In the wake of the #MeToo movement, there is one group of people’s voices that still remain silent: birthing people.
It’s wonderful that more and more women, female-bodied, queer, and trans people are speaking out against the sexual harassment and violence they have endured and continue to experience in our society. It’s wonderful that this information is so public that it is hard, even for the most privileged, to ignore. Sure, we won’t see an immediate end to sexism, male violence, and harassment. But it’s a step in the right direction.
I am concerned, however, about a huge blind-spot that our culture has: birth.
Birth is an intimate, vulnerable, and intensely human experience. UNICEF estimates that about 353,000 babies are born each day around the world. And every day, thousands (or hundreds of thousands) of birthing women experience violence during the births of their children. Birthing people are often coerced, threatened, and violated during their labors, births, or postpartum times. They are separated from their babies, ignored, or forced to experience any number of inhumane acts perpetrated by the patriarchal hospital system.
Obstetric violence is yet another form of sexual violence female-bodied people are consistently experiencing in our society.
There have been many stories coming out in the last 5 years where women or birthing people have reported cases of obstetrical violence. Caroline Malatesta won her lawsuit against the hospital where she gave birth after suffering PTSD and permanent nerve damage when the nurse forcefully held her baby in her vagina while she waited for the doctor to come into the room. “Kelly” sued her obstetrician for assault and battery after he conducted a multiple-cut episiotomy even though she explicitly sad “no.” Doulas report a “hidden epidemic” of doctors abusing women in labor.
However, there are still millions of cases globally where the rights of birthing people are ignored, where their genitals are touched or cut without their consent, or their bodies are used in ways they explicitly refused. It is not uncommon to see doctors forcefully conduct vaginal exams on women during labor, even while they explicitly tell them to stop, for no medical reason whatsoever. This is, by definition, rape.
Especially for immigrants, people of color, and poor folks, these stories all too often go unsaid and/or unheard. It takes privilege to stand up and say that one has suffered sexual harassment, abuse, and rape. With every story told with the #metoo hashtag, thousands of stories go unheard by women around the world who are not able to tell their stories for fears of greater violence or disenfranchisement. With every story about obstetrical violence we hear, thousands of other stories go unheard, getting internalized in women’s bodies and passed on to future generations.
My partner’s mother was raped when she went to her doctor for a routine prenatal checkup. She stopped going to that doctor, but she didn’t report him to the hospital because of the race and class dynamics that made her feel (rightly so) that the institution wouldn’t listen to her.
My grandmother, who survived the Auschwitz concentration camp when she was 15 years old, is more willing to talk about the horrible atrocities she suffered during the Holocaust than she is about her first birth experience in a hospital in Brooklyn, New York, in 1962. The experience of being strapped to a bed, verbally abused, and locked in a room alone during the birth of her first child was, for her, torture. She was then separated from her baby for a week and discouraged from breastfeeding. Subconsciously, she never forgave my aunt for having to live through that experience, and it continues to affect their relationship 56 years later.
There are some wonderful obstetricians in this world. Many male, female, queer and trans doctors advocate strongly for patient rights and autonomy and provide excellent, respectful, and compassionate care to their birthing patients. Unfortunately, these doctors are not the norm. They have managed to hang on to their sense of humanity through their journeys through medical school and their participation in the Western Medical System.
It’s not that doctors are bad people. The vast majority of doctors have good intentions, and want to take care of their patients as best they can. But they work in a system that does not prioritize consent, that positions their patients as less knowledgeable about their own bodies than they are, and that sets up a power dynamic where doctors can exploit their knowledge to get inappropriate access to their patient’s bodies.
Did you know that James Marion Sims, known as “the father of modern gynecology,” conducted experiments on female slaves, without their consent and without anesthesia? Did you know that medical students are sometimes taught to perform pelvic exams on anesthetized women, without their knowledge or consent? And that this is only illegal in four states? The Western Medical System has an abominable track record for prioritizing consent.
We need to start connecting the dots between the sexism, the violence of the patriarchy, and the Western Medical System. We need to start calling obstetric violence what it is.
Just as men who are true allies to women need to be actively engaging with other men to end rape culture, so must obstetricians, doctors, and other influential members of the Western Medical System band together to stop obstetric violence. Just as men need to stop thinking that they deserve control over female bodies, doctors need to stop thinking that they know better than their patients, and that they can do anything they want to their bodies under the guise of practicing medicine.
The midwifery model of care offers a much-needed alternative to Western obstetrics. Midwifery, a century-old craft, means “with woman,” and it does exactly that. The midwifery model of care prioritizes holistic female well-being (along with caring for the safety of the fetus/newborn). It is not only about keeping the birth safe. It is about keeping the birthing person feeling safe, which is an important part of protecting the physiological process of birth.
Just as cis- and trans- women in our modern society need advocates leading us to a world where we are not vulnerable to gender-based violence, birth needs midwives and other birth advocates to be a voice for the truth.
The health and healing of humanity depends on us changing the way we see birth in our society.
After all, we are ALL born. If mothers feel unsafe, violated, or abused during births, their newborn babies will store those experiences in their nervous systems. Medical research agrees: birth affects us in deep, lasting, and powerful ways. Whether we are born through a cesarean section, vaginally in a hospital with an epidural, or at a homebirth, our birth experiences affect us for the rest of our lives.
Tarana Burke, the founder of the #MeToo movement, said, "I see all these people who are interested in this issue. Sexual violence is deeply pervasive and touches everyone across race, class, gender and ability and we have to find a way to move the needle." Similarly, obstetric violence affects women and birthing people across race, class, gender, and ability. While every woman is vulnerable to obstetric violence, we are not all affected equality. Because of racism, women and babies of color are more vulnerable to the horrors of obstetric violence. In the United States, black women are dying in childbirth three to four times as often as white women, and Latina women die twice as often as white women. Black babies are more than twice as likely as white babies to be born prematurely.
We need more midwives, especially midwives of color, caring for more birthing people in this country. We need more women and birthing people to know what their options are around giving birth. We need our society to provide empowering images of birth to everybody, especially young people. We need people to know how mighty the female body is- that it can grow a life, and birth it into this world, with power and grace. When we are empowered to have our children in this way, we will birth a new generation that understands consent, body autonomy, and true empowerment. And that’s exactly what our world needs.
Let’s build on the momentum the #MeToo movement has built and end obstetric violence. Let’s make birth the safe, empowering, and connected event it should be. #BirthMatters.
Marea Goodman is a licensed midwife living in the California Bay Area. She is passionate about the liberatory power of birth and sees it as a key feminist issue. Marea believes that if we can change the way this society views birth, that it will have a key and lasting effect on the health and healing of future generations.