Amity responds on birth rape

Amity Reed has written a response to comments on her birth rape feature for The F-Word, made by an NHS doctor blogging under the name ‘Dr Crippen’. You may want to read this post for background

Having just emerged from yet another luxury shopping trip between school runs and coffee shop natters with my other part-time feminist friends (Ha! I am a full-time feminist and an at-home mother struggling to put food on the table many weeks, thank you), I was not at all surprised to read this scathing dismissal of medical and birth rape victims. The author’s characterisation of these women as fantasists, delusional and hysterical females with ridiculous expectations of bodily autonomy, was resignedly expected. Dr. Crippen exhibits the very lack of empathy that Debs and I dissected by dismissing these stories outright. In a move straight from the misogynist medical handbook – make them feel stupid and reinforce knowledge over personal experience – he follows the checklist to a T:

Refusal to acknowledge the patient’s experience? Check. Outright discounting of her interpretation of events? Check. Use of words such as ‘sophisticated’ and ‘high level of skill’ to reinforce authority? Claims of patient ignorance and ‘exaggeration of facts’ when he was not even present for the event? Yep, it’s all there, in all its ugly and hateful glory. This is exactly the kind of arrogant attitude that creates a chasm between those with a skilful and sympathetic bedside manner and those whose emotional detachment can lead to patient violation. Taking the human aspect out of patient care isn’t the practice of medicine; it is the following of protocol and technical training. Is this what was intended when the Hippocratic Oath, undertaken by all doctors, was written to say:

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing…If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

Respect is a two-way street. When medical professionals start disrespecting their patients’ wishes, how can they be surprised to discover that, in the process, they have lost the trust of those they are meant to help and heal? Doctors of the world, wake up and smell the revolution: being an MD (or a midwife or a surgeon or a nurse) doesn’t mean you get to play God, nor does it entitle you to make decisions on behalf of your patients in the guise of protecting them from themselves. As much esteem and power as you think your title automatically gives you, I and many others still think that you have to earn it. And that means listening, respecting, advising and learning to back off, even if it goes against your instincts and training. We still have the right to say no, even if your answer would be yes.

To specifically address Dr. Crippen’s comments about my article on birth rape, I would suggest he read more carefully my words. I never intimated nor stated that all obstetric intervention or even that all traumatic births are rape. I am fully aware that sometimes intervention is warranted and wanted. I am grateful for those interventions. I am aware that plenty of women experience traumatic births where no assault is involved. An unnecessary or botched c-section, pressure to have or not have pain relief, an early induction…the ethics of these things is questionable, indeed, and anger many people. If a woman reluctantly consents to these procedures under duress and later feels duped, tricked or unfairly intimidated into compliance, she will undoubtedly term her experience as traumatic, rightly so. Maternity care in the UK, and elsewhere in the so-called developed world, is in crisis and the conveyor belt of convenience that women are being hauled down in the ill-fated quest for perfect, controlled outcomes is damaging not only to women’s bodies but their psyches and well-being, not to mention what it’s doing to mortality rates for babies. However, this is not the rape of which I speak.

Let me say it again: birth rape is when a procedure or exam is carried out in which a body part or object (such as a hand, finger, suction cup, foetal monitor, episiotomy scissors, forceps, drug or needle) is inserted into a woman’s vagina without her consent and often after she has specifically declined interference. Holding a woman’s legs open to perform a vaginal exam while she screams “No!” is not and never will be okay. Putting something into her vagina ‘for her own good’ is assault, plain and simple, and no less abhorrent than the man who forces his penis into a woman because he feels it is his right to. Just lay back and let the people in charge do their important work, right? It will all be over in a minute, right? Wrong. The scars these women bear will last much longer than those inflicted on their bodies.

Practicing midwife and blogger Navelgazing Midwife talks candidly and openly about how her training led her to do horrible things to women in the name of convenience or gaining experience. By her own admission, she has been the perpetrator of birth rape. She recognises this and deeply regrets it. If she can acknowledge the harm being done in her profession and work to rectify that, why can’t others? She is a fine example of the saying “Doctors (in this case, midwives) are human, too,” which is to say that they make mistakes and let their personal prejudices, opinions and goals cloud their judgment. Of course they do. No one expects them to be perfect. But refusing to take a long, hard look in the mirror, own up to these errors and look for solutions, even after hearing pleas from those whose care is entrusted to them, is decidedly inhumane.

Dr. Crippen’s attempt to portray birth rape victims only as previously assaulted women who are transferring that abuse onto their birth experiences and unfairly blaming those who attended them is ludicrous and ill-founded. If anything, the anecdote from the woman who says that her birth experience brought back memories of the rape she endured at age 14 is evidence that something is desperately wrong with how childbirth is being managed. Though I do not assert that her story is one of birth rape, the woman quoted says:

I had an epidural (against my wishes) during transition. When being on my back and numb from the waist down it gave me flashbacks to the rape…I had no anger towards the doctor, only myself. Of course I was angry towards the perpetrator who raped me as a teenager but I just didn’t expect it to come flooding back to me when giving birth. I had no control over this. It just happened. Completely out of the blue.

So she had an epidural against her wishes, given under the orders of her doctor, which numbed her into submission. This reminded her of her rape because she was powerless, which led her to become angry with herself. Let me repeat that — angry with herself. She may think that anger was completely out of the blue, but it is very clear to me that by numbing her, her doctor was implicitly silencing her. There is nothing random about that. It may not have been rape but why, then, does it feel like it to her? What does it say about obstetrics and gynaecology that so many women, even in instances where rape was not actually perpetrated by the medical professional, end up feeling shamed, angry and/or violated? That they lack the terminology or are unable to put a finger on what went wrong or made them feel that way does not mean that medical abuse does not exist.

For too long, women have been treated as the sum of their parts. Even where we have made strides socially, when it comes to the physical we are still treated as the property of a patriarchal system that cannot and will not give us the deeds to ourselves. Sexually and reproductively, we are under the thumb and at the mercy of men. Pregnancy and birth in particular continue to be issues that those in power seem determined to hold onto, perhaps because they are exclusively women’s realm. And as we know, people in power often fear the unknown. There is nothing more loathe to some than that which they have little part in and which they will never be able to fully understand.

So when I, as a feminist, see abuses happening, I stop prettying it up and start calling it what it is – Assault. Rape. Injustice. Because I don’t care who it makes uncomfortable or whose delicate sensibilities it offends, only how it challenges their thinking and, hopefully, in turn, their behaviour.

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