“Modern obstetrics is rife with condescension, medical paternalism, and misogyny. Sometimes it's subtle, and sometimes it's not. Take these examples pulled directly from the website of a well-regarded downtown teaching hospital in Toronto, Ontario:
’Remaining in control of yourself and your fear is the one major way for you to help your labour along. Let the doctors worry about any abnormalities and, if none have so far been discussed with you, rely on their care for you and your baby. You are there to breathe and cope and push the baby out when the time comes.’”
“Obstetric Justice is more than simply the absence of Obstetric Violence. It cannot exist in Canada until every person has access to respectful reproductive healthcare that centres their needs and honours their human rights.”
“without explanation of any risks or reasons, she announced that she was going to break my water and proceeded to aggressively enter my vagina with an amnio hook. This was not a treatment I had been previously informed about or had given consent to. With much force, she repeatedly hooked and pulled, saying that it was very hard to break my amniotic sac. At one point, she pulled the hook out, said she wasn’t sure she had broken my water and I braced as she went back in to keep trying. She was aggressive, determined and didn’t care that I was extremely uncomfortable and confused. After she was finished I had a lot of bleeding. I was then given a pad to wear for that bleeding and was left with my midwife for further care. After giving birth to my daughter, we saw that she had three deep gouges out of her scalp. One of the gouges was right on the edge of her soft spot. It became clear that the bleeding I was having prior was not my own blood but was from the head of my unborn child.”
April 11 - 17, 2019 - This week, we are conducting a short, anonymous survey of Black birth workers in honour of Black Maternal Health Week. We are interested in hearing about how your identity and lived experience shapes the work you do. We also know that your perspective as a racialized individual is unique and often attuned to what others might miss.
This survey is spearheaded by The Reproductive Justice Story Project team member, Solana Cain. Solana is a journalist, photographer, and certifying Black birth worker passionate about creating stories that shine a light on reproductive injustice for Black and racialized communities.
“Once our healthy baby boy was here and I was brought up to the maternity ward, the nurses on staff proceeded to be very rude to my boyfriend, his father. The nurse assigned to me refused to allow him to help me bathe him, stating, "She needs to learn how to bathe HER baby!" Even though the baby was just as much his as he was mine. When he left the unit at one point I had a nurse come in and ask me if he was even the actual father of our son. We were young, only 19. We hadn't been together long, and my boyfriend is Indigenous. Due to them pushing him away in the hospital my boyfriend had a hard time bonding with our son. He was nervous and reluctant to help at bath times as he did not know, and he felt very robbed of those crucial first hours. Looking back on it I feel angry. It was horrible to act towards him, and in a world where young fathers take off all the time the nurses should be encouraging the ones who are around to stay around, not mistreating them and pushing them away. “
“I was very anxious that I couldn't get much milk out. I needed to feed my baby and I really wanted to do it naturally. The lactation consultant must have said something to my midwife because that evening my midwife came in and said she wanted me monitored, and that she was going to send staff in every 3 hrs to make sure I was actually going to feed him and ***THAT SHE THOUGHT I HAD BEEN SEXUALLY ABUSED AS A CHILD*** based on when they were wheeling me into the OR she thought I was sucking my thumb (I was biting my first as the contractions were strong). She thought that was regressive behaviour that showed this. Seeing as I was being monitored as though I was an unfit mom, still raw from the surprise c-section, and awoken every 3 hrs anyway - I could not sleep. I know statistically that sexual abuse happens primarily among family members and all I could think, as thoughts raced through my mind instead of sleeping, was who had possibly sexually abused me? That was what my child's birth story became. I was raw with exhaustion, wired with this shocking piece of information, still very afraid and alone in terms of figuring out how to breastfeed my baby.”
”Words have huge impact around these completely life changing moments like childbirth. I would like the midwifery profession to know the extent of pain that this caused.”
March 26, 2019 - In honour of World Doula Week, we’ve put together a short survey for doulas in Canada. Through the survey, we aim to learn about doula training, challenges, and strategies for speaking up about obstetric violence. The information gathered from this survey will be shared online and aid in the creation of future surveys and free shareable/downloadable resources on our website.
“Everybody in the medical community acts like a c-section is no big deal and is this easy breezy thing. For me, not a single day has gone by that I am not in pain. At my incision site, it feels like a knife point is pressing in. On days I exercise, the knife digs deeper. Other days it lets up but is never less than a 4 out of 10. There are certain types of pants I can't wear anymore. I get debilitating back pain that wraps around directly to my scar. My hips tighten with shooting pain directly to my scar. During my period, the pain is unbearable. Before I was pregnant, I was running 10-15 km. I still ran 5km until I was 20 weeks pregnant. Now, I can't run 1km without the knife blade digging in. I run anyway but it's definitely more challenging pushing myself through the pain. I've gone to physio and done the exercises, stretches, dry needling, scar tissue massage and nothing has been able to offer any kind of relief so I carry on and just deal with it. I would like to have another child but the thought is terrifying. What if they don't believe me again and I get to feel the doctor slicing and pulling? If I do have another, I will try to get a midwife although the waiting lists are long. If I'm to be stuck with a doctor again, I've decided against all interventions. No cervical checks, membrane sweep, induction, labour augmentation or epidural.”
“Now my biggest concern is how am I supposed to trust this Doctor? He has no knowledge of my background or history as he is fairly new to me (my original family doctor retired a few years ago). I have yet to voice my legitimate concerns regarding the miscarriages and don’t feel like he cares enough to make about my mental health issues to help make a proactive and reasonable plan in case PPD rears its ugly head once again. I spent the past 2 years trying to see him to discuss mental health issues prior to the pregnancy, but met with all sorts of interns and NPs, but not once have I spoken with him. I eventually gave up on the medical route and am currently receiving private mental health treatment that I pay for out of pocket.”
"I cannot rationalize the way I was treated, and as a health care provider myself it just erodes me to know this goes on day in and day out.
I had a sexual abuse history, but I find it absolutely absurd that you have to share that with people, just to get treated with more empathetic care in Obstetrics. All women should be assumed to have a trauma history given the statistics. And all women should be treated with empathy and compassion regardless of their abuse history. Also sorry, not sorry, not going to share that with someone just because you’re a health care provider, it's called building a therapeutic relationship. If you are asking me whether I've been sexually abused as a checklist, just like when my last menstrual period was, you probably aren't going to get an honest answer. I have been through significant gynaecological issues prior to childbirth and never felt traumatized by any procedure, despite my abuse history.”
“I am mad and saddened that in Canada, these experiences are more common than not; however, overall it all supports the notion that it's important to speak out and share stories of injustice as it provides an opportunity for change and a chance for support.“
“They completed the C-section noting had I waited any longer my uterus would have ruptured. They then asked me while I was open if I wanted my tubes tied, frankly I think that’s something that should be discussed prior to being on the surgical table.“
“Instead of referring me for the procedure, he told me to discuss my choice with the father first and come back in two weeks to have another pregnancy test and blood work done, just to be sure it was safe to proceed.
Something told me to move on this faster. I ignored his advice and looked up the nearest Women's Clinic in the phone book. When I spoke to the female doctors there I learned that, had I waited those two weeks, I would have exceeded the allowable window to terminate the pregnancy. After which I would have had to prove it was a risk to my health, or take legal action to get the procedure. Even the women doctors at the clinic asked me three times if I was sure about my choice before they brought the papers out for me to sign. As I was leaving the office the receptionist called me over to double check my procedure appointment.“
“I was told I had to hold my baby in my arms all night after not sleeping for 48 hours as she had a lot of mucous. I told the nurse I wasn’t comfortable with it fearing I’d fall asleep and she’d roll into the blankets and potentially suffocate. I was told I didn’t have an option. They propped me up with pillows and laid her in my arms for the night. Fast forward over a year later, I was still waking up almost every night frantically checking the blankets for my daughter (who had never slept in our bed). I even had a night where I begged my husband to check the bed to make sure she wasn’t there even though she was in my arms”
“No matter what framework you use, the basic problem is that fundamental human rights in childbirth are being violated on a daily basis around the world. In North America, in Canada and in the province of Quebec human rights are being violated as well. I speak to you today of the specific rights to health which should be guaranteed to all women and birthing people.“
“I was suicidal for years, and the way people treated me after the assault is a big factor in that. I attempted suicide about two weeks after the procedure. The hospital refused to let me stay after 72 hours because I was "just looking for a bed to mooch".
I still feel resentment about this. The main reason being it is 2018, over a decade later, and this is still a common story when it comes to sexual assault and abortions.
I was 14 and homeless. I am First Nations and gender-queer/2S. I didn't have the voice I have now, at 14. So, I never gave them feedback.”
“The next few days were not so good and I went from being fairly well to very ill requiring emergency surgery, being cut open from my breast bone to my pubic bone. Finding out I have a large cyst and umbilical hernia and had become septic. During surgery my heart stopped up to four separate times, leaving me in very poor condition in the ICU after surgery where I was to remain for many weeks.”
“What happens when patients raise the alarm about healthcare professionals practicing in their community? What does it take for the regulatory college to take these complaints seriously? What prevents doctors who do harm from jumping from hospital to hospital, and continuing to practice for years to come?”
“We need to feel comfortable saying “Stop!” when we see cervical checks without consent. Our clients should be the ones to advocate for themselves whenever possible, but there are times when they can’t and we must.”
Are you a doula or healthcare professional with a story to share about mistreatment and abuse in the healthcare system in Canada? Consider sharing your experiencehere on the Community Story Blog. Change can happen if we speak up together!
“As a Catholic teaching hospital, the cultural aversion to informed consent and bodily autonomy in your childbirth unit makes sense, however, some patients raised this culture as an area of concern in the feedback survey. You shared in your letter that you are “continuing to seek learning opportunities that expand care providers’ understanding of what obstetrical [sic] violence is and ways we can ensure patients don’t experience this under our care” In the meeting it was stated that “ideally we need to embed it into some standardized classes” but you were not able to speak to whether “obstetric violence” or “patient mistreatment” are terms that had come up at all yet, even in less formal conversations and huddles on the unit.
However, you expressed with certainty that there have still been no formalized discussions or training around what constitutes obstetric violence, and how to interrupt the cycle of obstetric violence in your Family Birthing Centre. It was also unclear whether the experiences of abuse and mistreatment some patients shared in their survey responses have been addressed in a comprehensive way.”