Rambling Road Family Wellness and Chiropractic specializes in chiropractic wellness care for all age groups and continued support as patients journey to optimal health and wellness.

Rambling Road Family Wellness and Chiropractic specializes in chiropractic wellness care for all age groups and continued support as patients journey to optimal health and wellness.

Correcting Perverse Incentives

"Silence" by John Henry Fuseli

“Silence” by John Henry Fuseli

Unlike acts of sexual assault that take place in the known realms of a domestic situation or random acts of senseless violence, women who are subjected to obstetrical violations on a hospital table under a spotlight during birth often do not feel like they have a voice. Not only is she silenced during the experience, but she is told to calm down if she chooses to mention it afterward.

A woman who feels her assault as rape and uses the term finds herself ridiculed. Told that her use of the word negates the experience of one who’s experienced “true” rape. But what other word is there for someone who’s sexual organs are exposed, whose legs are physically pried open, who is subjected to forced penetration over and over amidst her screaming and pleading for it to stop? And what makes one version of rape real and another not, anyway?

“…they fucking fisted me b/c I wasn’t pushing fast enough for them.”


Women are subjected to forced vaginal exams in spite of their verbal protests; they have episiotomies and amniotomies done against their expressed will; they have medications placed without awareness or consent; they are tethered, physically held down, and verbally bitch slapped into compliance.

“.. I stated NO traction and my doctor did it anyway to demonstrate to a resident who attended my labor…”

These are not rare and isolated incidents.

Women have been silent, unable to label these injustices for a long time; unwilling to subject themselves to further scrutiny; unaware, even, of where the root of the discontent lies. More and more women are speaking out and you can be sure that where one woman speaks, there are thousands of stories just like hers. These kinds of violations take place every single day in hospitals across the country and across the globe.

Every woman who enters the birthing system today faces a very real risk of being subjected to this kind of abuse.


While more and more women are choosing to claim their rights through processes of retribution, they are shut out time and time again. They are denied meetings with hospital staff to discuss their concerns, they are fed lines from hospital PR rep’s who minimize their experiences by telling them that the doctor just did what he thought was best.

But most disturbing is the mother who recently communicated her experience with trying to file criminal charges against her physician for forced penetration during her labor. Here is what she was told by a local law enforcement official:

“You are correct in thinking that when a person tells another to stop touching them in certain areas that they must comply with that demand, but in the case of delivering a baby the doctor must invade certain areas to perform his or her duties; this is why when you told Dr. XXX to stop and he didn’t it does not constitute a criminal offense. I realize that this is not what you wanted to hear, but as far as the State of XXX is concerned it is the truth… The District Attorneys Office … simply [does] not see this as a criminal offense….”

Ah ha. So, in other words, what we have is a present system that contains an understood (though not expressly written) exemption for medical providers.

What we have is an avenue for legalized assault.


So, here’s the deal. We can go on and on about our theoretical constitutional rights. We can say all we want that women can’t be “forced” to do anything; that no one can subject us to any unwanted medical procedure or intervention without our consent. But that’s all theory.

Until those rights are willing and able to be UPHELD, they mean nothing.

Where does this leave us? How can we move forward if we have no real rights to stand on? How can women not only stand on and claim their supposed rights but also fight for retribution when those rights have been clearly violated? And what is the point if women are told they have no rights?

Human Rights in Childbirth Logo http://www.humanrightsinchildbirth.com/

Human Rights in Childbirth Logo http://www.humanrightsinchildbirth.com

I asked these questions of human rights attorney, Hermine Hayes-Klein, founder and director of Human RIghts in Childbirth. She explained that just as women have the theoretical right not to be raped, the fact is we only have a 3% prosecution rate of rapists in the U.S. But this fact does not negate a woman’s right to not be raped, it reflects a much deeper reality in our society, not the least of which is a woman’s perceived value in a patriarchal culture.

The birthing system is presently fraught with perverse incentives. Profit, convenience and liability concerns cloud practitioner’s thought processes as they navigate their “checklists.” What is best for mother and baby become secondary to the physician’s motivators of self-preservation.

As bIrthing women, the task is before us to course correct away from these perverse incentives.


If we choose to behave as if we have no rights … well, then we don’t.

BUT, if women continue to INSIST that yes, we do, in fact, have these rights – rights to bodily integrity and autonomy; rights to informed consent and refusal; rights to say “NO,” and have that “NO” honored, we hold the power to shift these motivators. The consequences to care providers of threatened retribution have the ability to shift the incentives of care providers to respect women’s basic rights AND to practice in ways that are careful and non-negligent.

We have to keep fighting. We must keep pushing.

This entry was posted in Activism, Birth, Birth trauma, Choice, Feminism, Hospital by Kathi Valeii. Bookmark the permalink.

6 thoughts on “Correcting Perverse Incentives

  1. During my first labour I was never given the chance of a ‘normal’ delivery. It was a cascade of intervention all the way. I gave myself to them and was treated like a piece of meat. At the end I walked away traumatised with a live baby and staff were all smiles, as if they had done a good job and were patting themselves on the back.
    Change has to come from women themselves, speaking out. We have to change the way medical staff approach women in labour, teach them how to make each labour as normal as possible. Some women will always need intense medical care, but the majority do not.
    I believe in teaching women how not to fear labour as it is that very fear, and the hormones that are secreted, that end up leading us down the path to a medicalised birth.
    For my second birth I knew exactly what I wanted, and I got it. I had a lovely pain free labour where I was left to mobilise and relax and stay sat on a comfy chair till I wanted to push. Bliss. My blog was started to help other women to achieve a comfortable labour so that the cascade of interventions of a medical model of care can be avoided.
    Ann x

  2. We have to stop relating to childbirth as something that happens TO women, but rather as something that women DO, that they may or may not want assistance with.

  3. Very good article on birth rape. I have mentioned it and linked to your page on my forum thread about birth rape as well.

    I also consider “routine” pap smear screening to be a form of legalized medical rape, because despite in a lot of cases, women may give their verbal consent to be penetrated in their private parts for the pap smear, there is a lot of coercion being used by the gynecological industry to manipulate and threathen women into believing that cervical cancer is prevalent (which it isn’t as it is a very rare disease) and that ‘pap smears save lives’ (another lie). Another sabotaging way to get women into stirrups is by withholding them birth control prescriptions if they don’t comply to a pap smear which is not even required by the ACOG.

    • Thank you, Yazzmyne. I agree, the scope of abuses against women in this regard most certainly bleeds outside of the realm of pregnancy and birth. In fact, for many women who were violated in this way during birth, their yearly pelvic exam becomes a stage for further subjection and re-traumatization. Thank you for your work.

    • Pap smears do save lives. While working on a gynae word I met a young 42 year old who had never had a smear test. The cancer in her had started in her cervix had spread to her other abdominal organs. She was terminal. Her two children used to come to see her and it broke my heart to see them together. If she had only had a smear test then the cancer would have had a chance of being picked up, she may have been saved. Cervical cancer is a slow silent killer, there are no symptoms untill it is too late. I always stress to women how important it is to have a 5 yearly smear just in case. If they are reluctant then I tell them about Lucy. You can insist on a female doing the smear, it is a 5 minute job and you are covered for another 5 years. I have one regularly and while they are not nice, the possible alternitive is too awful to contemplate. Ann x

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