Monday, April 9, 2012

A midwife's perspective of birth rape

I try not to get riled up here but I have just read a post written by Sarrah Le Marquand (a journalist for the Daily Telegraph in Australia)  at the end of last week, about homebirth that has quite distressed me.

Sarrah's views on homebirth
In her post "Cancel those dolphins and consider your baby’s health" Sarrah critiques the reasons that women choose homebirth. In particular, she pours scorn on the women who choose homebirth because they feel safer there than they do in hospital. Sarrah does not believe there is any such thing as "birth rape" and clearly feels that women should open their legs and be grateful for whatever is done to them. She says women choose home birth because of "self-indulgence arising out of narcissism." She also says that people who talk about birth rape display "a disturbing lack of empathy for victims of genuine rape in the true sense of the word."

Homebirth and informed choice
I don't want to go into the pros and cons of homebirth here. I do believe it should be an option for women, when they have all the information to make an informed choice. I also believe that planned homebirth is a safe option for women who have no risk factors and are attended by skilled midwives.

Is there such a thing as birth rape?
What has upset me so much about Sarrah's article is her lack of knowledge, and insensitivity with regard to birth rape. Whilst the term "birth rape" is a controversial one, obstetric violence has been recognised in some countries as a legal offence. Sarrah says "the chief objective of the birth itself isn't to have a good time - it's to maximise the health and safety of a mother and her newborn child", yet she clearly has not talked to women who suffer post-traumatic stress disorder following birth.....these women are not healthy, and certainly have not, nor do they feel safe.

Scared to death
I have been a midwife for nearly 30 years. I am afraid to admit that I have seen women who have been subjected to very personal and intimate procedures without full information - indeed, in some cases, no information at all. I remember like it were yesterday, a young woman held down by a group of midwives as a doctor carried out a vaginal examination against her will. If that isn't rape, then I don't know what is!

I have seen women having procedures despite clearly saying that they did not want them. I have heard women beg midwives and doctors to stop doing something, yet they didn't. I shall never forget being nearly hit by a very elderly woman who was still living with very distressing memories of the midwife who delivered her baby 40 odd years ago. I have talked to women who have been so traumatised by birth that they have dreaded having another baby. You may say...that doesn't happen now....but you'd be wrong. I spent all last year listening to student midwives who told me similar stories.

Yes...some of these women choose home birth. They don't make that choice because they are selfish or egotistical...they make that choice because they are scared to death of what will happen to them if they go into hospital!

My feeling is that rather than writing in-sensitive rants that are uninformed and inaccurate, Sarrah would be better off focusing on ensuring that all women are treated with respect and decency by medical and midwifery staff. Maybe then she would find that women are quicker to choose to give birth in hospital.

For a balanced response to Sarrah's article, have a read of "Some home truths on a woman's right to choose" by Michelle Meares.


Anna Hughes said...

Nice Sarah. Thanks for sharing your experiences that back up how wrong this woman is. I have to admit that I birthed at home because I did not trust that I would be respected and listened to in the hospital. When I had to go there after the birth of our first child. My fears were confirmed. I was not listened too and was badgered until I gave in to the wishes of the registrar paediatrician who gave me two false bits of information in order to convince me to do what she wanted. I am a strong person as you know and I gave in. Thanks to the skill and level-headedness of my homebirth midwives I have a live first child today!

Sarah Stewart said...

Hello Anna, thanks for your comments. I didn't want to get into hospital or doctor bashing, but I am very concerned that the stories of women who are traumatised in hospital are heard. You've only got to scroll through the internet to read about the most appalling things that are done to women...and I have been hearing about them since writing this post. My point is...women want the best for their babies and for themselves. If you want 100% hospital births, you have got to address the issues that are barriers to women birthing in hospital. Sarrah's post was far too simplistic and did not address issues in a balanced way.

Anonymous said...

I have to say that I wanted a home birth because of my own fears of the hospital. First off, my epidural didn't quite work, and I was poked and prodded without permission many times, and my only reason as to why I didn't say a thing was the amount of drugs in my body and fatigue. My daughter's heart rate dropped below 60, and they did an emergency C Section, which I opted to be asleep for. After the birth, I had lovely time with my little girl, until one day, she went for a test, and they brought back the wrong baby. she asked me to confirm my tags with the baby, and she told me it wasn't mine, and left. That was traumatizing. Not to mention the women who handled my baby roughly. I'll never know how abusive they were to my baby without my careful eye watching.

Sarah Stewart said...

I am sorry to hear that you had such a sad time. It goes without saying that a lot of women have very positive hospitals birth experiences (myself included). What I object to is women having their choice taken away from them, and being abused when they do decide to birth at home.

Linda Stegeman said...

Hi. I am a Kiwi midwife who has been working in Oz for 18 months. In NZ there is no reason for midwives to be involved in not sharing information with women and supporting their choice. In Australia the system is very different and the same as before the LMC model commenced in NZ. The big problem is the difference between the medical model of care and women centred care and the ability and willingness for the health care professionals to understand the difference. Not all midwives offer women centred care (unfortunately) and not all doctors offer the medical model. I am aghast at the medical intervention that I see every day at work. It's like an avalanche and I am not sure whether it is possible to turn the tide back. I know how well continuity of carer works because I worked this way for 15 years. Great outcomes and mostly happy women. I have been waiting for women to become litigious and start fighting the intervention but they need to start becoming strong before it gets to that stage and asking for good information and choices. It would appear that only 21% of women in Australia make it through labour without an induction or augmentation of labour. That is horrendous. How can we pull back? Who knows?

Sarah Stewart said...

Good questions, Linda...and I'm not sure to go about it either. What is worrying is some research that is coming out now, that shows New Zealand women are feeling they are not getting the information they need to make informed choices about their care...this is a concern considering that 80% plus women in New Zealand have midwife LMCs.

Anonymous said...

Hi Anna, I was comforted to see your words, it is so nice to know it isn't just me. I told the doctor I did not want my waters breaking. I said NO. It was not an emergency - the choice she gave me was break your waters in 6 hours or now. I said no. She said she was just checking my cervix, then she hooked me inside with a white hook and forced them to break. I had told her no but she did it anyway. It was over 7 weeks ago and I still can't forget it. My partner saw and he likened it to seeing me being sexually assualted. He still can't believe that it happened. It forced me into labour when I was not in labour (at 39 wks preeclapsia but not emergency - urates normal BP up and down) After this happened I left my body through the whole thing, Sounds odd I know! It ended up with the first epidural failing, my daughter's heart nearly stopping and her being torn out of me by forceps, as she lay on my chest I thought I was bleeding to death as they did not tell me what was happening, swabs full of blood on the floor, I thought I had been shredded. I still don't think she is mine. I have experienced many branches of medicine as a professional and a patient, obstetrics is the only one where doctors get away with ignoring consent procedures, I mean basic stuff like No means No. I wish I could turn back time and stayed away from the hospital, or never got pregnant at all, because now I can't even do simple stuff like go shopping for food without having flashbacks, people just do not understand. I am normally a strong person, don't take any nonsense usually - I still don't know how obstetrics managed to "break" me.

Sarah Stewart said...

Dear Anonymous, it breaks my heart to read your story. If you haven;t done so already, please go and get some help...from a counselor or such like. Do take care of yourself and that beautiful family you have. Sarah

Kristen said...

Hi Sarah, I am a Women's Studies student writing my undergrad thesis on birth rape. The topic is completely unrepresented in the literature I have found. Do you know of any academic works on it? Also, THANK YOU from the bottom of my heart for writing about why you, as a medical professional, believe birth rape is real. In the US, where I'm from, it's difficult to even find a midwife that's willing to talk about these issues. As an "emergency" c-section mother, I am so motivated to see birth rape stop & to have women's experiences and emotions validated. Again, thanks for your post.

Sarah Stewart said...

Hi Kristen, I haven't really looked into this issue in any depth so don't have any references to hand. My best advice is to have a look at the Facebook page - Human rights in childbirth -

and take it from there.

cheers Sarah