Talk about bad timing!
Kim Lock has an opinion piece on obstetric violence in Australia’s Daily Life, on the same day that the Australian media is discussing yet another inquest into yet another series of homebirth deaths.
According to Lock:
A horrifying video recently appeared in my news feed. Earlier this year in California, during the birth of her baby, ‘Kelly’ has an episiotomy cut against her will. Human Rights in Childbirth shows Kelly, who had earlier disclosed to staff she had been raped twice in her life, flat on her back with her legs up in stirrups. Kelly clearly begs, “No, don’t cut me.” Despite her repeated protestations, and without any urgent medical reason, she is belittled by the doctor before he makes 12 cuts to her perineum.
Remove the crowning baby, gowns and masks, and put this same situation in another setting, what would we have? Sexual assault. Lawsuits. Worldwide outrage. And yet, because this occurred between hospital walls and beneath the gloved hands of a doctor, the woman remains powerless. As yet unable to find a lawyer who will take her case, Kelly has been told, “The problem is, you don’t have any damages. Your baby is fine and you are alive.”
“Remove the crowning baby, gowns and masks”?
In other words, only by taking this incident totally out of context can Lock make this into an episode of violence.
What’s a traumatic birth?
Australian organisation Birthtalk, describes traumatic birth, “A birth that you can’t let alone. It stays with you … It might not look ‘that bad’ to an outsider. It might not look ‘that bad’ to your partner … It could have been a caesarean or a natural birth. It might have taken 30 hours or 3 hours. A bad birth is defined by the way you feel, not just the events that occurred.”
In other words, there are no objective standards. That pretty convenient when you consider that Birthtalk produces the book How to Heal from a Bad Birth. A bad birth is whatever natural childbirth advocates want to pretend that it is.
Make no mistake, there is a problem with obstetric violence in contemporary childbirth care and it’s occurring at the hands of midwives. Midwives are letting babies die preventable deaths because “normal birth” is more important to them than whether babies live or die.
Consider the ongoing inquest into 3 preventable deaths at homebirth in Western Australia:
The traumatic hospital birth of a first child led a Perth woman to opt for a home birth with her second, the mother has told an inquest into her baby’s death.
The woman, who cannot be identified, gave birth to a boy at home in 2010 after a 40-hour labour assisted by two midwives.
The infant died in hospital from an infection and meconium aspiration two-and-a-half hours later.
The coroner is examining why the woman was not taken to hospital during the labour and what caused the baby’s infection.
In emotional testimony, the woman said she did not want to give birth in hospital because she had a traumatic experience with her first child and suffered from post-traumatic stress disorder.
She told the inquest she wanted to “maintain my own autonomy” and to have a support team around her.
When asked if there was anything that would have caused her to have a baby in a hospital environment, she replied: “If there was a clear pressing medical need, obviously I would have.”
But there WAS a clear pressing medical need, two in fact. The baby was infected with Group B strep and had aspirated meconium. Why didn’t this mother recognize these pressing medical needs? Because her midwives told her is was fine to ignore these warning signs.
A midwife has told the Perth coroner’s court the woman was not transferred to hospital during a home birth because it was not felt it was required.
One of the midwifes, Sally Westbury, gave evidence at the inquest today.
She rejected suggestions she should have transferred the woman to hospital much earlier.
Ms Westbury testified she talked to the mother and a back up midwife about going to hospital because of concern about the length of time since the woman’s membranes had ruptured.
However, Ms Westbury said because the mother was “afebrile” and “the baby was in good condition, it wasn’t felt that was required”.
She rejected suggestions that after the baby was born and the placenta had a bad smell, which indicated infection, she should have immediately transferred the woman to hospital, testifying that “observation” was the normal practice.
Ms Westbury also denied that her level of care was below what was expected, saying she “actually would do the same again”.
“Babies die in hospital in exactly the same circumstances,” she said.
This is pure ideological cant and it is killing babies who did not have to die.
The tragedy of this baby’s death follows the playbook of contemporary midwifery business generation to such an extent that it is practically a farce:
A “traumatic” first birth
A mother who wants to maintain her “autonomy
Multiple risk factors
Midwives determined to ignore those risk factors
A dead baby
Midwives who refuse to accept any responsibility
And the flourish of stupidity with which no story of midwife negligence is complete: the claim that babies die in the hospital, too.
The claims of obstetric violence toward mothers is part of an incredibly cynical plan to increase market share despite horrible outcomes. An unfortunate amount of contemporary midwifery practice is devoted to fomenting mistrust of obstetricians and hospitals. The plan has several critical aspects: the claim that obstetricians don’t follow the scientific evidence, the simultaneous (though totally opposite) claim that midwives don’t need to follow scientific evidence because they have “other ways of knowing,” and the demonization of obstetric treatment as “violence.”
Don’t get me wrong. I’m not claiming that hospital care is perfect. Although there is rarely any violence, there is a great deal of poor and disrespectful treatment. However, the chief victims aren’t Western, white, well off women; the chief victims are the elderly, people of color and those of lower socio-economic status.
Yesterday I wrote about the complete moral bankruptcy of UK midwives and the campaign of Birthrights to #FightFear of being held responsible for dead babies, so midwives can continue to promote “normal birth.” Not coincidentally, Hannah Dahlen, spokesperson for the Australian College of Midwives, was featured in both the Australian article about obstetric violence, and at the British conference organized to #FightFear. Yet on the day of the conference the British press was covering the appalling stillbirth rate that occurs at the hands of British midwives and could be halved by a simple ultrasound exam.
We need to talk about obstetric violence, but obstetric violence is very different from what midwifery marketers claim that it is. Obstetric violence is the chilling willingness of midwives to let babies die on the altar created to worship “normal birth.” Obstetric violence on the part of midwives comes from a desperate need to promote their own services regardless of whether or not those services are appropriate for an individual woman. Obstetric violence in midwifery is based on the notion that dead babies are a small and necessary price to pay for midwife autonomy and income.
The take home message is this: Birth is a business for midwives and the sole source of their income. They are willing to say and anything to maintain and increase market share; prattling about “obstetric violence” while ignoring dead babies is just the most obvious manifestation of their obsession with themselves.
The real question about obstetric violence is how many babies will die because midwives, in an effort to promote themselves, sow fear of medical interventions and distrust of obstetricians? If the views of midwives are any indication, there will be no limit.
