Obstetric Violence, or Doctor knows Best?

Lisa Pascoe
Lisa Pascoe

Two blue lines, wow, I’m pregnant. What do I do now?

For most women ‘what do I do now’ means finding a professional to look after them during pregnancy, labour and birth. These ‘care providers’ are commonly obstetricians and midwives, but can also include other professionals such as Doulas, Physiotherapists, Anaesthesiologists, Chiropractors, Naturopaths  etc. ‘Care Providers’ by definition should provide care but this is not always the case.

We are conditioned in our society to accept that ‘Doctor knows best’ and that any prescribed treatment, procedure or course of action is in the best interests of the patient. Sadly this is not always true when it comes to having a baby.

Birthing a baby is one of the most profound life changing events in a woman’s life. She can be left with complex thoughts and emotions; wonderful memories of an empowering birth, dissatisfaction from unmet expectations, Postnatal Depression or Post Traumatic Stress Disorder from traumatic birth or Obstetric violence; which is what we’ll focus on.
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What is Obstetric Violence?

Obstetric Violence is a valid legal term first introduced in Venezuela, and can be manifested in many ways such as forced vaginal examinations, disregard of the woman’s needs, verbal humiliation, forced unnecessary medical interventions, physical violence, discrimination based on age, ethnicity, socio-economic status, HIV or Hepatitis status, gender non-conforming and many others.

During late pregnancy and labour, many women feel like they are under constant pressure from their ’care givers’ trying to bully them into interventions they do not want.  It is all too common for the woman who is over 40 weeks pregnant to be pressured into an induction for no medical reason. She is told that her baby may die, her baby is too big, her baby is not engaged, her obstetrician is going on holidays and so on. Induction can lead to the ‘Cascade of Intervention’, traumatic birth or caesarean birth; it means continuous fetal monitoring, regular vaginal examinations and pressure to labour in a timely fashion.  The vision of her birth is slowly shattered.

Obstetric Violence is happening all over the world every day. It can sometimes be blatantly obvious, such as in the case of a Californian woman who’d suffered previous sexual trauma having her perineum cut (episiotomy) 12 times against her will; or it can be more insidious, such as in the case of a Glasgow woman who was bullied into a course of antibiotics, being told that if she didn’t do as they said, her children would be taken away by social services. The Glasgow woman fought for two years, but did manage to get an apology from the hospital.
There are many, many women who have experienced Obstetric Violence. Often with no recourse; ‘where do I go for help?’ ‘Who will believe me?’ Women are in a very vulnerable position during labour and birth, they do not know or do not have the confidence to question or refuse their ‘care providers’. A recent study suggested that there are as many women experiencing Post Traumatic Stress Disorder as soldiers returning from Afghanistan. This is not acceptable and we as a society need to expose Obstetric Violence and those who perpetrate it.
If you feel you have experienced Obstetric Violence please contact your local Maternity Choices branch. http://www.maternitychoices.org.au

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