Know Your Rights: Preventing Obstetric Violence

09/09/2024

In today's modern landscape, topics like contraceptive and abortion access, maternal mortality rates, and the intersectionality of class, race, and gender in the context of perinatal care are leading the conversation on reproductive justice.

These topics are vital, however, in order to have a well-rounded conversation about bodily autonomy, we must address the origins and impact of obstetric violence.

What is obstetric violence?

Obstetric violence is the blatant disregard of a patient's wishes that leads to the harm of said patient during or in relation to pregnancy, childbearing, and the post-partum period.

You've likely heard jokes about non-consensual procedures such as, the 'Husband Stitch,' in which an extra suture is added to an episiotomy or perineal tear to tighten the vagina and improve intercourse for your birth partner.

Women who have experienced obstetric violence also report being roughly handled or restrained during labor, being forced to birth in an uncomfortable position, or experiencing shame and humiliation in the form of verbal abuse from healthcare providers.

But it doesn't stop there. While more extreme examples of obstetric violence typically tend to make mainstream media, obstetric violence could also look like:

Neglect: Refusing to provide pain relief or ignoring a woman's requests for pain management during labor and delivery is a form of obstetric violence. Similarly, failing to provide information about the woman's condition, the risks and benefits of procedures, or alternative options, and leaving her vulnerable to the decisions of others qualifies as obstetric violence.

Privacy Violations: Exposing a woman's body unnecessarily or not respecting her privacy during exams, labor, or delivery, such as leaving doors open or having unnecessary personnel in the room.

Coercion or Manipulation: Pressuring a woman to consent to a procedure by withholding information, exaggerating risks, or using emotionally manipulative tactics. Threatening to withhold care, such as pain relief or support, unless the woman agrees to a certain procedure.

The list goes on, and it's a result of a much bigger issue within our society.

Why does obstetric violence happen?

It's no secret that women are historically disrespected.

The connection between obstetric violence and social inequity dates back centuries, spans across generations, and is upheld in countries all over the world.

(The following examples were curated for a scholarly article written by Elizabeth O'Brien and Miriam Rich.)

In 16th-century papal Rome, Roman Catholic authorities in houses of catechumens (institutions for non-Christians) sequestered Jewish women's babies unless they consented to being baptized.

In the late 18th-century, viceroyalties of New Spain and Peru performed forced caesarean sections on some women who struggled to give birth. Crown officials made the operations obligatory and insisted that the priority was to save the souls of fetuses and not the lives of their mothers.

In the system of hereditary slavery, enslaved women's childbearing was appropriated to enrich their oppressors, and women faced violent punishment and abuse for failing to conceive and give birth to healthy offspring. They were forced to undertake strenuous physical labor throughout their pregnancies, and they were frequently denied care and recovery time after giving birth.

Again, the list goes on.

It's still reflected in things as seemingly insignificant as the language providers use to talk to expecting mothers. Some healthcare providers will make disparaging and manipulative comments such as:

"Stop being dramatic; it doesn’t hurt that much."

"You wanted a baby, so you should be able to handle the pain."

"If you don’t cooperate, your baby could die."

"If you don’t let us do this procedure, you’re putting your baby at risk."

"Other women don’t make this much fuss during labor."

"I’ve seen women much younger/older than you handle this better."

"That’s a silly idea; we’ll see how you feel after a few more hours."

"This is what you get for not getting the epidural."

These sorts of statements not only undermine a woman’s experience during labor but can also have lasting emotional and psychological impacts, contributing to trauma and a sense of powerlessness.

How can I prevent obstetric violence?

While years of gender discrimination cannot be undone overnight, there are steps a woman can take to combat obstetric violence during her birthing journey:

Learn About Your Rights: Understand your rights as a patient, including the right to informed consent, the right to refuse procedures, and the right to respectful care.

Research Birth Options: Familiarize yourself with different birth settings (hospital, birth center, home birth) and the practices common in each. Choose a setting that aligns with your preferences and values.

Know the Signs of Obstetric Violence: Learn about what constitutes obstetric violence so you can recognize it if it happens and take appropriate action.

Interview Providers: When selecting an obstetrician, midwife, or doula, ask about their views on birth practices, informed consent, and patient autonomy. Look for a provider who respects your preferences and communicates openly.

Communicate Your Preferences: Clearly outline your preferences for labor and delivery in a birth plan, including pain management, positions for labor, and any procedures you want to avoid. Share this plan with your healthcare provider ahead of time.

Be Flexible: While a birth plan is important, be prepared to adapt if medical situations change. Make sure your preferences are honored whenever possible.

Bring an Advocate: Consider having a trusted person, such as a doula, partner, or family member, present during labor and delivery to advocate on your behalf if you’re unable to do so.

Prepare Your Support Team: Educate your partner and support team about your birth plan and your rights so they can help you assert your wishes during labor.

Birth Circle is here to provide you with everything needed to experience a healthy and beautiful pregnancy, birth, and postpartum. Visit our website to begin building a birth team that will advocate for your rights.