Birth Trauma: It’s Time to Speak Out Against Obstetrical Violence

One of my most frequent rants and raves is the minimal standard for excellence among the Obstetrical community. They believe that as long as mom and baby make it through the birth ALIVE, the woman should be satisfied with her care and that if she were to anticipate anything more from her pregnancy and birth than survival, she would be selfish!

The Midwives Of New Jersey have been working to promote the Midwifery Model of Care in New Jersey as a proven way to improve outcomes and satisfaction in childbirth for women and families.

Likewise, Christen Pascucci’s organization, Birth Monopoly, rejects the normalization of violent actions against women during childbirth. The culture of childbirth that routinely denies birthing people informed consent and frankly any decision-making at all results in an incredible imbalance of power. If anyone objects to the treatment they receive during their labor, they are threatened with the health and even life of themselves or their baby. The person is shamed or frightened into complying with abusive policies and behaviors. This culture of birth expects people to accept it as “just the way it is”. This acceptance sends an underlying message a family should be GRATEFUL for the care they received because mother and baby survived the process.

Women Speak Out About Their Traumatic Birth Experiences

As many as one third of women say that their birth experience was a traumatic one.  This video shared by a woman named Kelly* is just one example of obstetric violence. Kelly was coerced into a forced episiotomy.  Trigger warning: this video is restricted and is difficult to watch, especially for those who have experienced obstetric violence.  However, I do believe it is important to that we see and share these stories so that the silence can be broken as these atrocities are brought into the light.

American Childbirth’s project Exposing the Silence goes a little further than simply examining the outcomes of childbirth; rather, it examines ways in which routine childbirth care can be offensive or even abusive to women who have given birth.  Women were encouraged to tell their story without being judged.  Following is a quote from one of the photo essays:

You can be grateful and appreciative of having a healthy baby and still be completely traumatized by your birth experience. Being traumatized doesn’t equal being ungrateful – they are two entirely different things. Kimberly, Columbus

The words of these women are compelling. I am devastated to think of these young women, who could be my own daughters, suffering at the hands of medical providers. These are not isolated stories. I have heard women describe their births for years as terrible mostly because of how they were treated, not because of the pain of labor itself. My own mother describes childbirth as something akin to a violation. The descriptions in the photo essay remind me that my own care of a woman during pregnancy and birth is a priority every single time.

Good Prenatal Care Yields Rich Rewards

I am reminded that the work of prenatal care takes time and energy as I work to establish a trusting relationship, allow a woman to explore her fears and dreams about her birth and provide loads of information so that she approaches her birth with confidence. The good work of caring for a woman prenatally yields rich rewards in labor.

These stories compel me to keep my attention on the individual who is laboring before me and reminds me to be in the moment. Right now. With THIS woman. A singular focus. Yes, I have a husband and family. Yes, I have other clients. Yes, I have a business to run.  But all of those are not the priority during this woman’s labor and birth.

The testimonies of these mothers further convince me that I will sleep after the baby is delivered. It is not the woman’s fault that labor has started when I just got into bed or after a long day in the office. I know that she would have preferred to have started her work in labor after a good night’s sleep –  but honestly, this is rarely the case. I can and do sleep without any guilt at all once the baby has been put to breast, and the patient and her baby are beginning to doze. My fatigue is insignificant when weighed against a woman’s lifelong measure of herself as a woman. A loss of sleep pales in comparison to the triumph of a healthy mom delivering her healthy baby with dignity and respect. Fatigue is but a small sacrifice compared to the opportunity for my own life to mean so much more than I ever believed was possible.

Your Birth, Your Choice

The words of these women remind me that my own concept of the “perfect” birth does not matter. It is only important that my client feels well cared for, respected and safe throughout the whole process. We once had a client who chose a cesarean section over Pitocin augmentation of labor because even though the midwife believed she would deliver vaginally with stronger contractions, the woman did not want that intervention. Our client was very pleased with her birth and felt heard, in control of her body, baby and birth. Her value system was perhaps different than ours but the priority was to make her birth a safe, satisfying experience for HER. I sometimes think that the woman would labor better without her children, sisters, best friend or mom in the room. I might be right, her labor might progress “better” ultimately, however her choices are more important than my opinion. The hospital may have policies that I believe conflict with the needs of the newborn baby and his mother so I work steadily to create change by questioning the status quo, asking for policy changes and demonstrating respectful care.

Birth Without Fear

The work of the authors of American Childbirth: Exposing the Silence convinces me that we must continue to work in our own local midwifery practice, in our own hospital in Morristown and in our own state of New Jersey to promote the use of the Midwifery Model as the standard of care for childbirth. Not only should women not fear childbirth but every woman should come through their pregnancies and birth knowing more, loving more and becoming more than they ever expected. Hundreds of people in New Jersey are working toward this same end. Midwives, Doulas, Birth Activists, Physicians, and Moms. I really do believe that we can make New Jersey the best state in the country to give birth.

*Kelly is not her real name, her name has been changed to protect her identity.