International Women's Day

Today is International Women's Day! Yesterday, I watched Eve Ensler speak about "the girl cell" on YouTube. It contains some very disturbing content about rape and abuse and war violence against women in other countries. I also happened to read the following quote in The Birth Project book I am currently reading: "...if Beth or I recounted the facts of birth conditions in this or that country, we would be silenced by someone recounting her 'wonderful' home birth experience, as if her personal good fortune somehow overshadowed the larger political, social, and medical implications of what we had learned about the rest of the world." These two experiences made me think about the larger world of women and the many forms of violence they may experience in their lives (I've mentioned here several times that my pre-childbearing past was spent working in domestic violence shelters). It also made me think, however, that we cannot discount or ignore the violence women may experience in the birthplace in the U.S. Though it may not be as horrific and degrading and violating as some other experiences or as the experiences of women living in war-torn countries, it still is an important issue worthy of concern. It is also an issue that I see nothing about on the International Women's Day website, which I find interesting. There is a lot of excellent information on the site--but nothing that I can find about international birth issues.

Last year, I wrote an article about Birth Violence for their website, but it appears to have never been published. So, I decided to post it here in honor of this year's International Women's Day.

Birth Violence
by Molly Remer

"'Old wives' tales,' says the Oxford dictionary, are 'trivial stories, such as are told by garrulous old women.' It is significant that no one ever talks about 'old husbands' tales' or 'old doctors' tales.' Women are blamed instead. It is implied that there is poison in their speech and that the only safe thing to do is remain silent. The experiences that women share with other women are thus rejected and trivialized...In reality, it is not other women who instill and fuel anxiety in most pregnant women, but the medical system itself." This quote from the 1980’s book, Giving Birth, by Sheila Kitzinger, remains strikingly relevant today. When women in the United States today enter the hospital to give birth, many experience some form of institutional violence. They may not explicitly define it as violence, but listening to their stories provides a disheartening picture of maternity care today.

What kinds of violence occur in the birth place? Here are a few possible examples of “normative abuse” women may experience when giving birth in U.S. hospital setting

• Restriction of movement
• Restriction of nourishment
• Domination by those in positions of authority—must obey even when it is against her own best interests.
• Routine, forced interventions such as IVs
• Repeated, possibly painful, vaginal examinations by many different people
• Denial of option for VBAC (vaginal birth after cesarean)
• At the most extreme example of overriding patient rights, a forced cesarean section
• Vaginal cutting (episiotomy)
• Abusive language
• Separation from family/restriction of companionship
• Lack of respectful treatment
• Voice and wishes disregarded/unheard
• Emotional manipulation using baby as a “card” to force compliance (“you want a healthy baby don’t you?” No mother doesn’t. It is degrading and dehumanizing to suggest that she doesn’t.)
• Forced separation of mother and baby
• Administration of medications without consent
• Cord traction and interference with third stage (placenta) that may lead to hemorrhage.

The emotional treatment of women in labor is the most significant factor contributing to their satisfaction with their birth experiences (emotional factors of highest importance include having good support from caregivers and being treated with respect). According to Kitzinger, "We are only now discovering the long-term destructive effect on human beings and families of treating women as if they were merely containers, to be opened and relieved of their contents; and of concentrating attention on a bag of muscle and a birth canal, rather than relating to, and caring for, the person to whom they belong. The violence which is a common element in childbirth today leaves many women feeling that birth has been a kind of rape. This sort of experience is not easily forgotten. It can shatter a woman's self-confidence, make her doubt her ability to mother her baby, destroy joy in the expression of her sexuality, and attack her very sense of self--the roots of her identity. It is psychologically mutilating."

And, as Mary Rucklos Hampton says, "The effort to separate the physical experience of childbirth from the mental, emotional, and spiritual aspects of this event has served to disempower and violate women."

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Molly Remer, MSW, ICCE is a certified childbirth educator and activist who blogs about birth at http://talkbirth.wordpress.com and midwifery at http://cfmidwifery.blogspot.com.