Abusive Birth - Helping women to recognise it for what it is.

I stood in stunned silence, watching. The obstetrician was sitting between her parted legs, slapping her inner thighs with his hands, and angrily commanding her to “RELAX! RELAX! I can’t do this if you’re going to keep tensing up!"

Anna had just done a wonderful job of birthing her first baby. However, she’d sustained a tear that the midwife felt needed to be repaired by an obstetrician. The duty obstetrician had come in, hastily introduced himself then commenced the suturing of Anna’s birth wound. He injected her with some local anaesthetic, but clearly not enough because every time he drove his suturing needle into her vaginal wall, she tensed violently and stifled cries of pain. Rather than giving Anna more local anaesthetic, he told her off as though she was behaving like a naughty child, berating her for inconveniencing him, and resorted to slapping her. Her midwife didn’t say a word. Her husband sat holding the baby silently. I was shocked. 

This violent act took place a number of years ago now. I was a student midwife in my first year of training at Otago Polytechnic. Anna’s was one of the first births I attended. I was young and rather clueless, but my naivety didn’t blind me to the fact that what that obstetrician was doing was abusive and completely unnecessary. I relaid Anna’s story to my midwifery school advisor, asking what could be done to ensure the obstetrician didn’t simply get away with it. She said that it was up to Anna to lay a complaint if she wished to do so and that I should discuss that option with her, but really there was nothing else that could be done.

The next time I visited Anna I talked about the horrid incident with her. She was clearly still quite traumatised by the experience and said that she just wanted to try and put it all behind her. Laying a complaint was, for Anna, too difficult and daunting to even really contemplate. Her midwife never even made mention of the incident to her.

So that was it. That was as far as the issue went… well, for the doctor who caused the needless suffering it was anyway. I’m not sure about whether there were lasting consequences for Anna. My guess is that the abuse she experienced would have taken its toll for quite some time. Regardless, her first hours and days as a new mother will forever be tainted by the needless trauma and abuse she was subjected to.

Like childbirth, new motherhood is an incredibly vulnerable time in a woman’s life; certainly not a time when a women should feel she needs to fight battles over mismanagement by her hospital ‘caregivers’. Isn’t it more than just a little off that the onus was on Anna to speak out against that dodgy doctor? It bothers me that her midwife watched on in silence while he hurt Anna, and that she (the midwife) didn’t take any action against him afterwards. At the very least that midwife ought to have discussed with Anna what had happened, advised her of the complaints procedure, and supported Anna to lay a complaint had she felt willing to speak out.

Anna’s awful experience has stayed with me through the years since. I guess it was really the beginning of a recognition within me that the medical system does little to support the emotional, mental and spiritual well-being of birthing women… women who are meant to be experiencing the most profoundly joyous and treasured part of their lives - giving birth to their baby! And becoming a mother! There really is no more momentous an occasion that a woman will experience in her lifetime. Yet time and again through my years as a midwife I witnessed abusive undertakings of medical staff who treated labouring women as nothing more than a dysfunctional birthing body that required medical interventions to extract the baby. Just like their traumatised mothers, babies were subjected to treatment that cared little about their emotional wellbeing. It’s heartbreaking that for so many babies, their first moments outside the womb were cold, heartless and physically painful.

I discuss those incidences using the past tense because it was many years ago that I worked as a midwife. Since that time I have birthed three of my own children and many of my friends and colleagues have started their own families. Being the absolute birth nerd that I am, I frequently have discussions with women about their childbirth experiences. What is utterly undeniable is that the sort of abusive maternity care that I was witnessing years ago is still just as prevalent (and damaging) today. The abuse may not always be as overt as it was in Anna’s case, but it happens, and often in ways that lead women to believe that it is simply a standard part of what to expect when giving birth. Although women often express upset, confusion and pain (both physical and emotional) around what was done to them during their births, they are often unaware that the ‘care’ they received was inappropriate and unacceptable.

When I share with women about my own birth experiences… that I birthed my 10lb babies at home in a birth pool; that I was the one who picked them up out of the water to hold them; that they were almost two weeks ‘overdue’; that there were 9 others with me when I gave birth; that I never had a vaginal examination during any of my births; that my babies cords weren’t cut until after I’d birthed their placentas; that I enjoyed giving birth and looked forward to doing it again… sometimes it seems that that is their first inkling of an appreciation for what a gentle, loving and empowering experience childbirth can be; the sort of experience nature designed it to be.

As I hear more and more sad stories of unnecessary ill-treatment of women during birth, I feel compelled to do something to help support and educate others. This blog is one such way I hope to increase awareness around these important birth matters, because birth matters!

Have you, or someone you know, experienced obstetric violence, abuse or birth trauma of any kind? Perhaps the sharing of such experiences is one way we can begin to address the issue and help others to understand that there is such a thing as obstetric violence; it is real and it happens, and it is NOT okay.