Domesticating Bodies: The Role of Shame in Obstetric Violence

Abstract

Obstetric violence—violence in the labor room—has been described in terms not only of violence in general but specifically of gender violence. We offer a philosophical analysis of obstetric violence, focused on the central role of gendered shame for construing and perpetuating such violence. Gendered shame in labor derives both from the reifying gaze that transforms women's laboring bodies into dirty, overly sexual, and “not‐feminine‐enough” dysfunctional bodies and from a structural tendency to relate to laboring women mainly as mothers‐to‐be, from whom “good motherhood” is demanded. We show that women who desire a humane birth are thus easily made to feel ashamed of wanting to be respected and cared for as subjects, rather than caring exclusively for the baby's well‐being as a good altruistic mother supposedly should. We explore how obstetric violence is perpetuated and expanded through shaming mechanisms that paralyze women, rendering them passive and barely able to face and fight against this violence. Gendered shame has a crucial role in returning women to “femininity” and construing them as “fit mothers.” To stand against gendered shame, to resist it, on the other hand, is to clearly challenge obstetric violence and its oppressive power.

Why ‘normal’ feels so bad: violence and vaginal examinations during labour – a (feminist) phenomenology

“…Indeed, shame has been thoroughly investigated and pinpointed as one important mechanism for perpetuating obstetric violence by making it invisible: the 'gendered shame' permeating women's existence allows for the hyper-medicalisation and unquestioned control of women's 'dirty', 'shameful' bodies by medical staff. Obstetric violence is perpetuated because both labouring women and their doctors frequently see it not as violence at all but as the only way to 'save' women's overly sexual, polluted, shameful, untamed bodies from themselves (Cohen Shabot and Korem, 2018).…”

“…Obstetric violence has been defined as physical and psychological violence performed by medical staff against women giving birth (Sadler, 2016;Cohen Shabot and Korem, 2018). Researchers have recognised this violence as structural (Bohren et al, 2015;Miller and Lalonde, 2015) and as causing serious short-and long-term damage to many women; it is sometimes related to postpartum posttraumatic stress disorder (PPTSD) (Beck, 2004;Thomson and Downe, 2008;Elmir et al, 2010;Harris and Ayers, 2012;Simpson and Catling, 2015).…”

“…Researchers have recognised this violence as structural (Bohren et al, 2015;Miller and Lalonde, 2015) and as causing serious short-and long-term damage to many women; it is sometimes related to postpartum posttraumatic stress disorder (PPTSD) (Beck, 2004;Thomson and Downe, 2008;Elmir et al, 2010;Harris and Ayers, 2012;Simpson and Catling, 2015). It has been recognised as gender violence, not simply medical violence 1 (Cohen Shabot, 2016;Sadler et al, 2016;Cohen Shabot and Korem, 2018), and as being experienced very differently by white, Euro-American, middle-class women (like myself) than it is by marginalised, poor or minority populations, a difference defined as 'too much too soon' versus 'too little too late' (Miller et al, 2016). 'Too much too soon' refers to medicalisation and the overuse of technology in labour, which has been shown to diminish labouring women's self-image and sense of control and agency (Wolf, 2012;Behruzi et al, 2013;Smeenk and ten Have, 2003).…”

We birth with others: Towards a Beauvoirian understanding of obstetric violence

“…In Cohen Shabot's work on childbirth, she suggests that the dissatisfaction felt by countless women with over-medicalized childbirth has to do not necessarily with the loss of a 'natural' labor experience but, rather, with the erasure of the lived body, which is frequently objectified in medicalized childbirth, deprived of transcendence, and transformed into pure immanence, an instrument to be controlled and managed by medical authorities (Shabot, 2017a(Shabot, , 2017b. Furthermore, Cohen Shabot and Korem use this argument to explain the genderedness of obstetric violence, pointing out how this particular violence is directed at women because they are women -objects within patriarchal society, prone to shame, alienated from their bodies, and expected to remain passive (Shabot, 2016;Shabot and Korem, 2018). 1 Here I build on their research by focusing on a different theme: namely, how obstetric violence reduces women's subjectivity in labor not only by denying women control, independent decisions, and embodied integrity but also, significantly, by damaging the social, communal character of childbirth.…”

“…However, throughout this article, I deal only with childbirth as affected by obstetric violence – thus only in medicalized settings. Labor can also be experienced as violent and traumatic within non-medicalized settings (such as home births) but this is not defined as ‘obstetric violence.’ Sometimes women experience frustrating, shameful births not because of obstetric violence but because of glorified, idealized expectations of ‘natural’ childbirth that were not met (Charles, 2013; Shabot, 2017b; Shabot and Korem, 2018). However, I am not at all arguing that every birth is necessarily experienced as violent and/or traumatic.…”