The Normalization of Obstetric Abuse

As I traveled through a healing journey this past year to recognize toxic family patterns and generational wounds, I was pleased to see the awareness that not all abuse is physical nor is it always blatantly obvious. Articles and social media gurus brought topics like emotional manipulation, gaslighting, and narcissistic behavior into mainstream conversation.

As discussions occurred about toxic relationships, codependency, and dysfunctional patterns, I noticed there is one type of abuse that is not only excused in our society, it's expected.

Cristen Pascucci of Birth Monopoly labels this abuse as

obstetric violence


Obstetric violence is normalized mistreatment of women and birthing people in the childbirth setting. It is an attempt to control a woman’s body and decisions, violating her autonomy and dignity.

Most of us in the birth world are familiar with these horrible stories. Stories of providers sweeping a woman's membranes without consent or of an obstetrician performing an episiotomy as the patient screams at him not to. These violent stories are traumatic and abhorrent, but just as physical abuse isn't the only abuse that exists in relationships, there are other types of abuses in birth that are more subtle and maybe not even physical at all.

The most prevalent type of abuse I witness in birth is often not loud, or violent, or blantant at all. It is subtle and emotionally manipulative, which makes it all the more insidious and dangerous.

In fact, many of these manipulative providers are well-liked. They seem kind, friendly, with a jolly bedside manner, but these snakes in the grass can derail your birth plan slyly all the while making you believe it is your idea and for the best simply by the language they use.

These sneaky providers start planting seeds of doubt starting at your first appointment maybe by telling you that your pelvis seems small or your pelvic arch is narrow. Subsequent appointments bring comments about baby's "large" size. Starting in the 9th month, the provider may comment about little dilation or effacement after subjecting you to pointless cervical checks. Ultimately, when the provider brings up unnecessary interventions you never wanted, you relent because you were groomed to trust him/her and now are filled with so much doubt about your body's ability to birth your baby.

Unfortunately, such gaslighting tactics have worked to manipulate our entire society and has shaped the cultural misconceptions and fear surrounding birth leaving us with family members, and even other women who perpetuate the abuse. Gaslighting is a form of emotional abuse that causes victims to question their own feelings, instincts, memory, and perception. Society not only perpetuates the gaslighting pushed by OBs and MEDwives, they also engage in a large amount of victim blaming, telling the pregnant mama that this abuse is necessary because the "experts" know more than her so she should just be quiet and do what they say.

Provider/patient abuse isn't the only dysfunctional behavior in the birth world. Birthworkers also have to deal with a toxic phenomenon known as lateral violence from other birthworkers. Traditional midwives are targeted by MEDwives. Doulas who support autonomy and physiological birth are ridiculed by doulas trained with a medicalized birth mentality. Instead of attacking the patriarchal, medicalized system, these birthworkers almost seem to be suffering from a form of Stockholm Syndrome and side with the abusers.

Fighting this abusive system can seem like an uphill battle when we have so much against us-a society that condones birth trauma, providers who attack birthworkers trying to change the system, the media who vilifies physiological birth and pushes the medicalized, patriarchal system, but we can't lose heart. We as consumers have the the power to stop supporting this abusive system with our dollars. As birthworkers, we have the opportunity to educate and inform about normal, respectful care. We have to do the hard work now so we can make things better for the future of birth.

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