When gynecologists gaslight women

ŽK, 17. 9. 2020

From the UK to Ukraine, women are forced to endure traumatic reproductive health procedures without adequate pain relief because their pain “is not possible” or not important enough to prevent. In some cases this leads to torn uteruses and PTSD.

“This is what happens when you like men too much.” These words were spoken by a Zagreb doctor to a young woman during a surgical abortion. The woman then had her womb scraped without anesthetic, while the surgeon joked with his medical team about her sex life.

Her devastating testimony is recorded in a complaint to the UN Special Rapporteur on the Right To Health by the Croatian Parents’ Rights organization RODA. The organization invited women to submit their experiences of enduring reproductive healthcare without anesthetic under the campaign banner “Breaking The Silence” (#PrekinimoŠutnju). In the space of a weekend, they received 400 handwritten submissions.

“The stories involved women who had biopsies on their uterus, cervix or vagina without anesthetic,” RODA’s Head of Reproductive Rights Daniela Drandic told me over the phone.

“There were stories of women who had been through medically assisted fertility treatments and had their eggs removed without anesthetic. Women being sutured after childbirth, having their placenta manually removed, and surgical abortions or miscarriages, all without anesthetic.”

In some shocking cases, Drandic explained, “women were offered a shot of hard liquor before a procedure to make it easier.” One woman was scolded by her doctor while having samples taken from her reproductive organs. He said: “you didn’t cry while having sex, so shut up now.”

This is the reality of “obstetric violence” in Europe. From the UK to Ukraine, women are failed by the medical establishment and forced to endure procedures relating to their reproductive health without adequate pain relief. In some cases, the women’s experiences led to further complications such as torn uteruses, and PTSD.

Across the Adriatic Sea in Italy, birth activist and co-founder of Obstetric Violence Observation In Italy – or OVOItalia – Elena Skoko has collected similar stories via the campaign Mothers Have A Voice.

Over Skype, Skoko told me “many gynecological procedures are done without pain relief or the anesthetic is not working properly and women are not believed when they complain. Other times, as in childbirth, pain relief is forced on women. Women’s point of views [are] not taken into account when it comes to their experiences and to the care they need or want in maternity and childbirth. They are infantilized and made to feel inferior, which puts their life and the life of their babies at risk.”

OVOItalia has collected stories from women experiencing verbal abuse and even physical assault while in labor. One common technique called the Kristella Maneuver (the applying of pressure to the uterus to assist in vaginal birth), OVOItalia co-founder Alessandra Battisti described to me as “very traumatic for women because they do not expect it. The women feel they can’t breathe and many times they have broken ribs.”

THE LAST ACCEPTABLE FORM OF VIOLENCE AGAINST WOMEN

As with Croatia’s “Breaking the Silence”, OVOItalia invited women to submit their testimonials of obstetric violence, including abuse during childbirth. They then conducted a nationwide survey to gather data on women’s experiences of reproductive healthcare.

“Our campaign is the first time in Italy so many women have talked about their personal experiences of childbirth,” Battisti told me over Skype. “Women used to talk only in closed spaces among a few friends. There was not a public speech about it.”

According to Skoko, this silence was, in part, “because we didn’t have a discourse around this form of violence. Women, mothers, activists, researchers — they knew what they were talking about but it was very difficult to frame this experience of traumatic birth. Then in 2006, Venezuela made a law on gendered violence and they called this ‘obstetric violence’.”

But what is behind what US writer Elisa Albert calls “the last acceptable form of violence against women”? Why are women forced to endure painful and upsetting procedures without anesthetic? And why are women experiencing such unnecessary pain and trauma in the delivery room?

“Firstly it’s a multi-generational problem that has been going on for as long as hospitals have existed,” Drandic explained. “So when a woman says to her mum or sister or friend that she had a painful procedure, the response she gets is that this is just the way it is done. Secondly it’s a culture of reproductive healthcare that’s offered to women. We’ve had stories of trainee doctors questioning why women aren’t given some kind of pain relief and the response is always that’s just the way we do it.”

“I think it has a lot to do with the cultural idea that women have to suffer in order to be worthy,” she continued. “To be worthy of being mothers, to be worthy of being women, to be worthy of being anything. It’s a woman’s job, right? To deal with pain. That’s the idea we need to be challenging.”

Slovakian activist Zuzana Kriskova, who co-authored the report Women Mothers Bodies One and Two, agreed. “The rights to make decisions on your own body is not something you are taught from infancy,” she told me over Skype. “Women are taught to behave in a pre-approved way — not to provoke or be emotional. There’s an image of the good mother who sacrifices herself for her baby, and the pain of women is seen as good for them.”

For Alessandra Battisti, the causes of obstetric violence can also be explained by a refusal to believe women when they talk about their lived experience — especially when it comes to pain.

“It’s the same pattern that we observe with any other forms of violence against women,’ Battisti told me. “Women are considered to be exaggerating. When women say they feel pain, as after a c-section or episiotomy, the doctors tell them ‘no you are not in pain’. People think it’s only the woman’s view, and the stereotype that women tell things which are not true is still very strong.”

Kriskova reflected this analysis, telling me “male doctors are seen as having the knowledge and the knowledge that women have of their own bodies is seen as not reliable or acceptable.”