Tonight in my Introduction to Human Services class we cover Violence, Victim Advocacy, and Corrections. In a stroke of coincidence, I saw some great materials on Facebook this morning that I quickly added to tonight’s lecture:
During this same lesson, I also show my favorite mock poster about fool-proof ways to prevent sexual assault:
I truly think this is a chronic social issue—motherblame. We MUST look at the larger system when we ask our questions. The fact that we even have to teach birth classes and to help women learn how to navigate the hospital system and to assert their rights to evidence-based care, indicates serious issues that go way beyond the individual. When we say things about women making informed choices or make statements like, “well, it’s her birth” or “it’s not my birth, it’s not my birth,” or wonder why she went to “that doctor” or “that hospital,” we are becoming blind to the sociocultural context in which those birth “choices” are embedded. When we teach women to ask their doctors about maintaining freedom of movement in labor or when we tell them to stay home as long as possible, we are, in a very real sense, endorsing, or at least acquiescing to these conditions in the first place. This isn’t changing the world for women, it is only softening the impact of a broken and oftentimes abusive system.
And, unfortunately, domestic violence often begins during pregnancy:
Violence during pregnancy is an unfortunately common experience. Between four and eight percent of women experience domestic (intimate partner) violence during their pregnancies. The incidence of violence increases for women with unplanned or unwanted pregnancies with 26% of pregnant teens experiencing intimate partner violence and 15% of all women whose pregnancies are unwanted being in an abusive relationship. Indeed, murder is the second only to car accidents as the most common cause of injury related death for pregnant women. Sadly, these statistics are likely higher in reality due to underreporting or misclassification.
Our maternity care system unfortunately may also BE the perpetrator of violence against women:
While the situation is different from domestic violence in some ways, it is also similar. Abuse in the medical setting is also about power and control, the pregnant or laboring woman is often blamed for her situation, and verbal and emotional abuse can be similar. Because we are taught to “trust your doctor”, and in fact there is an explicit assumption of trust in the “fiduciary relationship” between the woman and her doctor who is an “expert”, most of us do not think about the possibility of abuse, and many of us stay with the OB or feel we have no choice about our health care providers or settings, especially when we are in labor. Also, the doctors and staff generally are not even aware that their behavior or actions are abusive.
And finally, “normative” institutional abuse may be a part of many women’s birth experiences:
“‘Old wives’ tales,’ says the Oxford dictionary, are ‘trivial stories, such as are told by garrulous old women.’ It is significant that no one ever talks about ‘old husbands’ tales’ or ‘old doctors’ tales.’ Women are blamed instead. It is implied that there is poison in their speech and that the only safe thing to do is remain silent. The experiences that women share with other women are thus rejected and trivialized…In reality, it is not other women who instill and fuel anxiety in most pregnant women, but the medical system itself.” This quote from the 1980’s book, Giving Birth, by Sheila Kitzinger, remains strikingly relevant today. When women in the United States today enter the hospital to give birth, many experience some form of institutional violence. They may not explicitly define it as violence, but listening to their stories provides a disheartening picture of maternity care today.