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

Abstract

In this article, I argue that many women lack the epistemic resources that would allow them to recognise the practice of vaginal examinations during childbirth as violent or as unnecessary and potentially declinable. I address vaginal examinations during childbirth as a special case of obstetric violence, in which women frequently lack the epistemic resources necessary to recognise the practice as violent not only because of the inherent difficulty of recognising violence that happens in an ‘essentially benevolent’ setting such as the medical one, but also, and mainly, due to the pervasive sexual reification of women under patriarchy and the pervasive shame to which women are subjected. My argument is that the practice of vaginal examinations is indeed experienced – bodily apprehended – as violent by many women, but that full epistemic recognition of this violence is frequently obstructed because the experience perfectly coincides with the normal phenomenological situation of women within patriarchy and thus cannot really be framed as violent. A phenomenological analysis presenting the embodied experience of women under patriarchy as always already essentially tied to sexual availability and commodification, and to shame, will explain this epistemological impairment. A phenomenological take on Judith Butler’s distinction between ‘recognition’ and ‘apprehension’ informs my analysis: I deploy it to provide a richer, more nuanced response to the question of why vaginal examinations are not fully recognised and expressed as violent – even when they are, frequently, apprehended as such. Furthermore, Butler’s ideas about the epistemic ‘framings’ through which we make sense of different kinds of lives (grievable versus ungrievable) will help me to explain how the patriarchal sexual reification of women in fact already frames sexual violence as not-violence – which ultimately also prevents labouring women (and obstetrics staff) from recognising vaginal examinations during labour as violence.

“My Soul Hurt, and I Felt as If I Was Going to Die”: Obstetric Violence as Torture

“…As a result, posttraumatic stress disorder (PTSD), centrally featuring the sense of lack of control, power, and agency to make sovereign decisions in childbirth, is a postbirth reality for far too many women (Grekin and O'Hara 2014; Ayers et al 2016; Yildiz, Ayers, and Phillips 2017; Beck and Casavant 2019). Structural ailments such as racism, classism, and, mainly, sexism have been recognized as being responsible for the propagation of obstetric violence through medicalized childbirth all over the world (Bellón Sanchez 2014; Cohen Shabot 2016; Davis 2019; Cohen Shabot 2020a). Many recent investigations have inquired into the gendered nature of the phenomenon: its connections to gendered shame, to the patriarchal need to put women's bodies back in their place and control women's subjectivities by controlling their birthing bodies (Cohen Shabot and Korem 2018; Cohen Shabot 2020a).…”

“…Sexual violence is not fully perceived as violence within patriarchal societies, since women are commonly perceived as inherently available for sexual consumption (and as naturally shameful and deserving pain) and men as naturally entitled to act on women. Thus, it has been claimed that the same mechanisms that make sexual violence invisible in patriarchal societies also act to mask the presence of obstetric violence or to hinder epistemic recognition of the phenomenon altogether (Cohen Shabot 2019; 2020a; 2020c). Gudorf's analysis perfectly matches these arguments regarding obstetric violence: in the same way that sexual torture and torture through rape have been rendered unrecognizable as torture, in spite of their pervasiveness and their function as a global tool for controlling women and stripping them of agency, and in the same way that many women have interiorized the inevitability of such torture and thus been emptied of the power to resist it, so too has obstetric violence remained a pervasive phenomenon wherein human rights are constantly violated, with no clear recognition of that fact by medical staff or, frequently, by laboring women themselves.…”

“…Structural ailments such as racism, classism, and, mainly, sexism have been recognized as being responsible for the propagation of obstetric violence through medicalized childbirth all over the world (Bellón Sanchez 2014;Cohen Shabot 2016;Davis 2019;Cohen Shabot 2020a). Many recent investigations have inquired into the gendered nature of the phenomenon: its connections to gendered shame, to the patriarchal need to put women's bodies back in their place and control women's subjectivities by controlling their birthing bodies (Cohen Shabot and Korem 2018;Cohen Shabot 2020a). Epistemic questions regarding the phenomenon of obstetric violence have also been pondered, since much of obstetric violence is in fact normalized violence, which is therefore barely or not at all recognized as violence (Cohen Shabot 2019;2020a;Liese et al 2021).…”

Innovative analysis methods of the Perinatal pedagogy

“…A factor is the communication problems of medical personnel: failing to recognise and meet the human needs of of patients [5]. Another factor is too active and sometimes unnecessary medical intervention, such as a vaginal examination [6] or a cesarean section [7]. Research shows that many couples make decisions to give birth at home as a result of negative experiences with health care providers [8].…”

“…For example, Patterson et al Speak of "toxic cultures" that determine the behavior of medical personnel [5]. Another sociocultural factor is the epistemological prerequisites of a patriarchal society, which prevent women from recognizing medical interventions (in particular, vaginal examination) as violence, although it is physically experienced as such [6].…”