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?
