WTF--emotional and physical abuse of women during childbirth

Roxxsmom

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I don't know why this surprises me, actually. What really surprises me is that no one seems to have studied or investigated this before. Laboring women are often slapped, pinched, shamed, yelled at, and mocked. they are often subjected to invasive exams and procedures without being informed or giving consent.

And while many of the incidents are occurring in places where health care providers are under-equipped and overwhelmed, the issue isn't limited to poorer countries.

"It was a very real problem everywhere, but it was difficult to compare findings," she (the study author) says.

The new Lancet study addresses helps bring consistency to the measurement of abuse of pregnant women.

"This study looked at maltreatment across four different countries using two different measurement techniques – and even so came up with consistent findings that more than a third of women experience some sort of maltreatment," says Moyer. "These results put to rest assertions that maltreatment is rare, that it is too hard to measure or that it varies widely."

The new study confirmed that poor women and young women were at greatest risk of abuse.

Teen mothers often get treated poorly when they need support and compassion.

Health-care workers might not hesitate to mock a teen mother, for example, when she cries out during labor.

https://www.npr.org/sections/goatsa...ping-and-yelling-at-mothers-during-childbirth
 

Brightdreamer

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Not surprising, unfortunately.

Mom's obstetrician was a "sadist" - her words - and that was in the 70's. And IIRC, it's been a persistent Thing for medicine to disregard women's concerns or pain; with nothing being more inherently feminine than childbirth, perhaps no time when a patient is more vulnerable, it stands to reason that this inherent misogyny would come to a peak in the delivery room.
 

frimble3

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I doubt this is something new.
I'd bet back in the day, when midwives were all there was, there were also unsympathetic, unkind women doing that work, because, hey, someone had to do it.
I'd bet that cries of "Push harder, you lazy b-----!" ring down through history, as well as "Stop whining about a little pain!"
And, there have always been families who are more interested in getting the baby than the mother's health.

It's just that now, there are more witnesses, and more ways to inflict pain.
 

ElaineA

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I'd bet that cries of "Push harder, you lazy b-----!" ring down through history, as well as "Stop whining about a little pain!"

Or the *most* common one, at least in the Christian world: "This pain serves as a universal reminder of God’s judgment for the sin Eve brought into the world."
 

Kaiser-Kun

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Back during my wife's first pregnancy she went to a young, big shot gynecologist for a check-up. The bastard smugly drove her to panic by telling her about how Mexican women were filthy and promiscuous and most of them developed infections that never happened in the civilized world. Then he gave her a very painful examination.


Then I went there a couple of hours later and punched him right off his chair. The receptionist made zero effort to stop me from leaving and I heard her telling him he had it coming a long time ago.
 

kikazaru

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I usually don't condone violence, but good for you Kaiser-Kun.

I am in a fairly small city and there are no dedicated gynecologists - just gp's. One doctor came from a country where misogyny is the norm and he rarely gave women medication for pain (and not just for childbirth) because according to him women don't feel pain as much as men do. This was told by the nurses who worked with him (my mother among them) and people I knew who were his patients. And since doctors are apparently gods, he worked up until the late 90's with impunity.
 

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Had to fire my OB halfway through my pregnancy (late 2003) for fearmongering. I was lucky; both our insurance and the area we lived in gave us the opportunity to find a different caregiver.

My mother was doped into insensibility when she had my brother. When she was in labor with me, she asked them to please not drug her. They said "Okay, we won't" and drugged her anyway. She remembers more of my birth, but not much.

No matter where you live, it's rare to find a woman who went through pregnancy and childbirth without being infantilized and lied to.
 

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A woman I worked with (Latina) said the nurse slapped her while she was in labor and demanded she speak English. She was a young mom newly immigrated. Her English is perfect now.

A friend is a doula and said several doctors and nurses tried pressuring a 16 year old to get sterilized. They were very rude and condescending to her. My friend stepped in and told her she didn't have to do anything she wasn't comfortable with and that just because she was a teen mom it wasn't the end of the world and that one day she might marry and decide to have more kids. She grabbed my friend hand and thanked her so much.

This is why it's important to have people in the hospital with you advocating on your behalf.
 
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Roxxsmom

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My mom remembers how awful giving birth was in the 60s--even in a major hospital (in Boston) noted for its Ob program. She wasn't informed about what was being done to her, let alone asked to give consent, and subjected to painful and humiliating internal exams, shaving (maybe not a big deal to many modern women but it wasn't at all the thing back then), enemas, being forced to push "uphill" with feet pointing skyward in stirrups. All this was much more for the doctor's comfort than the patient's.

In the US, a more patient-centered approach gained popularity after the early 70s, at least for those with access to state-of-the-art healthcare. Not that we are at the cutting edge when it comes to quality of maternal care.

In poorer countries, there's been more of an emphasis on reducing maternal and fetal mortality. Still, slapping a woman for not having her thighs open wide enough or for not pushing hard enough?

There is a thing called compassion fatigue. It happens to people who work in various caring professions--teaching, medicine, counseling, working with animals--who are overworked without adequate support. There' a process of mental triage one goes through when one has finite time and emotional resources and near-infinite demands on these things. That's inevitable, but it's also not uncommon for people in these professions to become cynical, or even to start resenting their clients/students/patients etc.

Sadly, this seems to be more and more the norm for people in almost all care giving professions these days. Everything is so profit driven, but even when a service is government provided, there's an endless emphasis on doing everything as cheaply as possible.
 
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frimble3

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Back during my wife's first pregnancy she went to a young, big shot gynecologist for a check-up. The bastard smugly drove her to panic by telling her about how Mexican women were filthy and promiscuous and most of them developed infections that never happened in the civilized world. Then he gave her a very painful examination.


Then I went there a couple of hours later and punched him right off his chair. The receptionist made zero effort to stop me from leaving and I heard her telling him he had it coming a long time ago.
Thank you, Kaiser-Kun, for striking a blow for women everywhere! Reasoned arguments are a good thing, but with some people a good punch is faster and more effective. Apparently, his receptionist agreed.
 

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Where my wife gave birth in June of last year was considered one of the top 5 hospitals for maternity in the country, and her treatment there was TERRIBLE! When they checked her dilation using theie fingers, she would be in agony, and a nurse said very mockingly to her, "How are you going to give birth if just a little check like that hurts??" It turned out that she was not dilating because the cord was wrapped three times around our son's neck, so she had to have a C-section.

The way the staff was treating her pain, you'd think no one in the world had ever experienced similar issues as my wife. They were either the most poorly trained staff or totally incapable of thinking.
 
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Roxxsmom

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I've run into thoughtless health care providers outside of OB too. I don't know if it's worse for women overall than men for other health issues. It's certainly the case that women's health concerns and symptoms are often dismissed, and the fact that they feel certain kinds of pain more frequently, and may perceive at least some pain types differently, and often more intensely, than men is downplayed. In fact, women's pain is taken less seriously overall, and I understand black patients pain is generally taken less seriously than white patients'.

But women giving birth seem to be especially vulnerable. Maybe it's because of all the value judgments surrounding pregnancy and childbearing in general, and because it's something all women are "supposed" to experience or something. And it seems to me that pregnant women lose their personhood or individuality in a way. It's always seemed to me they become "pregnant ladies" and the focus is more on the process of gestation and birth, with the focus on the production of a baby, than on the woman as an individual with individual quirks, needs, or desires.
 

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But women giving birth seem to be especially vulnerable. Maybe it's because of all the value judgments surrounding pregnancy and childbearing in general, and because it's something all women are "supposed" to experience or something. And it seems to me that pregnant women lose their personhood or individuality in a way. It's always seemed to me they become "pregnant ladies" and the focus is more on the process of gestation and birth, with the focus on the production of a baby, than on the woman as an individual with individual quirks, needs, or desires.

That's it in a nutshell: that the woman is the essentially-disposable wrapper for a fetus. It's an attitude personified in the anti-choice movement (that would rather see a woman die of a nonviable ectopic pregnancy than be saved), but rooted in fundamentalism, misogyny, ignorance, and all sorts of tangled societal and economic crud that still dominates our world, apparently...
 

regdog

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Cheers to you, Kaiser.


My paternal aunt was a big baby, her mother was a very small woman. She was having a terrible time trying to delivery my aunt and after hours of laboring the doctor said to the nurses, "Forget it, just leave them, they're both going to die anyway." They all walked out of the delivery room and left my grandmother and unborn aunt to die. My grandmother was wide awake and had been given no pain medicine so she was aware of everything.

The doctor told my grandfather, he panicked and went all over the hospital to find another doctor to deliver my aunt. He found one. It took a long time but he was able to get my aunt delivered. My aunt was in dire distress and again they wanted to leave her to die, but the doctor tried a blood transfusion from my grandfather and it worked. Both survived.
 

lizmonster

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That's it in a nutshell: that the woman is the essentially-disposable wrapper for a fetus. It's an attitude personified in the anti-choice movement (that would rather see a woman die of a nonviable ectopic pregnancy than be saved), but rooted in fundamentalism, misogyny, ignorance, and all sorts of tangled societal and economic crud that still dominates our world, apparently...

I think this is a bit of an oversimplification. The veneration of the fetus, especially by evangelicals, is a fairly recent phenomenon; the devaluation of women isn't. It's impossible to generalize globally, but we're not a species that has a problem reproducing, so it makes a weird sort of sociopathic sense that the individuals involved in the act of childbirth might get a bit elided.

The history of childbirth and childbirth care is absolutely bound up in patriarchy and power, but I suspect that has more to do with cis men feeling left out of something important. The present state of social structures around the world always makes me feel like they're kind of annoyed childbearing people are actually something they need, and they'd prefer to remove as much autonomy as possible.
 

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I've run into thoughtless health care providers outside of OB too. I don't know if it's worse for women overall than men for other health issues. It's certainly the case that women's health concerns and symptoms are often dismissed, and the fact that they feel certain kinds of pain more frequently, and may perceive at least some pain types differently, and often more intensely, than men is downplayed. In fact, women's pain is taken less seriously overall, and I understand black patients pain is generally taken less seriously than white patients'.

But women giving birth seem to be especially vulnerable. Maybe it's because of all the value judgments surrounding pregnancy and childbearing in general, and because it's something all women are "supposed" to experience or something. And it seems to me that pregnant women lose their personhood or individuality in a way. It's always seemed to me they become "pregnant ladies" and the focus is more on the process of gestation and birth, with the focus on the production of a baby, than on the woman as an individual with individual quirks, needs, or desires.
This dialogue is so important. I realized when Serena (world famous and worth MILLIONS) stated she was ignored after telling the medical professionals something wasn't right after giving birth then the regular patient doesn't stand a chance. Luckily she persisted and was helped.

A new Vogue profile of Serena Williams sheds light not only on the health risks that can come with childbirth, but also how those factors — coupled with racial bias in the medical field — can have dangerous, even life-threatening results for black women.
In Vogue’s February cover story, Williams recalls dealing with serious complications shortly after the recent birth of her daughter, Alexis Olympia. Williams explains that the problems started the day after her daughter’s birth by Cesarean section, when Williams felt short of breath. Due to her history of pulmonary embolisms (Williams underwent emergency treatment for a life-threatening embolism in 2011), the tennis star quickly alerted a nurse about her symptoms.
But the response wasn’t what she expected. Vogue writer Rob Haskell explains:
She walked out of the hospital room so her mother wouldn’t worry and told the nearest nurse, between gasps, that she needed a CT scan with contrast and IV heparin (a blood thinner) right away. The nurse thought her pain medicine might be making her confused. But Serena insisted, and soon enough a doctor was performing an ultrasound of her legs. “I was like, a Doppler? I told you, I need a CT scan and a heparin drip,” she remembers telling the team. The ultrasound revealed nothing, so they sent her for the CT, and sure enough, several small blood clots had settled in her lungs. Minutes later she was on the drip. “I was like, listen to Dr. Williams!”
https://www.vox.com/identities/2018/1/11/16879984/serena-williams-childbirth-scare-black-women
 

frimble3

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Cheers to you, Kaiser.


My paternal aunt was a big baby, her mother was a very small woman. She was having a terrible time trying to delivery my aunt and after hours of laboring the doctor said to the nurses, "Forget it, just leave them, they're both going to die anyway." They all walked out of the delivery room and left my grandmother and unborn aunt to die. My grandmother was wide awake and had been given no pain medicine so she was aware of everything.

The doctor told my grandfather, he panicked and went all over the hospital to find another doctor to deliver my aunt. He found one. It took a long time but he was able to get my aunt delivered. My aunt was in dire distress and again they wanted to leave her to die, but the doctor tried a blood transfusion from my grandfather and it worked. Both survived.

That is a truly horrible story. Thank God that your grandfather wouldn't take "No" for an answer.

I gather this happened some time ago, or I'd suggest we all chip in to send Kaiser-Kun on a little trip, so he could 'splain things to a couple more doctors.
 
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Roxxsmom

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While the US has improved infant mortality statistics in recent years, maternal complications and mortality have not improved. We have the worst rate of maternal deaths in the developed world. Only in the US has the number of women who die of pregnancy-and-childbirth-related complications actually rising.

https://www.npr.org/2017/05/12/5280...ate-of-maternal-deaths-in-the-developed-world

https://www.nytimes.com/2019/05/07/health/pregnancy-deaths-.html

https://www.valleynewslive.com/cont...-while-other-countries-improve-489290461.html

About half these deaths and complications are preventable.

It's also well documented that Black (and Native American too) women in the US have much higher rates of maternal morbidity and mortality, even when differences in education, income, access to health care, and maternal health are controlled for.

https://www.ncrp.org/2019/04/u-s-ma...is-philanthropy-listening-to-black-women.html

https://www.hsph.harvard.edu/magazine/magazine_article/america-is-failing-its-black-mothers/


It's still hard to get many people to take that seriously, though. Even people I know in health care fields, and who consider themselves liberal, insist it's because Black women have more high blood pressure and other issues (ignoring the social issues that contribute to this discrepancy), or because Black women are less well educated overall, and they refuse to acknowledge there are worse outcomes, even for healthy, well-off, educated black women who have access to health care.
 

lizmonster

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It's still hard to get many people to take that seriously, though. Even people I know in health care fields, and who consider themselves liberal, insist it's because Black women have more high blood pressure and other issues (ignoring the social issues that contribute to this discrepancy), or because Black women are less well educated overall, and they refuse to acknowledge there are worse outcomes, even for healthy, well-off, educated black women who have access to health care.

I'm not sure how one could attribute the racial disparity to anything other than racism.

I'm not a black woman, but based on my experience with my OB, the "doctors don't listen to women" thing is a factor right out of the gate. It's not a stretch to get to "doctors listen to black women even less."

It's absolutely shameful.
 

Roxxsmom

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I'm not sure how one could attribute the racial disparity to anything other than racism.

I'm not a black woman, but based on my experience with my OB, the "doctors don't listen to women" thing is a factor right out of the gate. It's not a stretch to get to "doctors listen to black women even less."

It's absolutely shameful.

It's easy if you think that black women have more high blood pressure for genetic reasons (without acknowledging that living with racism is a stress factor), or if you think it's simply because black people choose not to eat right, or are willfully ignorant, and if people don't want to see that racism is an issue independent of socioeconomics, something even well-off, educated black women face.

So if it's all about poverty, I ask them, why do well-off black women have worse outcomes than poor white women?

This story is heartbreaking. It's about an educated, professional Black woman (she worked for the CDC) who died after giving birth. She knew something was wrong, but her health care providers didn't believe her until it was too late. They could have saved her, but chose not to.

https://www.npr.org/2017/12/07/5689...iving-birth-shalon-irvings-story-explains-why

This isn't an uncommon story.
 
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lizmonster

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It's easy if you think that black women have more high blood pressure for genetic reasons

If you honestly believe this, you should be monitoring blood pressure, listening to the patient, and taking very seriously any issue that comes up. What's happening is the opposite of that.

(I know you know, Rm. It's just crazymaking.)
 

Roxxsmom

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If you honestly believe this, you should be monitoring blood pressure, listening to the patient, and taking very seriously any issue that comes up. What's happening is the opposite of that.

(I know you know, Rm. It's just crazymaking.)

No argument from me there.

But it's pretty well documented that medical providers don't take the pain of women, or of Black people, as seriously. They take longer to treat it (and other symptoms too) and are more likely to brush off female patients and black patients when they insist something isn't right with them. Black women are facing a combination of two forms of bias. There's a strong element of "What does this person know?" at play here, not to mention generalized ignorance by some health care providers of what to look out for in general in the hours, days and weeks after delivery.

https://www.npr.org/sections/health...-of-health-risks-for-mothers-after-childbirth

This isn't the same thing as physical or verbal abuse of women during labor, but I think it's related.
 
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Roxxsmom

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This article is interesting. It's about a woman named Lynssey Addario, who has been writing news stories about worldwide maternal mortality for a decade now.

https://www.npr.org/sections/goatsa...as-spent-10-years-covering-maternal-mortality

One thing that's kind of interesting is how thankless this topic is. Maternal mortality is something most editors and journalists shy away from, maybe because it doesn't fit in with the traditional "warm and fuzzy" narratives about motherhood. It's an issue most people don't pay much attention to.

...Colleagues have said things to me about some stories — like the woman giving birth on the side of the road in the Philippines and the Mamma Sessay story — because they're sensational, but no one really asked me about the work, which is interesting in and of itself. I think people sort of shy away from talking about birth, you know? Unless it's something happy and positive.