Only hidden if you haven’t been paying attention, but at least it’s starting to make the news now.
In the final minutes of Malatesta’s labor, she says this struggle became a violent physical assault. She describes how her nurse forcibly wrestled her onto her back while another nurse pressed her infant’s crowning head into her vagina for six minutes. Malatesta says her screams of “Stop!” were ignored as she struggled in what she calls “torture.” Her son Jack was born healthy and unharmed, but Malatesta suffered severe nerve damage as a result of the assault.
The term “obstetric violence” appears nowhere in US law, but other countries like Venezuela and Argentina are beginning to define it as a crime against people giving birth. It is an umbrella term that includes disrespectful attitudes, coercion, bullying, and discrimination from care providers, lack of consent for examinations or treatment, forced procedures like C-section by court order, and also physical abuse. In 2016, the American College of Gynecologists and Obstetricians (ACOG) issued a comprehensive committee opinion affirming that a “decisionally capable” pregnant woman has the right to refuse treatment, and discouraging “in the strongest possible terms” the use of “duress, manipulation, coercion, physical force, or threats… to motivate women toward a specific clinical decision.” However, their opinions and resolutions are not binding.
What was shocking for doulas that we spoke to was not the disrespectful way Malatesta had been treated or even her physical assault, but the fact that she had fought back publicly and legally against her abuse. And that she had won.
Most doulas agree that the issue of obstetric violence is especially severe for women of color, and that discrimination based on race, ethnicity, age, socio-economic status, and marital status are widespread in maternity care.
In standard OB-GYN care, Morrison says, women are barred from making choices in ways that would be unthinkable in other medical situations. She believes the root of this approach, and of obstetric violence, is the idea that a mother and baby are separate entities, that the baby has “rights” that supersede his mother’s. “So all agency has been taken from women,” Morrison says. “And the people who have done that are obstetrician-gynecologists.