This is an old (and yet new) issue. Abusive behavior and treatment of laboring women is pretty old. The early hospitals that promised a safer childbirth hid layers of abuse under a veil of scopolamine. Gone are the days of tying women to beds and blindfolding them during labor. Yet, it is still common practice to treat laboring women abusively. There is a relatively new term for this phenomenon: obstetrical violence.

Obstetrical violence is a recognized issue by the World Health Organization. The WHO defines obstetrical violence as disrespectful and abusive treatment of women during childbirth. A few countries like Argentina and Venezuela have introduced legislation aimed at protecting women from obstetrical violence. The WHO says that the issue of obstetrical violence is not confined to any particular socioeconomic or cultural space. It’s been observed in developing nations and developed nations across many cultures and religions. Here in America, even being a celebrity can’t save you from being verbally abused by your OB-GYN. In her interview on More Business of Being Born, actress Melissa Joan Hart described how during the birth her first child her doctor yelled “You’re one push away from a c-section!” at her repeatedly.

Obstetrical violence isn’t anything new. Especially with the advent of scopolamine, abuse of laboring women became the standard of care. Scopolamine took away the memory of childbirth, but it also caused women to become so delirious that they were difficult to control. The 1914 Trained Nurse and Hospital Review described women under the influence of scopolamine as becoming so unruly they were given more narcotics. The babies were born heavily narcotized and even asphyxiated. With the delirium and wild behavior, women had to be restrained and doctors frequently used forceps for deliveries, often injuring both the mother and the baby. Of course the women remembered none of this and the fathers were not allowed to see what was going on. (For a doctor’s account of this read my post on Michael Crichton’s obstetrics rotation from his days as a doctor.)

Even today when scopolamine is no longer used, women are still susceptible to abuse and exploitation in labor because of the simple fact that labor is so intense that it becomes difficult to focus and make decisions. (When I was in labor with my oldest, my husband asked me if I was having a contraction and I said, “I don’t know.” This was after getting on all fours in the middle of Target because I could no longer stand or walk through the contractions.)

This is precisely why some care providers feel that pregnant women should simply do what they are ordered to do whatever they are told. However, this vulnerability is all the more reason why pregnant women need more protection, not less. People who are vulnerable are extremely likely to be exploited, which is why we rules for additional protections in were instated for pregnant women, fetuses, children and prisoners in human research. For obstetrical care this is especially true in countries like the United States where outdated and harmful procedures are still routinely used in childbirth or legitimate procedures are overused. And of course, the article in Broadly that has been going around describes several incidents of verbal, physical and sexual abuse that have absolutely no place in civilized society, let alone a health care facility.

Another pressure point that is the safety of the baby. When you are not in a clear mental state and an authority figure says you need to do something for the safety of your baby, you’re likely to do it— regardless of whether it’s safe or necessary. This is why I’m including obstetrical violence as part of my curriculum in my upcoming childbirth class that will be released later this year.

We talk openly about woman’s right to bodily autonomy when it comes to sexual consent, abortion and birth control. But for far too long, laboring women have been ignored by the women’s rights movement. It’s past time that health authorities and women start talking about this issue.

2 Comments on “Obstetrical Violence: The Forgotten Issue In Bodily Autonomy

  1. Leaving the idiocy of scopolamine aside as a failure of the past, you might want to reread and think about this post and your presentation of it. Essentially, your premise of “obstetrical violence” is largely refuted by your repeated and quite factual statement that women in labor, even without scopalamine, are often not competent to make right and quick decision or take needed, decisive action during labor. Hence, what you describe as abuse or violence could also be equally accurately described as speaking in a manner that will penetrate the woman’s condition and get the job done – the job being having a live mother and child at the end of the labor process.

    Now, I’m not saying that obstetrical violence is a lie or that it’s true. I’m just trying to point out that your argument and your explanation / evidence seem to be at odds.

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    • Jon! I remember you! You commented on my other blog, Corvidae History. Didn’t expect to find you here on my pregnancy, birth and breastfeeding blog. =) Looking back, there are several assumptions that I did make when I wrote this, mostly because my readers have primarily been women who have given birth, many of whom have experienced the dark side of American obstetrics. Of course, if I want to help other people understand the issue, I can’t assume that everyone has the background. So I did go back and add in a paragraph to support my thesis better. Thanks for helping me write a better blog. You’re welcome to check my logic on any of my other posts. The outside perspective is helpful. Thanks again. =)

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