Thursday, September 16, 2010

Birth Rape or a Negative Birth Experience?

I've been planning blog posts all week but I've been so busy living life I haven't had the time to write about it. Too bad too because there is some great stuff too. We've been baking, schooling, playing, crafting, sewing, knitting, cooking, dancing, meeting and of course, drinking coffee. I have even made bread. There will be a post about that, there HAS to be a post about that.

But instead of a post on golden crust and French style homemade bread I find myself with much heavier topics on my mind.

I haven't written about birth much and haven't actually attended one since last December and I was the birthing woman. This feels strange but also right at this time. Still a birth junkie though, I've been reading as usual and today I read this article on the Parenting blog. Melanie, the author, addresses the use of the fairly new term "birth rape" when discussing bad birth experiences. She shares with her readers some of the details of her first birth, a negative experience in a hospital and then why she feels that, though it was a negative experience that led to her choosing a home birth the next go-round, the term "birth rape" is not an appropriate label. The crux of her argument is that the doctor and hospital staff at her birth were not set out to intentionally harm her.

I want to agree with her, really I do. Maybe it is true most of the time that a bad birth experience is just that, a bad birth experience. But there are times when I feel "rape" is an appropriate term. And I say that as a rape survivor.

Merriam-Webster defines rape as:
1 a (archaic): to seize and take away by force b : despoil

2: to commit rape on

1: an act or instance of robbing or despoiling or carrying away a person by force

2: unlawful sexual activity and usually sexual intercourse carried out forcibly or under threat of injury against the will usually of a female or with a person who is beneath a certain age or incapable of valid consent — compare sexual assault, statutory rape

3: an outrageous violation

To seize and take away by force
I feel I experienced birth rape once and have witnessed it twice. I was told "if you had just gotten the epidural and delivered your placenta better then I wouldn't have to do this to you" when my OB was manually performing a DNC without any pain relief to remove the retained placenta fragments after she pulled on the cord because (and these were her words) "she was so tired and ready to be done with this already." I had been told more than once that it was the end of her shift. She entered my body 3 times that I remember, telling me to be still and I would thank her later. The way she spoke to me as she forced her arm up to her elbow inside me through my freshly torn vagina and bruised cervix while she scraped the inside of my uterus and searched for the fragments and how she had my legs restrained by nurses triggered flashbacks of my rape that haunted me for 2 years. I passed out from the pain and when I came to later I was told it was my fault, that I wanted a natural birth and "well, was it worth it?" When I became more educated years later and read through my own chart I understood what happened and I know the risk of a retained placenta and immediate postparum hemorrhage but I also know that the attitude with which it was done and the blame being placed on me was all too similar to what my sexual abuser did as well. Perhaps her intent wasn't to harm me but, like a sexual predator, her actions demonstrated that she was primarily thinking about getting what she wanted.

Despoiling, to commit rape on
The 2 times I saw what I feel was birth rape included a home birth transfer and I heard the on-call doctor tell the mother "everyone would be so much nicer if you had come here in the first place. This is what you get for being stupid enough to try a home birth" and then he cut her a 4th degree episiotomy that was completely unnecessary for the 3rd time mom birthing a 6 pounder.

Unlawful sexual activity... carried out forcibly or under threat of injury against the will usually of a female
I have several Labor and Delivery nurse friends that tell stories. There is a OB in town that has a horrible reputation among the nurses at the hospital where he does deliveries because of his poor treatment of patients. Poor doesn't even begin to describe it. One story my friend tells is of a young woman, a teen mom having her first baby. She was afraid and refused a second vaginal exam (smart girl, in my book) because of the pain from the first one. This doctor sat there between her legs and bellowed at her that he was in charge and she was just a little slut that needed to open her legs and let him do what he needed to do. She whimpered and obeyed. He hurt her again in that exam and told her she was no good at birth and he'd probably have to cut her open to get her baby out. Yes, those are the words my friend says he used. The nurses finally stood up to him and threatened to report him if he didn't change his treatment of this patient.

An outrageous violation
The other birth rape experience I witnessed was by a midwife in a birth center and was even more traumatic than the first with the midwife saying "you really want me to do this, you'll be thanking me later so stop being such a whimp" as she repeatedly tried to manually dilate a posterior, slow progressing, hard cervix despite the laboring woman begging her to stop and to get out of her. All my interventions to protect my client were ignored and her actions didn't stop until the 3rd time when I told the husband that he needed to tell the midwife to remove her hands from his wife and explain what she was doing. When she did I physically put myself between my client and the midwife until we had her word that she would not do another cervical exam without the express and clear permission from the mother. That birth was one of the most horrible I have ever seen and even included a light smack on the rear of the birthing mother on hands and knees when she tried to move away from the pain the midwife was causing her. In any other situation there would be no question that language of assault would be appropriate in describing the events that took place, just because it is birth and these people are supposed to be helping does not give them license to exert dominating control over a woman's body against her will. When I left the home of that couple after getting them settled back home several hours later I sat in my car and bawled. What I had witnessed wasn't just a series of unfortunate events or even unnecessary interventions but a vile form of abuse under the guise of assisting someone in the midst of an extremely and intensely vulnerable time. I won't even go into the desperate feelings of guilt and failure as a doula that hounded me in seeing my client abused and me feeling powerless to stop it.

I understand the writers point. Not every case of an undesired intervention equal birth rape. However, there are some where the attitude is clearly not just "this is what we do to get a healthy baby" but rather one of punitive power masquerading as care. Birth rape is a strong and unsettling term and rightly it should be. It should not be used lightly but it should not be ignored. If we tell women that they cannot describe their experience with language that points to assault we put more barriers in the way of their healing and for those suffering from PTSD as a result of their birth experiences we make it even more challenging for them to find the help they need. We need to be careful that we do not dismiss these traumatic experiences and that we encourage women to use the terminology they need to accurately express what happened to them. I don't want an us vs. them attitude between doctors and women or doctors and the natural birth community but not all health care birth professionals are as benevolent as we would like to believe. There are many wonderful and talented doctors, nurses and midwives I have been privileged to work with and know. Far more truly caring ones than not and most of them love what they do and recognize the honor they have in attending birthing women. I am grateful for this. The small handful that have made me sit in my car and sob are greatly outnumbered. But they are there and they are hurting women and families, traumatizing them by looking out for themselves, their needs and wants over those of the very people they are serving. That is how rape happens, when a position of power is abused to control someone to proceed in an action by violating their body through force against their will.

Melanie may not feel that her personal negative birth experience wasn't birth rape and it sounds as though she has found healing through her second birth and that's wonderful. For me and some other women "negative birth experience" just isn't the right terminology for what we went through. Birth rape feels closer. It may make us uncomfortable but that's exactly what it should do.

What do you think? Is Birth Rape too strong of language for birth related abuse? What would be some other terms we could use instead? Do you feel it is fitting?


  1. Oh I totally agree - for me what I experienced is definitely Birth Rape: here's just part of my story

    this was just the induction: I was placed in styrrups and was naked from the waste down. A midwife jumped from behind the curtain and said welcome to Christina's inducement. Presenting - and then she went on to the midwives present, each time one would pop out from behind the curtain - this was apparently suppose to be funny, but it just made me feel more insecure. I'm a very private person and hated being exposed like that and laughed at.

    The obstetrition who came in was the one I had requested not to see again after he gave me an internal examination that wasn't required - it was written in red letters on my file that he was not to see me. I looked at one of the midwives and sher just shook her head and said he was the only one on.

    I was having a trial proceedure (2 balloon catheter) the obstetrition had no idea how to insert it. The midwife took him around behind the curtain - I could here her trying to explain what to do.

    First he tried to insert the speculum - He tried 5 times - shoving it into me harder and harder whilst I screamed. He then threw it - all bloodied - on the floor and inserted one of his hands up inside of me. He then grabbed the catheter with his other hand and then shoved that inside of me and inserted it manually.

    I would have passed out at this stage if it wasn't for my partner (now ex) pressing on my nail beds (something we used as medics to see if a patient was responsive) I was crying and in so much pain and begging him to stop, I tried getting up but my partner held me down - I begged both him and the midwives to stop the obstetrtion.

    I could hear a noise like water hitting the floor - I looked over the side of the bed to see a huge puddle of my blood on the floor. - A midwife ended up putting a contaminated waste bin under the bed to catch the blood.

    the whole time the obstrition ignored me - he never spoke to me and once he finished he just walked out.

    I was wheeled into the ward, my partner was told to leave and I was left alone, in extreme pain and completely terrified.

    On the way back to the ward the midwife had said that I was already 1cm dilated before they induced me and that I probably would have gone into labour if I had left it a couple of days (I still don't understand why they went ahead if this was the case)

    In the end the induction was unsuccessful and I ended up having my waters broken 14 hrs after the induction.

    If someone had done that to me who wasn't wearing a lab coat they'd be in jail right now, but all I was told was be thankful your baby is ok. But what about me and the trauma I went through - and what about my baby - he ended up going into distressed - I was told it was because I wasn't progressing - could it not have been from all the trauma myself and my baby experience in their hands

  2. In the instances you've described, I would definitely agree that birth rape is appropriate. And this is coming from a survivor of both rape and a negative birth experience for which I would not use the description of birth rape. *I* feel triggered and ill just from reading about it.

  3. I think birth rape is absolutely the right term to use, for many reasons including because it makes people uncomfortable. People need to at least get uncomfortable, and recognize that women are too often (even if it's rare it's still too often) abused during their births. Whatever our place is in the birthing community we have to be willing to do our part to stop the abuse.

  4. Incorrect term. I think what you describe are instances where the patients are just not smart. Any doctor to call a patient a slut and try to forcibly perform a vaginal exam or any exam is a lawsuit not to make money but to have this filthy pigs liscence taken away. You did even worse by allowing your client to stay there with you right there. I would gave stopped the exam by any means called the police and advise her not to go tothe particular midwife that was doing such violations.

    There is a reason why there's a code of ethics abd an ethics review board in the medical field because of individuals Like them. If a patients goes to a doctor and from day 1 they feel the doc or health professional isn't professional and doesn't feel comfortable with the provider it is the patients responsibility to seek a new provider not stay and set themselves up to fail. If you got luck of the draw at a hospital with the oncall doc and you don't feel at ease with this doc you can request a new doc which is why most hospitals have more than one ob on call. And there are patients bill of rights and if you do not familiarize yourself with then don't blame the doc. Yes docs are aholes but not all and if yours was you had a choice and as soon as doc purposely inflicts pain with the intent to do so when there's a pain free or more comfortable alternative you should have sued the bastard so no one has to go through that again.

  5. I choose to birth at home after I was abortion-raped. i do not often say this because so many people feel that i deserved to feel so horrible about myself for deciding it was not the time in my life to have a child. but it was rape. completely. If I did not have the love and support of my husband I would have killed myself for what the staff of that clinic put me through.

  6. I thought I should add that i am also a sexual rape survivor. if anyones comparing here

  7. Before reading your post, I thought the term 'birth rape' was a bit OTT. But goodness, I would have never believed such things could happen to a woman at her most vulnerable. This saddens me to no end. I was lucky, I had a wonderful, natural birth, in a birth centre, with my midwife and my husband, just as I had wanted...

  8. These stories are horrible and sad to hear, especially since child birth is supposed to be a wonderful, natural, miraculous event. I am a nurse, though I never worked in obstetrics. I'd think that anyone in the medical profession who witnessed or participated in this sort of treatment should have criminal charges brought against them. I am not a litiginous person, but feel strongly about advocating for patients' rights.

  9. I disagreed with this term when I heard it the other day and thought it was over the top....

    Until I just read the 2 stories you posted and the one in the comments. That is birth rape. So I think as long as we do not call every negative birth experience birth rape and know that there is a difference then I think it is okay to use.

  10. Just thought I would say I disagree. My first birth was when I was 17 and he was undiagnosed back to back I had constant contractions for 24 hours with no break and when I asked for pain relief the doctors were shouting that I was a silly little girl I couldn't handle the pain and they were going to give me a section to shut me up. I was crying pleading and begging 30 minutes later my son was born facing the ceiling. I don't consider this that bad a experience.

    My second birth I went in at the last minute as I was denied a hospital birth I had my waters broke against my wishes, I was after delivering my daughter believed to be hemorrhaging. I had 3 doctors in the room one holding my legs down another kneeling on the bed pushing my stomach and a third shoving her hand up inside of me to see how bad things were it was agony they didn't have time to ask my permission they thought I was dying. I was begging them to stop as my bruised and swollen vagina was in agony but I am glad the did this as my blood was running on the floor and there was a pool around the bed and the doctor also said sorry she had no choice but I would thank her later. I am 22 years old and incontinent and 18months on I am unable to have sexual intercourse because of the damage done.

    However I am also a rape victim I was raped the Man ripped my hair out while he was raping me my face was all swollen where he stamped on my face I could not even see as my eyes were completely closed my vagina was bleeding everywhere and so were my breasts as he repeatedly bit and tore flesh from them I was 13. After he finished he urinated over me and by this point I was barely conscious and could no longer feel anything I lay for what seemed like ages (though it could not have been that long) terrified that this would be the last thing that happened to me, but happy to die because it meant it was ended and he had finished. My Father found me and rushed me to hospital. I would rather go through ten bad births than one more day being that scared frightened child.

    I don't think it should be called birth rape, I think it should be called medical abuse ( this does not just happen during labor and I think the term is more suitable I was medically abused during labor sounds to like what is being described) A child told their birth was birth rape must feel absolutely horrible. Sorry if I hurt anyone's feelings with my post although I have to say even other rape victims describing birth as the same as my rape in which I was completely alone with no one trying to help me does upset me a bit. I just wanted to say that I have experienced what many (not all) would call birth rape and rape and the experiences for me were so different that I really could never call my birth a rape for one thing I never gave consent to have sex but when I got pregnant and decided to keep the baby I gave my consent to give birth.

    I got nothing out of being raped I got a baby out of giving birth and while yes medical staff can be cold and callous they do try and do their best to keep everyone alive not to hurt you. They just sometimes forget that you are not just a sack of meat and have feelings or they realize and hurt them because they are impatient or cruel while a rapist is fully aware you have feelings and gets off and eventually ejaculates over the pain he caused you. I fail to see any stories where a medical professional is driving sexual satisfaction from his abuse of position.

  11. In reference to Anonymous who said that these patients were not smart and basically inferred that a patient who did not immediately act when already in pain or labor while being victimized got what they deserved and their only recourse is to try suing...this is exactly what people do with rape. She was asking for it. She was dressed a certain way. She wasn't smart and should have left. She should have valued herself, she should have known her rights...etc, etc.

    Abuse of a woman's sexual organs, in birth or otherwise, against her wishes, is rape. Regardless of whether she is laboring or not.

    I agree that litigation, where feasible and appropriate, should be pursued. But denying women the terminology to call rape rape helps no one. Birth rape is a necessary term and it should disgust and call attention to a very real problem within the industry.

    But continuing to blame the victim and call into question her motives or her education is at best crass, and at worst, abusive.

  12. Anonymous September 17, 2010 1:25 AM - sooooo.. you would consider the woman who was 'just not smart' and got herself 'despoiled' with a phallus not, technically, rape?

    I have seen and counseled women who have experienced birth rape and it is what it is.. semantically, physically, emotionally, it is.

    Jessica, funny thing is, I JUST wrote about this as well: .feel free to visit my post and link back to yours.. I think, combined, there is great information on the validity of this term.

  13. IF YOU ARE TOO IGNORANT TO SAY NO AND EXPRESS YOUR FEELINGS ABOUT THE BIRTH YOU WANT THAN THAT ISN'T THE HOSPITALS FAULT it is yours and it sure as hell isn't rape. You stayed there, you allowed them to do a procedure you did not feel comfortable with. This is why you HAVE to pick a OB/GYN YOU are comfortable with and who you know will help you and work with you to make the right choices. To me this term sounds like another way to blame the doctor for your own inability and fear to stand up for yourself.

  14. This just makes me cry. I am so sorry this has happened to you and that you have witnessed it. It further drives my desire to become a midwife and help honor women through the process of birth. ((hugs))
    And I agree - the word should be used to describe such cases. My mom thought her OB was trying to kill her when he removed her retained placenta after birthing me. He didn't even explain what was happening. She said that was the worst part of child birth.

  15. I feel the term may be correct in certain instances but i feel it may end up being overused as a alternative term for a negative birth experience. i think there is a difference. I think just because an experience is traumatic and against your will does not make it rape. If the doctor is practicing sound medical judgement and ethics with the patients both mother and baby best interests in mind then it is not rape even if they go against the persons will. if they act unethically and do unnecessary procedures out of spite i feel birth rape is appropriate.

  16. I just have to say these doctors are so lucky I was not their patient because they would have paid a nice chunk into my daughters collage fund and I would have taken their licence from them. I also agree it should be called medical abuse. Birth Rape is a little extreme.

  17. Wow, I feel really lucky my birth experiences were fine! My pregnancies, however, were awful with HG and I received some negative treatment from doctors and nurses. It is such a vulnerable time and it is horrible that some people were treated this way!

    I have never experienced it, so maybe I can't say, but I would probably label it "birth assault".

  18. Any Doctor, midwife, nurse, PERSON, who treats women, in laobr or out, or any other person, that way, deserves to be called a rapist. To the Annonymous rape victim who disagrees with the term birth rape, and introduced the term medical abuse... While I see and understand your point, I have to disagree with you. I also need to tell you that both the births you described were HORRIBLE experiences. I read them to my husband, and he said he'd have hit the DR who said anything like that to me, or treated me that way. Maybe you don't have a GOOD birth experience to compare them too. The fact that you have permanent damage is not negated by the wonderful fact of your sweet child... I think children are a sweet blessing, and negate just about every pain in the world, but the abuse being described in this article and the comments is TOO MUCH. A child is still worth it, but I have a question for you... had your horrible rape resulted in a child, would that experience have been worth it? Would a sweet and innocent child, a product of that horrible event, who might even look like your rapist, make everything ok? I doubt it, which is why so many rape victims abort or give up for adoption any children that result from their rapes. (By the way, I would never TELL a child that their birth was a birth rape... duh!) Yes, children are the greastet blessing EVER -- HANDS DOWN!!! -- but abuse and rape are still just that... I have been raped, abused, and molested many times, the first when I was five, and viloent or not, they were all horrible experiences. Fortunately, my birth experiences have been WONDERFUL quiet, non-violent homebirths, nothing to trigger a tramatic response. I thank God for that every day. But I also know the difference between rape (sexual or otherwise, as rape is NOT just sexual, which means a caregiver need not derive sexual pleasure from his rape of a birthing woman for it to be called rape), and abuse (sexual or otherwise). The story that included the (now ex) partner that sat by, even helped the rape, was the saddest. My husband would NEVER allow such a thing. And anyone who believes that ANY of these women got what they asked for, or were to stupid to help themselves... well, walk in their shoes, experience rape yourself, then tell me how you feel...

    Birth rape is not a strong enough term for the stories I have read here today -- ALL of these stories, whether the teller believes they are or not. Rape is a violation of you, emotionally, physically, sexually, mentally, financially (that sales man raped you, dude, I paid half that price...), mentally, etically, ANY WAY... Rape is Rape, a violation of the person, a degredation, a surpression, through the use of power, intellect, sarcasm, force, trickery, ridicule, any means possible... to make that person feel inferior to you. Rape is rape.

    (And I totally agree that all of the SOBs described in this article AND the comments, should have their licenses revoked and should be sued within an inch of their lives, if not taken out back and beaten like an omelet...)

  19. In relation to my earlier comment to miss attitude. Whether or not the motives are sexual the only crime that is charged as rape is to violate someone in a sexual manner this is not violating someone in a sexual manner. It is using your medical power to abuse someones body which is a completely different thing and as I said something that the person choose they choose their hospital to give birth and where and who they trusted to defend their wishes in the labour room.

    Female circumscion is the same as what is described here it is a uneccsary painful precedure forced on young girls to violate their body, it is done for the same reasons described above using power to violate and their body and deface it and in most cases causes more long term damage than any of the negative birth experiences described above. A womens genitals violated to teach her her place by someone in power who she should trust. But it is not called rape it is charged as abuse, GBH and/or assault and that is why they are different surely you see this. Birth assault ewould be more appropriate to what is occuring here.

    Secondly many have said that it has to be a uneccesary medical procedure well unless you have a medical degree and are actually present seeing all the doctor can see then you cannot judge whether a doctors actions were uneccasary or whether he fought he was saving a patients life, yes the acts were done abusively but you cannot say if they were forced without reason. You certainly cannot judge this via second hand hear say. Hope this clears up exactly why what is occuring here IS NOT RAPE but abuse.

  20. Anonymous Sept 17th- It sounds to me like you're the ignorant one. No-one deserves to go through the kind of ordeals women have described above, and anyone unfortunate to have experienced such a trauma should certainly not be blamed for the actions of someone else. It is all to easy to say what should have been different AFTER the event, but I don't feel a labouring woman is always in a position to argue or stick up for herself, and certainly doesn't always get to 'choose' her care provider. Do you also feel rape victims somehow 'asked for it', or encouraged the perpetrator somehow? I agree that not every bad birth experience should be called 'Birth Rape', but there are obviously instances where this is the only term that fits, sadly. I feel women’s bodies and, in particular, their vaginas are as sacrosanct during pregnancy and birth as they are at any other time. Care during birthing should be based solely on the well being and needs of the mother and baby and not upon time constraints or personal needs of caregivers or facility administration. I am appalled and deeply saddened by what I've read, particularly having experienced two beautiful, peaceful births myself with wonderful midwives- the way it can and should be. There is an amazing organisation called AIMS ( which dedicates itself to helping improve the maternity services, but also helping mothers recover and find peace after experiencing traumatic births.

  21. Wow. I have read some pretty horrific things tonight. I am so sorry to all of you who have had what should have been the most beautiful experience of your lives turned into... well, rape. Because I agree, that is exactly what it is.

  22. Wow, this really hits home for me. I remember leaving the hospital with my newborn this past May and thinking that I felt violated in a way I didn't expect to after giving birth. Most of the nurses were uncaring and though my doctor (a resident) tried to be kind, he seemed frustrated after I didn't progress and the vaginal exams seemed to become rougher, more painful. I was told that the pain was just from the way my vagina was shaped--but as they dug for my cervix I felt so humiliated and violated. I look at my small daughter now and wonder what giving birth will be like for her; and though my prize at the end was well worth the suffering, I'm not sure I want to give birth ever again.