So it’s super important to get this systemic problem rectified.
THERE'S HOPE! HERE IS WHAT YOU CAN DO:
- Find the right birth team
- Explore home birth and birth center births (for low-risk pregnant people home births are just as safe as hospital births!)
- Explore midwives in addition to OBs.
- Educate yourself! Attend a childbirth education class, read some books
- Hire a doula!
- Know your rights: in the workplace and in getting and receiving care!
WATCH THESE FILMS
Remember you are your best advocate. Always. You are the only one with your body 24/7. Listen to your body’s subtle cues. If something doesn’t feel right, say something. Compile a set of data points from research you’ve done and take them to your next appointment with your doctor. Take an advocate with you to your next appointment if you are uncomfortable speaking up or feel like that support will be useful.
Sadly, we can be amazing self-advocates and sometimes still not be heard or listened to. Here are some important people/orgs doing this work from an institutional level:
- Birth Rights Bar Associations, legal services for childbirth injury and more
- Black Women Birthing Justice, collective of African-American, African, Caribbean and multiracial women who are committed to transforming birthing experiences for black women and transfolks
- Patrisse Cullers, Senior Fellow for Maternal Mortality
- Hermine Hayes-Klein, Lawyer, researcher on reproductive rights
- ICAN, International Cesarean Awareness Network, working for education around cesarean
- Midwives Alliance of North America
By: Eleanor Burke, Bellingham, WA