... doesn't mean it's ethical.
(This is part of a post I wrote in May 2006 and it seems appropriate even today. This was right after I learned the term "birthrape.")
I worked in hospitals for 15 years before moving to birth centers (there was crossover) and finally now in home and hospital birth. I know what hospital birth looks like. I know what doctors are thinking because I have spent HOURS with them at the nurses station talking to them. Nurses have confided in me, telling me the vile things that come from physician's mouths the moment the door is closed. I have heard vile things with my own ears from doctors and nurses - and midwives.
Birth trauma is not a doctor-only proposition. Birth trauma happens with nurses, direct-entry midwives, licensed midwives, certified professional midwives, certified midwives, etc. Some of the most horrid things I've seen have come from a midwife's hand or mouth.
Here, from an old post and my birth stories blog - and while midwives are specifically addressed (because of the original discussion) it obviously encompasses physicians and nurses as well:
Birthrape: The experience of having fingers, scissors, and/or tools put/pushed/shoved inside a woman's vagina or rectum without her direct (or indirect) permission.
Being coerced, manipulated, or lied to regarding the health and safety of the baby or themselves so the midwife is able to do something to the mother's vagina, rectum, cervix, or perineum, usually with excuses; rarely with apologies.
Some find the definition expanded to:
The midwife taking the woman's Power by using disparaging comments, unsupportive expressions, speaking around her as if she is unable to hear or process requests or information.
Even though consent forms are signed in the hospital, birth center, and at home, consent for care does not include the manipulations or coercive words to get women to obey the caregiver.
I thought it was time I shared some of the thousands of comments I have personally heard that have facilitated birthrape over the years.
I share them and am writing about them and speaking about them and nearly screaming about them in the hopes that midwives will hear what they are saying that is sending their clients into therapy, pushing them to depressions that require medication and alternative therapies, keeping them from coming back to the midwife at all because of her Power Hunger and covert misogyny. Too many women (in my opinion) find Unattended Birth their only acceptable option after their experiences with professional caregivers in birth.
You see, most midwives talk a good game. They will say any number of things in pregnancy to lead the woman to believe she (the mom) is in control. I have sat through hundreds and thousands of prenatals with midwives and listened to the party line about how they believe in a woman to know, how they will "let" them labor how they want, how they will limit vaginal exams, etc. And then, when labor is in full swing, I sit by (or participate) in the amazing disregard for the woman's prenatal wishes and dreams of an unhurried, unfettered, un-directed birth. I am not a part of the delusion or lies anymore.
* Women in labor don't really want to use their birth plan.
* Women in labor aren't able to verbalize their needs.
* Women in labor don't know when they need to pee or drink or eat.
* Women in labor don't know when to change positions.
* Women in labor can't make decisions.
* Women in labor want an epidural.
* Once labor kicks in, they all want epidurals.
Directives That Disembody Her Being
* Lift her leg.
* Move her to the bed.
* Grab her knees.
* Put her feet in the stirrups.
* Put her hands on the grips.
* Push her head to her chest.
* Push her chin to her chest.
* Put pillows under her head.
* Put pillows under her butt.
* Pull her down to the edge of the bed.
* Push with her so she knows how to do it right.
* Count for her so she knows how to do it right.
(while these next phrases end in periods and question marks... almost exclusively, the following words have been shouted at women... an exclamation mark is more appropriate, but there aren't enough in the computer to add them all)
Comments That Negate Her Intelligence (spiritual, physical, emotional, and intellectual)
* You aren't pushing right.
* Push like this.
* Get mad at the baby.
* Quit making noise.
* No, push longer.
* Push like you are having a bowel movement.
* Push the watermelon out.
* Push the bowling ball out.
* Don't push in your chest, push in your butt.
* Push like you mean it.
* What are you doing?
* Can't you push harder?
* Have you ever been raped? (asked in labor)
* Are you an abuse survivor? (asked in labor)
* Have you been abused? (asked in labor)
Coercive and Manipulative Remarks
* I need to get in there.
* (pressing knees apart) I need to do a vaginal exam.
* C'mon, just let me see what is going on.
* I'll do it quick and fast, I promise.
* I promise to be gentle.
* I just want to feel the baby's position.
* I just want to see how dilated you are.
* You asked me to be your midwife, now let me do my job, okay?
* I'm a woman, too, I know how it feels... I promise to be gentle.
* I remember how vaginal exams felt in labor, I promise to be gentle.
* Do you want the baby to come out or not? Just open your legs.
* Are you sure you are ready to be a mom?
* You had no problem opening your legs 9 months ago.
* Just let me break your water, it will speed things up.
* If I break your water, the head will be applied better on the cervix.
* If I break your water, prostaglandins will stimulate things nicely.
* Here, drink this. (as Gatorade with cytotec is given to the mom)
* You might feel a pinch. (as pitocin is injected into the vaginal vault)
* I am just wiping up some stuff. (as pitocin on a gauze is pushed inside the vagina or rectum)
* Here, drink this. (as blue and black cohosh are given without consent)
* Here, put these under your tongue. (as homeopathics are given without information or consent)
* I'm just feeling your cervix... it might hurt a little. (as manipulations to the cervix are done... from stripping the membranes to manual dilation)
* I'm just feeling your cervix. (as cytotec is put onto the cervix)
* Do you want your baby to die?
* You don't know the seriousness of the situation.
* You have been a martyr long enough.
* Just take the medication.
* Just get "your" epidural.
* Would you like something for the pain? (in the middle of a contraction)
* This will take the edge off.
* It doesn't do anything to the baby.
* If you were my daughter/sister/mother....
* I have had three scheduled cesareans myself! I don't know what you are complaining about. (being wheeled into the OR)
* Stop whining.
* Why are you crying?
* What is wrong with you? Are you trying to hurt your baby?
* In this day and age, no one needs to suffer in childbirth anymore.
* Mothers and babies died without hospitals 100 years ago.
* Let me call the anesthesiologist... just talk to him about your options.
* No, you can't eat... just in case you need a cesarean... and your labor is rather slow moving.
* No, nothing by mouth after 7 centimeters. (or any number the caregiver randomly pulled out of her ass)
* Only ice chips.
* Oh, Bradley... they always have cesareans.
* You wanted a homebirth? That's child abuse!
* Are you one of those La Leche League people who nurse until the kid dates?
* Do you vaccinate? (after discussion of no erythromycin in the baby's eyes)
* You want your baby to go blind? (after refusal of erythromycin in baby's eyes)
* Your baby might bleed to death. (after refusal of Vitamin K injection for the baby)
* It's just antibiotics.
* God, you have terrible veins!
* Where are your veins?
* (to the Licensed Midwife during a transport, a nurse asks) Do you know how to take a blood pressure? Did you do any?
* Why did you wait so long?
* Why did you get here so early?
* You aren't in labor.
* How would you not know if your water broke or not?
* Can't you stop moaning?
* Be quiet!
* Oops, your water broke! (while using fingernails or fingers to break it on purpose)
Whispering to Other Birth Attendants
* My god, I wish she would hurry up.
* I am so bored!
* She is going so slow.
* I wish she would let me break her water.
* My baby needs to nurse, I need to go home.
* My boobs are going to burst if I don't go home and nurse. She needs to hurry up.
* I am so tired.
* I want to go home.
* I am going to talk her into letting me break her water so she will hurry up.
* I am going to talk her into letting me manually dilate her so she will hurry up.
* I need her to hurry up.
* She's holding back. There must be some emotional barrier we haven't found yet.
* I bet she was abused. Look how she: keeps her legs together/cries with exams/doesn't want us to touch her/doesn't take her clothes off/won't take her shirt off/won't relax enough to let the baby out/is afraid to be a parent/hasn't worked through her issues/has body image issues/has eating issues/is fat/is thin/lives in her head/isn't in touch with reality
* She is so noisy.
* She is too quiet.
* She needs to let go.
I am exhausted writing this much pain. I know there are hundreds of thousands of remarks that have been said that I haven't been witness to and I encourage women who have had them said to them to email me privately so I might start a list that lets caregivers know what not to say to women during pregnancy, labor, birth, and postpartum.
This came as an addendum to that blogspot:
* There's not much happening here (as the midwife does a vaginal exam)
* One woman wanted to stand on her own during her births, but, both times, was forced to do a deep squat or be supported by others, causing vaginal tears and "mad" that she wasn't honored at her own births (her words).
* I had a midwife write me thanking me for disclosing what she, too, has seen in her training.
Blessed Be! I am not alone!
This next series from a nurse friend of mine:
* "Stupid Bitch" (said by a Doc before he even left the room)
* The same doc (we hated this prick, he still practices) elbowed a woman (hard) in the thigh because she wouldn't open wide enough for him
* "Well, the Anesthesiologist is here now for another pt and he wants to go home, this is your last chance for an epidural"
* "If you would just stop moving we could get a good tracing on the baby" (and other variations of the same)
* "Quit being such a baby"
* "Oh come on, it doesn't hurt that bad, you are only ____cms dialated."
* "These stupid wetback women just scream and scream, I wish they would shut up" (same prick as above)
* "If you don't hurry up we will have to do a c-section"
* "No way is that one going to deliver vag, did you see the size of her?" (I personally have never seen a vag delivery of anyone over like 200, that is after preg weight)
* "No you can't walk because you are on pit" (everyone I have ever seen in labor was on pit)
* "Walking doesn't do anything for labor" (said by a doc, different one than above)
* "Oh no, she has a birth plan"
* "If you wanted to walk you should have stayed home" (after her IV is in and she is on pit now)
* "Give her a sleeper already so she will be quiet and stop bugging us"
How can people NOT believe women would consider their experiences traumatic and abusive.
It would be wonderful to demonstrate a completely natural birth in the hospital (NOT a homebirth in the hospital as many would want to call it) and watch all the care providers squirm with discomfort as their jobs became almost useless "just" sitting and observing. It would take an incredibly strong woman to be able to withstand the intense tension brewing, but it would be a great lesson for hospital personnel to witness. I believe it could never be done - and that's just so sad. It's sad that not only could we not even demonstrate a normal birth, but that nothing like it would ever occur in the hospital setting. The closest I have seen is in in-hospital birth centers, but even that is difficult to compare to a homebirth.
When I first heard the term "birthrape," I was really offended as a woman who has been raped before. However, talking to police and deputy sheriffs as well as lawyers, the above descriptions of what happens in hospitals absolutely fits the LEGAL definition of rape and assault. It is simply so foreign to our legal system and our mental health system, the designation hasn't yet been given its rightful place. There were times when terms and syndromes or disorders didn't exist even when people carried them in their brains and bodies. This simply is a new one - BECAUSE of our medical system seeing women as THINGS and not people - the pain is catching up to us all.
Medical care sees women as a number - as a collection of symptoms to be treated. It is in this disembodiment that abuse can occur without thought or concern.
Many, many, many of us are saying NO MORE.