“Screaming, ‘No! No!’ It was Literally Like Being Raped”: Connecting Sexual Assault Trauma and Coerced Obstetric Procedures

Abstract

How does the victimization of women’s bodies in medical interactions contribute to their experience of gendered violence? We answer this question by joining sexual assault and birth trauma literatures with the medical sociology conversation on the power of hospitals as organizations and the hierarchy of the doctor-patient relationship to analyze the interviews of 101 women who identify as having experienced a coerced, pressured, or forced labor or birth procedure. We find some respondents analogize their experiences to that of someone who has been sexually assaulted, and they and other respondents describe the aftermath effects in ways similar to those who have been victims of sexual assault. Our research demonstrates that clinicians and hospitals are harming patients, often through the normal application of established hospital protocols and behaviors, when women do not feel involved in decisions about their care.

The Biomedical Subjectification of Women of Advanced Maternal Age: Reproductive Risk, Privilege, and the Illusion of Control

“…Despite their knowledge of the downsides of the medical model of birth, many participants cooperated with their providers in part because they anticipated their knowledge and social status would protect them from having a negative birth experience. These dynamics led some to regard their birth experiences as traumatic, in part because they expected they would be exempt from the well-documented harms of the medical model of birth (see Brubaker and Dillaway 2009; Chadwick 2017; Davis 2019; Gibson 2014; Morris et al 2021).…”

“…First, our findings suggest that the persistent medicalization of birth in the United States continues to constrain pregnant people’s autonomy during the birth process and exert a negative influence on birthing people’s experiences. When combined with implicit bias, these dynamics can result in obstetric violence, which in turn contributes to high rates of maternal morbidity and mortality, especially for Black women in the United States (Crear-Perry et al 2021; Davis 2019; Morris et al 2021). While the women in our sample still benefitted from their intersectional privilege and cultural health capital, our findings highlight that there are limits to the kinds of control pregnant women of advanced maternal age can have in the context of their biomedical subjectification, a process that marks their bodies as always already risky.…”

“…Recent scholarship on women's assessments of their birth experiences focuses on how medicalization can contribute to traumatic birth experiences (Chadwick 2017;Morris et al 2021;Watson et al 2020). While the literature often uses "traumatic birth" interchangeably with "obstetric violence," "childbirth abuse," "mistreatment," "birth rape," and "negative birth experiences" (Chadwick 2017;Morris et al 2021), in this article, we use the phrase "traumatic birth experiences" to refer to events or care surrounding the birth of a baby that cause significant psychological or emotional distress, which may or may not involve physical injury, for the birthing person (Greenfield, Jomeen, and Glover 2016). The time frame of "birth" includes not only the onset and progression of labor to either vaginal or cesarean delivery but also admission to a hospital for medical intervention to induce labor and the end of care provided by medical professionals in direct relation to the birth (Greenfield et al 2016).…”

“…Feminist conceptualizations of the medicalization of pregnancy and birth help illuminate the contours and context of traumatic birth experiences precisely because of how medical authority and reproductive risk management through technoscientific interventions, such as labor induction and augmentation, pain management, and cesarean delivery, often converge to prioritize a “healthy baby” over the pregnant person’s agency and autonomy in the birth process (Morris et al 2021:2). Concurrently, intersectional scholarship on the social determinants of racial disparities in maternal and child health outcomes reveals that medical racism—when the patient’s race “influences medical professionals’ perceptions, treatments and/or diagnostic decisions, placing the patient at risk”—shapes Black women’s medical encounters that threaten their positive birth outcomes in ways that differ substantively from White women’s obstetric experiences (Davis 2019:591).…”

Trauma-Informed Care Education Initiative Explores Impact on Perinatal Nurse Secondary Traumatic Stress and Workforce Challenges

“…15 There are many patientspecific factors that contribute to its occurrence, but relationships and interactions with clinicians have shown to be leading factors in the development of birth trauma. [15][16][17][18][19][20] Trauma-informed care (TIC) can simultaneously improve birthing patients' experiences and reduce nurse STS through maximizing protective factors and minimizing stressors. [21][22][23][24][25] This initiative's developers define TIC as one element of organizational change that prioritizes the individual as the leader of his or her own health and recognizes how person-centered care shifts unhealthy power dynamics to mitigate the potential for trauma found in each care interaction.…”