XX Factor: the blog

The Still-Cruel Maternity Wards

  • Posted: February 25, 2010 at 11:13 AM
  • By Henci Goer

In 1959, the Ladies' Home Journal published an article called “Cruelty in the Maternity Wards,” in which women told stories of their inhumane treatment during childbirth. Despite the uproar it provoked, 50 years later, nothing substantial has changed. Really. Recently, a pregnant Florida woman was confined by the court to bedrest and ordered to submit to any treatment her doctor deemed necessary, including cesarean surgery. This is one of a string of similar stories appearing over the past months: A New Jersey woman with PTSD and depression in her past was deprived of custody of her child at birth because she refused to sign a blanket consent at hospital admission for cesarean surgery, an act cited as proof she was too mentally ill to be a fit mother. An Arizona woman with a prior cesarean was told if she showed up in labor and refused automatic surgery, the hospital would get a court order and perform it anyway. And an Illinois woman was literally tortured throughout labor by her doctor to punish her for not calling before coming to the hospital while medical staff stood by and did nothing.

These stories aren’t aberrations. We have a culture of impunity in maternity wards. Once pregnant, a woman effectively cedes her right to autonomy and bodily integrity to obstetric staff who sometimes—on grounds of fetal welfare, self-protection from malpractice suits, or mere convenience—manipulate women into compliance in ways that would be considered fraud in any other venue. Without fear of being called to account for it, they can bully, coerce, humiliate, and threaten. And, yes, they can physically mistreat or even sexually assault them—imagine if the Illinois woman’s story occurred outside of an L&D unit.

 

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Re: LizzieBennett's request for organizations addressing this...

By: auros | Sat, 02/27/2010 - 20:53

See here for numerous organizations active in different aspects of birth politics and research. Also, the ACLU has gotten involved in the Samantha Burton case (the Florida case linked from the post).

When you're limited on word-count...

By: auros | Sat, 02/27/2010 - 20:49

...in a short guest blog post, it's hard to lay out all the details. If you want the details, check out her site or borrow her book from the library. (Or wait a year -- I know there's an updated edition on the way some time soon.) You also can read an extensive collection of articles, linked from this page. (If you want a thorough primer, you could start here -- it has all the numbers you could want, and extensive footnotes.)

For a first statistic: Roughly one in three US births (31%, in the numbers reported for '08) is now delivered by Cesarean section. Here's an article in the LA Times reporting the figure, along with a discussion of the direct costs and the surgical complications related to this increase. And, as I pointed out in my first post, we know that childbirth has become significantly less safe, at the same time that the increase in interventions has occurred.

As far as women's rights to make decisions about labor and delivery, and the manner in which doctors are given the right to overrule women's decisions about their bodies, this is partly a cultural issue (what do doctors think is acceptable to do? do women who disagree get support for rejecting the doctors' choices from other staff in the hospital?) and you could perhaps construct a poll of hospitals to identify the percentage that consider it acceptable to perform a surgery without consent. (Of course, the poll might be biased by the fact that no sane administrator would ADMIT that their hospital would do that sort of thing, even if their Ob/Gyn dep't had already done so in the past.) But it's also a legal issue. If women are being ordered by courts to submit to surgery, it doesn't matter exactly how many cases may have occurred that didn't get well-documented -- what matters is that this is standing precedent in those jurisdictions. Which is completely outrageous.

Also, as an aside, don't tell me what I don't know about statistics. I did statistical linguistics as my job for many years, and more recently did my MBA thesis on a Power Purchasing Agreement business model, including a statistical model of a swap market trading a fixed return for a return indexed to power prices.

Auros, ms-quoted-- Not so fast...

By: DuckworkerMike | Sat, 02/27/2010 - 17:11

I don't care, Auros, if she's your aunt, and if some people-- even many people-- respect her. And MQ, she did not *address* my concern, she merely alluded to its existence. I am fully prepared to believe Auntie is right-- once she shows her figures and their sources. In THIS ARTICLE there is nothing more than a scattering of stories removed from any context whatsoever. So far I'm the only one, among the four of us, to present an actual number-- 4,300,000. And I ask again: against THAT number, how many instances of the sort Henci mentions are there? And is the number higher or lower than in the past? I never said there wasn't a problem, and stipulated that all the examples provided are true, but if they are the only examples, then it's not a problem except at the individual level where those afflicted live, and for them, at an individual level, I am sorry. But that does not mean there is a widespread, pervasive, common problem, and it does NOT prove that "in 50 years nothing has changed." The author makes an assertion and fails to back it up with evidence. I merely asked for the evidence. Hardly an indication that I don't know what I'm talking about. It's an indication that I understand the place of statistics, which you two, I would suggest, do not.

The RN's point of view

By: JazzRN | Sat, 02/27/2010 - 05:29

I have 10 years experience as a L&D nurse in a variety of settings, from inner city hospitals to large teaching institution hospitals and home birth experiences [ Curb side- Front seat of the car experience also].
Here's a couple of points from the RN's view:
1] If you're ever in need of medical care in Florida, walk, crawl, fly or drag yourself to the nearest next state before walking into a hospital in Florida... The MD lobby owns the state legislature and there is virtually NO ACCOUNTABILITY or recourse under law. The state is therefore a magnet for every hack MD in the USA.

2]In all my experience, across every type of hospital, I have never known a doctor to force a woman to get a C-Section against her will or filed a Psych order against a new mother.
I have seen Md's deliver a baby in 2 minutes and bring it back to life on the mother's belly too many times to count

3] I have worked with midwives who deserve sainthood way before any Pope and I have worked with midwives who should be selling used cars.....

4] There is just way too much bad science floating around the internet...

The Pitocin that is used to augment or induce labor is chemically indentical to the oxytocin produced by the human brain...it is not the drool of Satan that some would make it out to be, but like any medicine can be used carelessly or inappropriately....

A well timed and expertly placed epidural can be the gift of the Goddess, but the brain is still the strongest drug known to humans.
If you don't use your brain to educate yourself before its time to go into labor, you put yourself totally in the hands of the professional you've chosen to facilitate your experience.

DuckworkerMike- you seem to be confused

By: ms_quoted | Sat, 02/27/2010 - 01:23

I am not sure if you're familiar w/ Henci Goer but she is highly regarded in the childbirth industry as someone who seeks EVIDENCE based maternity care. She is not into using "anecdotal" stories and she specifically addresses that in this article (The first sentence of the second paragraph).

organization supporting women's reproductive rights

By: Henci | Sat, 02/27/2010 - 01:09

To the commenter who wanted the name of an organization, addressing pregnant women's reproductive rights, I recommend the National Advocates for Pregnant Women: http://www.advocatesforpregnantwomen.org/.