What Is Obstetric Violence and What if it Happens to You?

If you haven't yet come across this term "obstetric violence," let me first start by defining it: obstetric violence is the physical, sexual, and/or verbal abuse, bullying, coercion, humiliation, and/or assault that occurs to laboring and birthing people by medical staff, including nurses, doctors, and midwives. In short, obstetric violence is anytime a person in labor or birth experiences mistreatment or disrespect of their rights, including being forced into procedures against their will, at the hands of medical personnel.

Obstetric violence happens in hospitals throughout the world, including in the United States. For this blog post, I'm going to limit my focus on issues and stories that have occurred in the U.S., though there are even greater occurrences with obstetric violence outside of this country.

If this topic is unfamiliar, I will share a widely known story that depicts obstetric violence, as well as a short list of examples:

In Southern California in May of 2013, Kimberly Turbin, who was insured by a company that provides free or low-cost healthcare coverage, went into labor and proceeded to Providence Tarzana Medical Center to have her baby. As a two-time rape survivor, upon arrival she asked staff to be gentle with her and ask permission/explain before doing any procedures during birth. The attending physician was Alex Abbassi, an obstetrician she had met just one day prior to going into labor. When she was ready to begin pushing, her doctor told her he was going to perform an episiotomy -- a procedure that is no longer performed routinely, and only performed in cases of distress and emergency. Turbin and her baby were not experiencing medical distress. Despite Turbin's repeated pleas not to cut her, Abbassi continued, without her consent, claiming that the cut was necessary so she wouldn't "rip." He proceeded to cut into her perineum 12 times. The incident was caught on video by Turbin's mother. Three years, and a lot of work and crowd-funding later, Turbin was granted a lawsuit case of assault and battery against her doctor. Ultimately, in 2017, she and Abbassi settled out of court. The doctor gave up his license to practice in 2015.

Stories like Kimberly Turbin's are not out of the ordinary. What is out of the ordinary, however, is that she ultimately received monetary compensation for the harm done. Most cases of obstetric violence do not, even when they are reported and a lawsuit is filed.

Obstetric violence happens on a wide-ranging spectrum, and includes the following:

• Vaginal exams without consent
• Forced cesarean surgery
• Physical force to prevent birth while waiting on the doctor to arrive
• Physical restraint during birth
• Sexual comments or sexual assault during exams or procedures
• Bullying into procedures, like induction, episiotomy, or cesarean, without medical reason
• Failing to get consent
• Being treated/spoken to disrespectfully and/or without regard for autonomy

The reality is that in pregnancy and childbirth, as in life, you have human rights. Per the Human Rights in Childbirth organization:

A person does not lose their fundamental human rights when they become pregnant. Every human being, regardless of their pregnancy status, has the following rights:

• Right to Informed Consent
• Right to Refuse Medical Treatment
• Right to Health
• Right to Equal Treatment
• Right to Privacy
• Right to Life

The National Partnership for Women and Families and Childbirth Connection also talks about rights specific to pregnant and birthing people in a document called, "The Rights of Childbearing Women," which details 20 specific rights, including the right to accept or refuse procedures, drugs, tests, and treatments, and to have those choices honored.

When these rights in childbirth are ignored or forcibly denied, it is obstetric violence, and it is illegal. If you or someone you know has experienced obstetric violence, it's important that you tell your story, report the incident, and offender is held responsible.

Currently, the process for this is not always straightforward or simple. You can start by contacting your hospital's administrative office to file a formal complaint. The organization Improving Birth has resources on their site to help you with this process, including the "Accountability Toolkit," which provides detailed steps for filing a formal complaint after experiencing mistreatment in birth.

You can also submit your story and request contact from the Human Rights in Childbirth organization for help and information on seeking justice.

You can also seek legal counsel and representation.

In addition to seeking justice for mistreatment in birth, those who have experienced obstetric violence must also deal with healing the trauma from their birth. Healing and recovery from a traumatic birth is a critical piece of your short and long-term health and well being. Improving Birth offers a free "Pathways to Healing" resource guide to help you through this process.

Until more families speak up and out against the mistreatment and harm that has goes on in the maternity care setting, the environment will not change and providers and staff will continue to practice in the same ways. While obstetric violence is not the norm for every person giving birth in hospitals, it does happen and it happens more often than it should (hint: it should never happen!).