Obstetric Violence: How to Advocate for Yourself in the Delivery Room
Welcoming a new baby into the world should be joyful and exciting. But not every birth goes as planned. It’s true that the best laid labor intentions can give way to emergencies and medical interventions. But, as a patient and a human being, you should know your rights and be given the opportunity to ask questions and provide consent. Of course, that doesn’t always happen. Some women walk away from high-intensity hospital situations—or even everyday prenatal appointments—feeling violated. It’s true that obstetric violence comes in many forms, and it can strip a mom-to-be of the positive experience she has been dreaming about for months. To that end, it’s important that all pregnant people and their carefully chosen teams know how to advocate for a smooth labor and delivery. Here’s what to know.
Obstetric violence, which is essentially defined as physical, mental or emotional abuse during pregnancy, childbirth or the postpartum period, is only recently getting acknowledged as a problem in the medical community. It most commonly happens in hospitals, and can occur at the hands of doctors, nurses, midwives, anesthesiologists and other medical professionals. The unfortunate reality is that it’s usually a result of unconscious or systemic bias against women—and it disproportionately affects those in underrepresented communities.
A 2019 national US study entitled Giving Voice To Mothers, found that one in six women reported experiencing mistreatment, ranging from verbal abuse to a loss of basic human rights during pregnancy or childbirth. Women who had hospital births, in particular, reported a higher degree of misconduct. Those who were most likely to endure this injustice? Women of color. On the other hand, white women, over the age of 30, who were planning a vaginal birth were least likely to experience it.
Abuse comes in many forms. Physical abuse is the most recognized form of obstetric violence; this includes performing medical procedures—be it a dilation check, membrane stripping or episiotomy—without a patient’s consent. Of course, emotional abuse is also possible. This may be defined by neglect, a general lack of respect or a flat-out refusal of necessary medical care and treatment. It also includes ignoring questions and using threats or intimidation to quiet a patient.
Although obstetric violence can derail a peaceful birth plan, there are some steps you can take to advocate for yourself and your comfort.
Many birthing people don’t voice their discomfort in the delivery room out of fear. But you know your body better than anyone else. If you’re not feeling confident enough to express yourself verbally, there are some other ways to set the tone: Dim the lights and play calming music. This immediately demonstrates that you’re in control of the mood and vibe, and it prompts others who enter the room to follow suit and respect your space.
Create a birth plan
Creating a birth plan in advance is a great way to establish communication with your team from the very beginning of labor. In fact, The Reproductive Health Journal recommends doing this to help steer the process of labor and delivery, and improve your overall birthing experience.
Work with a doula
Doulas are extensively trained to support moms before, during and after childbirth. They’re educated in ethics and care; moreover, your chosen doula will be familiar with your specific birth plan, so they can speak up on your behalf if and when you’re unable to do so.
Assemble a strong birth team
Establishing a strong care team can also boost your confidence. Lamaze International notes that creating cohesive communication ensures that everyone on your team stays focused on your labor and well-being. When assembling your squad, make sure you include people who make you feel supported and safe. The team can consist of a partner, family, friends, a doula or trusted medical staff.
If you’re curious about something, speak up and ask questions. There’s no rule that says you can’t be inquisitive about what’s happening to you, your body and baby. It’s important for you to understand what the medical team is doing and why they’re doing it.
Understand your right to refusal
Take confidence in knowing that you can refuse anything at any time if you feel unsafe. The American College of Obstetricians and Gynecologists (ACOG) makes the point that a capable patient has the right to refuse treatment—and that decision should be respected. Of course, emergencies do crop up, but that doesn’t mean your rights are obliterated. In fact, this is when your team should talk you through what’s happening and share the options.
If you believe that you’ve been a victim of obstetric violence, there are many support options available to you. The most immediate option is to contact the hospital or birth center’s administrative office to file a formal complaint. You can also contact state boards that regulate physicians, midwives and nurses. Birth Monopoly conveniently compiles all of this information for easy access. Of course, action won’t heal all your wounds, so seek out a therapist or counselor if you need to talk to someone. Most importantly, be gentle with yourself.
The good news is that the birthwork community is advocating for better, safer and healthier pregnancies, labors and deliveries for moms-to-be, and working to fight obstetric violence. In the meantime, empowering yourself and your support team can help you have the experience you want.
About the expert:
Genevieve Jeffries is a doula and the founder of Woman of the People, a private practice based in San Diego, California. Her passion for women’s rights is the driving force behind her work. She’s also the founder of Sisterly Obstetrics, which focuses on pairing expectant mothers with proper prenatal resources.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.