I sat down to write a piece on the glaring disparity between the way that we sanction and discipline physicians vs. the way we discipline midwives – the clearly defined enemy border, the edges of which have been charred in a centuries-long professional gendercide. While physicians are civilly sued and professionally sanctioned, midwives remain tied to the stake, prosecuted under criminal law for things like practicing medicine without a license all the way up to charges of homicide and manslaughter for maternal and fetal demise.
I’m trying to keep my narrative focused, but I’m having trouble. Because in the course of stating facts and laying out statistics, I keep running into the obvious undercurrent …. that within the maternity care system, physicians are protected from their socially accepted violence against women, and not just in cases of demise, but in the ways in which they are allowed to overpower women, penetrate them against their will, hold them down, chastise them, threaten them, and coerce them into whatever procedure or intervention they deem fit. Their acts so disturbingly resemble childhood molestation in the ways that a woman is treated as infantile, how she is cooed at in order to keep her calm and quiet so he can just “do his job,” how she’s splayed open on the slab, her humanity erased with a polka dotted robe and a sideways glance.
There is an unspoken belief that a woman’s body is her OB’s canvas, a swath of fabric to drape and position and slice however he deems fit. Her job isn’t to participate; it is to lie, unmoving, unfeeling; flattened to the to the bolt in pressed submission.
Gross Violations, and the Everyday
There’s this true story about a doctor who thought it would be amusing to slice his initials into a woman’s abdomen while he sewed her up following her cesarean. A signature of sorts along the bottom of his work. And another, more recent story about a physician who secretly videotaped pelvic exams with a hidden camera around his neck. It went on for about eight or nine years before he was caught.
The gruesome and nefarious nature of these cases made them both universally recognized oversteps. Both ended with large, civil settlements, and the graffiti artist was charged with assault, sentenced to probation, and prohibited from applying for a medical license for 5 years; the voyeur committed suicide before a determination about criminal charges was ever made.
It made me think about how ironic it is. How routinely violating women in labor through various means is not punishable as a criminal offense. How disfiguring a woman’s vagina without consent is a perfectly acceptable and understandable “standard of care.” The way that snipping straight and crooked lines within the normally covered orifices of a woman’s panty line is an unnamable, untouchable offense. Surely, her tender skin, already stretched to capacity, burning with illogical elasticity couldn’t be expected to spring back to normal again, anyway. So long as the work isn’t labeled with signed graffiti, the scar tissue that remains is the honorable remnant of a sort of pinning ceremony. It will be a painfully tight, visible reminder of his capped head between her thighs; of the way her first steps nearly brought her to her knees and she’d swear railroad tracks had been built in her crotch.
So, while we debate and speculate and hyper-focus over the most alarming and disturbing cases of physician assault, we miss the every day violations of digital rape, vaginal mutilation, and forced and coerced compliance. These are equally egregious, and not a single provider is held accountable for these violations. Not civilly or criminally. It is considered socially acceptable to ravage a woman under bright lights and sterile gowns. There is no retribution for women who are routinely held down, spread open and told to behave.
Dying to Keep Us Safe
We accept these bad behaviors under the pretense that it’s all “for the good of the baby.” Doctors and entire hospital systems deny women the rightful use of their own bodies. They back women into corners, force them into surgery, and bully them with forceful hands and verbal abuse all in the name of “safety.”
Which is interesting, because the U.S. – a country that boasts the most money spent on maternity care in the world, with some of the highest intervention rates and lowest homebirth rates – has some of the poorest health outcomes when compared against other developed countries. The U.S ranks sixtieth in maternal mortality (only one of eight countries with an increasing mortality rate, and the only developed country, at that). FIFTY NINE other countries do better at keeping pregnant women alive than we do. We fail at infant outcomes, as well. The U.S. finds itself lagging behind 68 other countries including Egypt, Turkey, and Peru with more first-day deaths than any other developed country. More than 11,000 newborns die on their first day in the U.S. every year. That’s 50% more than all other industrialized countries, combined.
So lest we think that it’s extremely rare for women and babies to die, or lest we think that maybe they die, but they don’t die in the hospital, we need to face some sobering realities. Deaths at birth occur both in and out of the hospital. But, considering that a minuscule percentage (less than 2%) of women birth at home, the disproportionate criminal charges against midwives for deaths is unconscionable.
A Good Birth Outcome isn’t Guaranteed
No matter the location, unforeseen accidents and tragedies happen. Like the baby who gets hung up in her cord or the developmental anomaly no one could prevent or foresee. And sometimes, the fallible humans that attend women make devastating mistakes. Like the physician who used too much force during an instrumental vaginal delivery, or the midwife who attended a complicated breech birth at home. Both ended with a still baby, but only one resulted in manslaughter charges.
In fact, we hate the idea of a woman making choices about her own body and her pregnancy so much that we will place anyone upon the flaming stake who chooses to assist her in stepping out of line. What this relays most is not only #howwehatewomen, but how we absolutely loathe those women who have the audacity to make choices about their own bodies and their own pregnancies. The disparity reveals not only a distaste for and a witch hunt of midwives, but for pregnant women, as well.
Brandishing the midwife as a loose-cannon, baby-killing criminal is not only a sinister attempt to bring down an entire profession, it is more aptly a vehicle to terrorize women – to keep them afraid of accessing the few birthing choices that they actually have. Under the guise of “safety,” we increase the likelihood that more women will birth unattended, and that others will succumb to non-evidence based care that places them and their babies at risk.
So, let’s just be honest.
We don’t really care about “protecting” women. Women don’t need protection from only certain care providers, women don’t need protection from ‘insidious’ abortion clinics, and we certainly don’t need protection from ourselves, or from choices we might make about our health or our pregnancies.
When are we going to start really protecting women from the daily infringements – from the assaults and overriding of rights? When are we going to stop hyper-focusing on the risks of one kind of care-provider, and simultaneously ignoring the institutional practitioners who place women at daily, hourly, unnecessary risk through outdated standards of care? When are we going to address women’s holistic need to be autonomous decision-makers in their healthcare, both in and out of pregnancy? When will the time come to honor the sacred space of a woman’s transition into motherhood? At what point are we going to stop ushering so many folks there on the tailcoats of trauma, disfiguration, and loss?
Folks, this is not about playing nice and building bridges. None of us should be interested in building bridges with our oppressors. None of us should be invested in mitigating our personhood with those occupied with and operating under a patriarchal agenda.
“Women of today are still being called upon to stretch across the gap of male ignorance and to educate men as to our existence and our needs. This is an old and primary tool of all oppressors to keep the oppressed occupied with the master’s concerns.” – Audre Lorde
It’s time to maintain our focus on our legitimate and glaring human rights concerns. It’s time to insist with brute-force pressure that those inflicting harm course-correct. No more meekly begging if we may please have our rights.