Arkansas Midwife Loses License - Mother Speaks Out Merged

[ClaraOswin]

13 hours ago, Ali said:

This so much.

I was actually so angry reading this thread earlier when I encountered the talk of obstetrical violence that I had to step away.

It is ridiculous and naive to think that birth will be easy and without complications. It works out well for some women. They should call themselves blessed and stop pushing that expectation that it will be the same for others. Birth is unpredictable. Many don't have it work out according to their birth plan. What matters is a healthy mom and a healthy baby.

I have two healthy children because I had enough wisdom to listen to advise from my doctors each time. I had two C-sections. I attempted to have a VBAC and there were complications. If I had ignored my doctor's advise, I could have had a still born baby instead of a healthy son. I am glad I did not think I was an expert on birth because I had read some Encyclopedias and surfed the web. Doctors are not all knowing . They weigh the risks based on the data they have and make recommendations. In hindsight, they might sometimes make different decisions.

We went to the baby class at our hospital while I was pregnant. At one class, we were given 9 (or something like that) index cards and told to write down our wants for labor/delivery - healthy baby, healthy mom, no c-section, my doctor to be there, no forceps, etc. We were then told to take a certain amount away...the least important ones and whatnot. Basically as an illustration as to what could happen. Obviously most were left with just a few cards like healthy baby, healthy mom. I thought it was a good exercise to do.

6 hours ago, Granwych said:

I must be one of the minority who healed fast after a C-section--wychling was born on a Monday, we would normally have gone home on Thursday, but wychling developed jaundice and was kept till Saturday(I stayed, too.)  I was given the okay to drive the week after the birth.

 

I would say I healed fairly quickly since it was a schedule c-section. I don't think I had any driving restrictions (unless I were to take the Percocet, which I didn't.) But I couldn't get in/out of bed on my own for quite a while. I couldn't do things around the house like laundry/vacuuming. Or lift super heavy objects. It's a big incision through many layers. That's always going to be a bigger recovery than a non-complicated vaginal birth. (Though I have known people who tore badly during a vaginal birth and the healing was really bad.)

[Denim Jumper]

22 minutes ago, ClaraOswin said:

We went to the baby class at our hospital while I was pregnant. At one class, we were given 9 (or something like that) index cards and told to write down our wants for labor/delivery - healthy baby, healthy mom, no c-section, my doctor to be there, no forceps, etc. We were then told to take a certain amount away...the least important ones and whatnot. Basically as an illustration as to what could happen. Obviously most were left with just a few cards like healthy baby, healthy mom. I thought it was a good exercise to do.

I like that! I was the birth warrior who showed up with a 3 page bullet-point birth plan, but quickly came to the realization that Baby didn't know (or give fuck) what my plans were.

And I think that is something women need to come to terms with: we should expect to be treated with dignity and respect, while understanding that we must also give up a certain level of control during labor. There's another patient involved who is depending on the adults in the room to make safe, evidence-based decisions.

My last birth was a violent and traumatic experience. Not because of anything that was done to me, but because it was that kind of birth. At some point I realized that the people in that room had collectively attended thousands of births,  and my baby depended on me to trust them and not presume the stereotype of someone having a golf match to get to. Although, funnily enough, my midwife did leave for a few hours to go to the office holiday party.

[SilverBeach]

I guess all surgery is violent, as is any bodily situation involving a lot of blood. I had uterine polyps once, they were violent as hell. I just never heard the word violence associated with medical care or conditions. I thought it was a given that some types of medical care are painful, bloody, and invasive. Maybe its just semantics, but in my 61 years I have not seen the term used in this context. I haven't been under a rock and I am well educated. But I learn something new every day.

[allthegoodnamesrgone]

50 minutes ago, ClaraOswin said:

We went to the baby class at our hospital while I was pregnant. At one class, we were given 9 (or something like that) index cards and told to write down our wants for labor/delivery - healthy baby, healthy mom, no c-section, my doctor to be there, no forceps, etc. We were then told to take a certain amount away...the least important ones and whatnot. Basically as an illustration as to what could happen. Obviously most were left with just a few cards like healthy baby, healthy mom. I thought it was a good exercise to do.

I would say I healed fairly quickly since it was a schedule c-section. I don't think I had any driving restrictions (unless I were to take the Percocet, which I didn't.) But I couldn't get in/out of bed on my own for quite a while. I couldn't do things around the house like laundry/vacuuming. Or lift super heavy objects. It's a big incision through many layers. That's always going to be a bigger recovery than a non-complicated vaginal birth. (Though I have known people who tore badly during a vaginal birth and the healing was really bad.)

My 1st C/section was a bitch to recover from, but that was done after 24 hours of pitocen labor and 4 hours of pushing. I felt & looked, like I'd been hit by a truck.  My second was scheduled, and even though I went into labor the day of my c/section it was only about 2 hours of contractions and I only dilated to a 2. Yes I still had the c/section I couldn't push out an 8lb baby so there was no point in trying with a thought to be bigger baby and she was she was over 9lbs. I was only in the hospital 2 days after the birth, my 2 1/2 year odl was NOT doing well with mamma being in the hospital he was scared and confused. so I had to go home. I remember about a week after she was born, running up the stairs because DS fell out of bed and was screaming.  I scooped him up and carried him down stairs with out even realizing I was carrying a 40 lb 2 toddler (yes he was 40 lbs at 2 he was ery tall and still is).  I regretted a few hours later, but I still did it.  The scheduled surgery and the mamma bear in me just made it so much easier, PLUS I NEVER had to sit on my stitches and I have awesome bladder control. 

[SnazzyNazzy]

6 hours ago, WhatWouldJohnCrichtonDo? said:

I went into my first labor with hopes, but no real expectations of how things would happen. I knew I didn't have any way of knowing how things would go. I went into my second labor with the understanding that it wouldn't necessarily be like my first. I wish we could stop having unrealistic expectations. That's actually one reason I don't tell my birth stories much; I don't want to sound like I'm bragging about how well it went or give unrealistic expectations to moms-to-be. Sigh.

Both of my labors and births, were relatively uneventful, complications wise. I always talk about my first son's birth, more negatively than my second son's, because truth be told, by the time delivery rolled around, I was pissed off.

It was an extremely long 24 hours that included : FOUR doses of P-Gel, THREE attempts at getting an epidural in, said epidural not totally working. The absolute worst of the injustices, is that my mom stole the Twinkies my BFF snuck in for me, AND eating them right in front of me. I was already about 15 hours in, and was starving. It will be 13 years ago this year, that the Twinkie incident happened, and I still have not let her forget about it, in fact, I remind her of it every year on his birthday.

[FakePigtails]

15 hours ago, feministxtian said:

My first child was delivered by an intern...I ended up with an episiotomy that took 32 stitches to sew up. I felt every bit of it. He literally laid scissors against my child's head and cut. I STILL have problems with the scar from that...34 years later. My water broke and without explaining a damn thing to me, I got an IV needle shoved in my arm, hooked up to pitocin, had an internal monitor shoved up my vagina and screwed into my baby's head.....ALL with out any of it being explained to me. Then, to add insult to injury, manual placenta removal without even a sedative. 

Second birth...midwife in a military hospital. No pitocin, no IV, no episiotomy. Baby had a bigger head than the first one. 

Third birth...OB/GYN who LOVED delivering babies. Never rushed...no cervical checks at the end of pregnancy, and I think three while I was in labor. The initial check when I got to the hospital, a check an hour later to see if I was progressing and then one right before I started actively pushing. That brat had an even bigger head than the first two and nary a skidmark. 

My first labor and birth were horrid. 

See your first experience is why I don't completely write-off claims of obstetric violence and birth rape. I've heard enough recent stories of basically forced unnecessary cervical checks (and those hurt a lot for me, so I'm grateful I had midwives who only did them when necessary) and episiotomies done without permission or explanation in non-emergency situations that I just can't write those situations off. And I mean, if it's not an emergency and a doctor is forcing hands or monitors or whatever into  a patient's privates, I can absolutely see why it's seen as sexual assault.

Unfortunately, the manual placenta removal without sedatives or painkillers seems to be common in the US based on birth stories I read while pregnant. I don't class that as an "OBs are assholes in the delivery room" thing so much as a "women are expected to cope with absurdly painful gynecological procedures and tests in general" thing. I was extremely glad I'd chosen an epidural when a piece of my placenta stayed behind!

That said, I'm with whoever said (I can't find the post and hope I'm not imagining it!) that the answer is better training for doctors, midwives and nurses in hospitals and not just moving women to non-hospital providers who have no accountability who in some cases (and widespread ones too, according to those midwife bloggers) are also doing illegal and dangerous things, just in ways that go completely unnoticed by their patients. Both situations are terrible but the patients in the latter are completely unaware of what happened and thus in their minds have nothing to report (and, of course, there aren't even bodies to report to even if they knew!). And not having medical care immediately at hand means bad decisions are more likely to cause poor outcomes that are worse and permanent - and no way to receive compensation because of how common it is for those providers to not have liability insurance.

To bring in my own experience again, I did need an episiotomy and was given warning that it and possibly a vacuum might be needed well before (because of the decels my baby was having) and was told near the end that I could try to push her out and probably tear on the next contraction and when that didn't get her out (potentially because I was afraid of what damage I could do to myself if I really gave it my all and some) was advised that an episiotomy was the safest option for the next contraction and gave the go-ahead for that. I was told after that I probably had just a few more contractions (which, at a few minutes each adds up in terms of time) to go before things for Mini FP were much more likely to go bad. I didn't ask what they would have done if I'd refused. It's hard for me to come to a conclusion about what should be done in cases where patients are stubborn in those circumstances since I believe patient autonomy is critical but if a minor procedure like an episiotomy can save the health of a baby . . . so I can only hope caregivers talk about these interventions before they're needed and patients are open to having them. But poor bedside manner and behavior on one side and exaggerations and propaganda (because I much in the "natural birth" community is that) make it all complicated in the end.

[feministxtian]

I think the reason the episiotomy got to me is that it was done WITHOUT a local and the stitching was done WITHOUT a local. It didn't really hit home for me until my third baby who had a head that was an inch bigger around than the first baby and aside from a little swelling and bruising of the lady parts...he came out just fine. 

My second birth wasn't that bad...but military hospitals SUCK! 

#3 child's labor and birth was so easy and almost painless. It was also VERY short! 

[FakePigtails]

59 minutes ago, feministxtian said:

I think the reason the episiotomy got to me is that it was done WITHOUT a local and the stitching was done WITHOUT a local. It didn't really hit home for me until my third baby who had a head that was an inch bigger around than the first baby and aside from a little swelling and bruising of the lady parts...he came out just fine. 

My second birth wasn't that bad...but military hospitals SUCK! 

#3 child's labor and birth was so easy and almost painless. It was also VERY short! 

Oh gosh, that's even worse! I actually read birth stories while pregnant where people with epidurals still felt it all and told my midwives I was absolutely not okay with that, and it didn't end up being an issue for me (thank any and all deities for that!).

[Coconut Flan]

I don't know it if it's true, but I was told that they couldn't do a local or it wouldn't "take" for the episiotomy and/or stitches.  The tissue is paper thin just before and after birth.  It isn't uncommon for a larger second or third baby to have no problems being born while a first one is more likely to get stuck. 

A friend of mine paraphrased it as once you've paved the road, you might as well drive down it. 

[feministxtian]

46 minutes ago, FakePigtails said:

Oh gosh, that's even worse! I actually read birth stories while pregnant where people with epidurals still felt it all and told my midwives I was absolutely not okay with that, and it didn't end up being an issue for me (thank any and all deities for that!).

All three of mine were all "natural"...a pitocin induction after my water broke was the WORST thing I have EVER experienced. That was the first. I chalk it up to being young, on medicaid and being thought of as "less" than the women who had a private OB and all that stuff. The second one at the military hospital...well, it was the middle of the night and military hospitals are not known for great care. My third, private OB, private insurance...got treated MUCH better all the way around. 

[Casserole]

A year or two ago at my yearly routine PAP smear/GYN check-up, my regular doctor was out delivering a baby and I opted for whichever doc was available in their practice over rescheduling. This woman nonchalantly, mid-exam, says "did you know your uterus is backwards? Let me manually flip it." I was definitely not "informed" and there was definitely no "consent." Both her hands were up in there painfully trying to "flip" an organ... I couldn't sit comfortably for two days. Further research told me what she did was absolutely not necessary. Also interesting that in my 10+ years with the same doctor no one mentioned it, let alone showed concern about it. 

 

Use whatever terminology you want; I felt violated and assaulted. 

[Mercer]

I definitely think birth trauma and obstetric violence are real things and need to be talked about. Obviously not every birth that doesn't go as desired (even painfully so) falls into those categories, but I do think the medical system can be stacked against patients at times, especially women of color, indigenous women, poor women, queer women, or otherwise marginalized groups. Abuse of patients unfortunately sometimes happens, particularly when the power dynamic is such that the patient feels unable to speak up, and birth isn't some magical sacrosanct place where the usual systems of classism/racism/sexism cease to apply.

That said, I really dislike the term "birth rape." Rape is a specific thing. It's not just a generic term that means "something bad that happened." If a patient is in fact sexually assaulted during a birth experience, there's already a term for that - sexual assault, no qualifier needed. If a patient is subjected to other types of violence... that's wrong and horrific, but not every act of cruelty is a rape.

I feel like that language simultaneously makes the general public more dismissive of the problem (by making it seem like the whole thing is just melodrama) while also dismissing the suffering of sexual violence survivors by stripping the word "rape" of specific meaning for the purpose of co-opting it for a different use.

[Karma]

@Casserole that's awful!  I was told my uterus was retroverted - I think during a PAP smear pre kids. It has never been an issue. I've got no idea why a doctor would do that to you!  Ouch  

[Imaginary_Wonderland]

I have never heard of the term obstetric violence before, and while it was interesting to read about, like the poster above said the term birth rape has been really bothering while reading about birth trauma. Perhaps I am being over sensitive victim triggered by the term, and it is not a big deal to most people. I really liked Mercer's post as it reflects how I was feeling about the use of the term but wasn't sure how to put words to it. I get a bit mad and ragey when i see or hear people ( I don't mean users here but in general) using the term rape to describe other things. I don't agree with it, to me rape is rape, and the word shouldn't be tagged along to describe something else in a more dramatic way. I kinda cringe a bit when I hear people joking about being fraped or fraping someone (facebook rape) or more recently I heard the term road rape to describe getting revenge or hassling another driver you feel has wronged you while driving. That's just two examples but heard the word being tagged onto other terms or situations too. 

[Casserole]

2 hours ago, Karma said:

@Casserole that's awful!  I was told my uterus was retroverted - I think during a PAP smear pre kids. It has never been an issue. I've got no idea why a doctor would do that to you!  Ouch  

Very much, ouch! I have no idea, either. I had never heard of it prior to that day, but in my searches it seemed a non-issue; I have zero reproductive health issues/pain/symptoms, and I'm no where near trying to conceive (though all the research seems to say it'll either stay retroverted or possibly "pop up" to normal once a baby is in there - so again, a non-issue) I won't call it rape or sexual assault because there was nothing sexual about it, but it felt like I had been assaulted. No warning, not even a "relax" warning, just two large hands inside of me trying to move my organs against their will.

Anyway, not sure where I'm going with this. The talk of "birth trauma" triggered me and I can't imagine being in the shoes of the women who have experienced it. You're so vulnerable during child birth and while everyone surviving takes priority, taking away a women's autonomy in a non-emergent situation is horrible. 

 

Also, off that topic, but still in line with the thread - I saw a hospital semi-local to me that has a birthing center in it added a few whirlpools for water births. That makes me ridiculously happy. If I should ever procreate, I can (potentially) have the water birth I want with the security and safety of a hospital. 

[SilverBeach]

There is already a term for obstetric violence too, bad medical care. No need for a special name when pregnant women are the victims. 

[Coconut Flan]

Firmly telling them no and stop that is also a good beginning along with saying touching me against my will is assault so stop now.  You can also refuse to be treated by interns or even to be examined by them.  I may have done these things. 

[feministxtian]

1 hour ago, Coconut Flan said:

Firmly telling them no and stop that is also a good beginning along with saying touching me against my will is assault so stop now.  You can also refuse to be treated by interns or even to be examined by them.  I may have done these things. 

I didn't know that 34 years ago. I was 18 and terrified. 

[feministxtian]

18 hours ago, SilverBeach said:

 

I guess all surgery is violent, as is any bodily situation involving a lot of blood.

 

My husband had the granddaddy of all surgeries, considered more complicated than even a heart/lung transplant and yes, it was unbelievably violent. He was cut from breast bone to pubic bone, had his guts rearranged and removed and sown back up. He had deep bruises from the edges of the incisions all the way around to his back for weeks. HOWEVER...he (and I) knew that going into the surgery that it was going to be long, complicated and had a high complication rate. The alternative was a slow, painful death due to rampant diabetes and malnutrition. 

THe difference between his surgery (and most of the surgeries I've had) and my first birth especially, were that we BOTH knew that they'd be painful and have a long, painful recovery. We both deal with some of the aftereffects of those surgeries, but sex still being uncomfortable after 34 fucking years after some fucking intern decided to cut me from fucking stem to stern and then do a shitty job of putting me back together was NOT something I had signed on for when I went to gave birth to my child. 

[jozina]

I was halfway down the path of obstetric training. I stopped, primarily because of how litigious it was.  There are bad doctors in every area, but there are few other areas of medicine where people want a potentially traumatic event to be a delightful experience and start waving around the threat of a lawsuit if they don't get their own way on things that are potentially harmful, or if they ignore multiple warnings and discussions of risk then something goes wrong and they start insisting they were never told it could happen.  Things go wrong - absolutely! Nothing is perfect. Having cover for when things go wrong - again, absolutely!  Bad doctors getting called out on bad practices - absolutely, don't give all of us a bad reputation. Bad doctors getting sued - sure. Communicating well so that everyone understands what is going on and documenting it in detail - definitely. But most of the time when I've seen people start mentioning lawsuits they are not being sensible. I didn't want to put my family through the stress of a lawsuit so I got out. And off I went, to an area where more things go wrong but almost no-one gets sued.

Where I am (part of Australia) you can totally refuse to be treated by any given doctor - intern, registrar, consultant, whoever. If you're in a public hospital you can also then be told that you will need to wait until someone else is free to do whatever is needed. No malice, but you'll get good treatment without being able to pick who provides it. If it's an intern it's usually placing an IV that people complained about.  If I was scrubbed in theatre, it was overnight and the consultant was nowhere to found then you could be waiting a looooooong time for that IV if you refused the junior doctor because we just don't have that contingency. A consultant is not going to be called in overnight or take a break from work only they can do if it isn't medically necessary.  And then when they were free that consultant was way more likely to miss your vein anyway because they place maybe one or two a month and the intern has likely placed ten that shift.

Running joke at most of the departments I worked at amongst midwives and doctors was that people would be less likely to think we were out to force women into c-sections or instrumental deliveries if they sat in our handover room for ten minutes.  It's a super busy area and if a woman delivers without any interventions it's super - we might actually get to eat lunch! The midwives running around between rooms only needed to spend minimal time in with you so they might get to sit down with a coffee! If you don't deliver on that shift no-one is going to try and hurry things along because it is shift work, and the next person on will do it.  I can do a c-section my sleep, so doing another one is about as exciting as cooking my favourite meal. Happy to do it, but I'm not going to toss it in the bin after I make it so that I get the excitement of making it again or pretend I think it's dinner time in the morning so that I can make it twice that day. I make no comment on medical services but the ones I've worked in, but my eyes glaze over when I read birth stories from my area that claim a birth was hurried along in a public hospital. I feel like some women read horror stories online that aren't local to them, turn up wanting a fight which they expect the midwives will side with them on and then...find no willing combatants but themselves.

It isn't a midwife vs doctors thing here most of the time any way. Most midwives are amazing and I loved working with them. They tended to have identical views to the doctors when someone turned up with very unusual or impossible requests. There were a few who were aggressive, just as there were a few doctors who were rude to the midwives, but they really were the exception.

I miss obstetrics and I think I'd have made a competent and caring obstetrician, but I am very glad I changed course.

[Coconut Flan]

@feministxtian Pain remaining after an episiotomy heals is I believe a known complication of the procedure.  I had a perfectly competent, fully trained OB for my first delivery which was complicated by factors out of his and my control.  The child was born sucking its thumb.  It's a bit more difficult to deliver head plus arm/fist.

What I did, however, was find an OB after that who was even more experienced and we discussed solving that problem.  It ended up the best solution for fixing my issue was to let me tear the old scar during delivery.  It worked.  There are doctors who can perform surgery to fix that kind of problem.  In my case it was since you're planning to have more children, then we should wait for the next one. 

I'm sorry it happened and it's no fun, but there are solutions. 

[SweetFellowshipper]

On 12/31/2016 at 5:48 PM, Ali said:

This so much.

I was actually so angry reading this thread earlier when I encountered the talk of obstetrical violence that I had to step away.

It is ridiculous and naive to think that birth will be easy and without complications. It works out well for some women. They should call themselves blessed and stop pushing that expectation that it will be the same for others. Birth is unpredictable. Many don't have it work out according to their birth plan. What matters is a healthy mom and a healthy baby.

 

I was equally triggered reading the outright denials of obstetric violence and assumptions that women who tell their stories are naive, thought their birth would be perfect, etc., rather than assuming those women's experiences of violence (which are widely available and don't fit the "they thought it would be perfect" narrative) are valid. I had to step away to consider a less angry response. I would suggest that people read stories of obstetric violence (for example, about how people use the term) before making assumptions, as many of them are inaccurate.

The topic is intersectional, as it disproportionately affects women who are part of marginalized populations.

Forced sterilizations of Latina and black women in the U.S. throughout the 50s-70s were violent, and they were birth trauma. Women undergoing labor, under extreme distress, were promised pain medication only if they signed off on being sterilized, or they were given information only in English, which they couldn't speak. The laws passed as a result are why we have medical info available in multiple languages. This happened in the U.S. Fairly recently. It is not just a third world country issue. And women in marginalized populations in general continue to have less access to quality health care, less choice overall in their care, and less of a chance to choose their provider if one makes them uncomfortable or afraid. Women who have been criminalized, who are disproportionately poor/WOC/disabled, often have to give birth while handcuffed and restrained. 

Luckily, it is a problem that is increasingly being noted in the U.S. Obstetric violence is already a legal term in Venezuela. This resource also includes case studies of forced c sections and other abuses, in answer to those who asked if forced interventions really do happen. It also compares the U.S. lack of attention to this kind of violence to measures taken in Latin America that have reduced reports of obstetric violence. I would suggest giving it a read.

http://www.sciencedirect.com/science/article/pii/S0968808016300040

As a survivor of multiple rapes and extreme physical abuse, I personally don't prefer to use the term "birth rape," but I *was* penetrated against my will by two different nurses after expressly telling them I did not want to be and needed time, and saying throughout the procedure that they did not have my permission to penetrate me and to please wait. If that or worse is an experience to rape to some (it certainly fits the legal definition of sexual assault and/or rape, and btw the legal definition of sexual assault doesn't require the perpetrator to think of it as assault, enjoy it or take sexual pleasure in it), then I don't blame them for using the term, though I understand why it's inflammatory. And I am a person with many privileges (white, educated, able bodied, legal citizen), so I cannot imagine the experiences of others who don't have them. 

It's interesting that people are so against the terms obstetric violence (which I prefer, and which is used because this is a specific widespread problem, not just "bad medical care" any more than abuse is just a "bad relationship") or birth rape but want to minimize or dismiss what may have happened to women while giving birth without actually being there. Doesn't the same thing happen in instances of police brutality or domestic violence, and actual rape? People assume the authority knew best, that there must be extenuating circumstances, that she must have been the one in the wrong, that there must be more to the story, that "not all men" are like that so it must not happen to others, that there can't possibly be any alternatives or a way to reform police forces so we just have to live with it, that because THEIR experience wasn't like that it must not happen to anyone, that educated people can't commit real assaults, it was just verbal abuse so it wasn't violence, that they probably were naive or uneducated or didn't understand? Particularly when the woman involved is trans, queer, poor, or a person of color? That's all I could think of reading these comments.

[SweetFellowshipper]

Info about the legal term in Venezuela...

 

In an editorial published online on October 6, 2010 in the International Journal of Gynecology and Obstetrics, Dr. Rogelio Pérez D’Gregorio, President of the Society of Obstetrics and Gynecology of Venezuela described the specific mentions of the term “obstetric violence” as it appears in the Organic Law on the Right of Women to Be Free from Violence, enacted in Venezuela on March 16, 2007.

The law defines obstetric violence as “…the appropriation of the body and reproductive processes of women by health personnel, which is expressed as dehumanized treatment, an abuse of medication, and to convert the natural processes into pathological ones, bringing with it loss of autonomy and the ability to decide freely about their bodies and sexuality, negatively impacting the quality of life of women.”

Dr. Pérez D’Gregorio highlights two phrases for consideration, the first of which is “health personnel.” In Venezuela, this includes obstetricians, residents, medical students, nurses and technicians. Midwives are not included because, as Pérez D’Gregorio notes, “midwifery does not exist in obstetric practice in Venezuela, where all deliveries are attended by physicians in an institution.”

In addition, the phrase “the appropriation of the body and reproductive processes of women by health personnel” is, according to Pérez D’Gregorio, “contrary to good obstetric practice, whereby medication should only be used when it is indicated, the natural processes should be respected, and instrumental or surgical procedures should be performed only when the indication follows evidence-based medicine.”

The following acts executed by care providers are considered obstetric violence:

(1) Untimely and ineffective attention of obstetric emergencies; (2) Forcing the woman to give birth in a supine position, with legs raised, when the necessary means to perform a vertical delivery are available; (3) Impeding the early attachment of the child with his/her mother without a medical cause thus preventing the early attachment and blocking the possibility of holding, nursing or breast-feeding immediately after birth; (4) Altering the natural process of low-risk delivery by using acceleration techniques, without obtaining voluntary, expressed and informed consent of the woman; (5) Performing delivery via cesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman.

In these cases, the person or persons responsible are subject to a fine of two hundred and fifty (250 TU) to five hundred tax units (500 TU) and the court will submit a copy of the sentence to the professional body or union responsible for disciplinary actions.

 

[Ali]

1 hour ago, SweetFellowshipper said:

It's interesting that people are so against the terms obstetric violence (which I prefer, and which is used because this is a specific widespread problem, not just "bad medical care"

In the United States, it is bad medical care. In the United States, there is something called informed consent. There are means to complain about poor medical care. There is the ability to ask for a new nurse or a new doctor. I don't know much about medical care in other countries. I am going to stick to commenting about current medical care in the United States.

If you want to focus on past medical care in the United States or issue with medical care in developing countries, that is a completely different subject that I am not educated enough to comment on at this time.

[SweetFellowshipper]

1 hour ago, Ali said:

In the United States, it is bad medical care. In the United States, there is something called informed consent. There are means to complain about poor medical care. There is the ability to ask for a new nurse or a new doctor. I don't know much about medical care in other countries. I am going to stick to commenting about current medical care in the United States.

If you want to focus on past medical care in the United States or issue with medical care in developing countries, that is a completely different subject that I am not educated enough to comment on at this time.

No, the article I posted (the science direct one, from a peer-reviewed international medical journal) is about current obstetric violence in the U.S. It was published in May 2016 and all examples are from the 2010s. I am not only talking about other countries. Here it is again, with case studies of forced medical interventions and threats of arrest or harm for women who would not comply, along with several other forms of systemic and individual violence: 

http://www.sciencedirect.com/science/article/pii/S0968808016300040

Another review of the existing literature and statistics on abuse (their term) of women during childbirth that spans globally and suggestions for ending it, from 2010, done by the Harvard School of Public Health. It includes several examples from the U.S., including forced detention in facilities and racism experienced by black women during childbirth:

http://www.tractionproject.org/sites/default/files/Respectful_Care_at_Birth_9-20-101_Final.pdf

If bad medical care is psychologically or physically violent, it is violence. If someone penetrates you or does harm to your body without your express consent, it is violent, despite it being done by a doctor, nurse, midwife or technician. If informed consent is not followed, as in the examples in the two articles, it is nonconsensual violence. And the idea that everyone can ask for a new nurse or doctor is untrue for all populations and a privileged position. 

Violence done by police is still violence. Violence done by medical professionals is still violence. Violence done by any authority figure that you have the right to complain about is still violence. When companies violate discrimination laws or the ADA, is it not discrimination because the people have the right to sue or complain? No. Citizens have the right to sue or file complaints about police brutality. That does not make police brutality "bad police work." It is still brutality.