On medical rape: This is one of those inter-blogular stories that I inevitably end up misrepresenting because I haven’t followed most of it, but from what I can tell, it’s ugly. Check out that link for the backstory.
Here’s the general run-down: A radical feminist blogger named Debs put up a post about undergoing a gynecological procedure with a new doctor. She consented to the procedure initially, but it became increasingly painful and she repeatedly asked her doctor to stop. She ended up screaming and in tears, and the doctor still wouldn’t quit. She posted about it on her blog, and said that it felt like “medical rape.” The post is now down, but from what I can tell from reading excerpts, her point wasn’t the terminology — it was the need to discuss how the medical establishment treats women, especially in the context of gynecological care, and how doctors imposing their will on you in that setting is a deep and painful violation. Well, Dr. John Crippen, who writes for the NHS weblog, came across her post and promptly decided it was his place to emphasize that she was not “medically raped.” Nevermind that the terminology really wasn’t the point; he takes offense at women (not just this blogger) comparing what he calls “bad obstetric experiences” to rape. And so he rips Debs to shreds — claiming that she doesn’t understand the female anatomy, that she’s hysterical (shocker), that she’s psychologically ill, that she’s obsessed. He wonders how she managed to get pregnant in the first place (because, ya know, she hates having things in her vagina, and an invasive medical procedure is just like sex). He calls her and another feminist activist “coffee-shop feminists” and “disgrace[s] to feminism.”
Apparently the “childbirth can feel like rape” line of argument is occasionally used by home-birth activists — that women want control over their own birthing processes, and that this may be especially true for women who have experienced sexual assault. This is a big issue in both the U.S. and the U.K., as the medical establishment attempts to limit and sometimes even outlaw home births. So the “Medical procedures can be traumatic when women remove their consent or don’t consent in the first place” line isn’t just striking a nerve about the particular procedure that the blogger had; it’s getting to a bigger policy question of who should be in charge of women’s bodies.
In another post, Crippen quotes one woman who he thinks is out of line:
I was a victim of rape at 14years old, a virgin. I had a hospital delivery and specifically said no epidural for baby no.1. I had an epidural (against my wishes) during transition. When being on my back and numb from the waist down it gave me flashbacks to the rape.
They call it body memory. It was horrendous, so bad that my partner left me a month after my son was born. He couldn’t handle my PTSD.
I had no anger towards the doctor, only myself. Of course I was angry towards the perpetrator who raped me as a teenager but I just didn’t expect it to come flooding back to me when giving birth. I had no control over this. It just happened. Completely out of the blue.
I believe that many survivors of abuse and rape are reminded of it by feeling out of control. This is what labour can do. For me it was being numbed from the waist down and flat on my back (this is how as a child I disassociated myself from the experience, by numbing and removing myself from my body).”
He then quotes another doctor:
“I am repeatedly struck by the high level of self-reported childhood sexual abuse and rape in homebirth advocates. I put in the words “rape survivor homebirth” into Google and found 15 separate instance of phrases like “since I am a survivor of rape, I wanted a homebirth” or “as a survivor of rape I knew that the way my OB treated me what just like rape”. There definitely seems to be a notable association of these phenomena: a history of previous sexual assault, a bad childbirth experience, and PTSD. Here’s my question:
Why is there such a ferocious insistence that it was the childbirth experience that caused the PTSD and not the previous sexual assault?
There seems to be a large group of women who report being sexually assaulted in some way, and they are adamant in their insistence that the assault did not have serious psychological repercussions. They were fine until they had a baby. The psychological issues became apparent then and, therefore, it must have been the doctor’s fault.
What is going on here? No matter what the doctor did, it could not begin to compare to the original assault. I am almost forcibly struck by the level of anger toward the doctors. Yet there is a curious lack of emotion toward the original assailant. The level of anger directed toward the doctor seems startlingly high, and the level of anger toward the assailant seems curiously low.
It feels like there is a psychological need to blame the doctor INSTEAD of the original attacker. Why should that be?”
It’s not too difficult to see the strawman arguments being made here.
But it gets worse. Crippen seems skeptical when women report almost any kind of rape. He writes:
Change the scenario a little. The room becomes a student bedsitter in a University Hall of Residence. John and Mary voluntarily enter the room together late at night after a party. They have both been drinking. The next morning, Mary leaves the room in tears and tells a friend that John made her have sex against her will. The friend calls the police. John is arrested. John agrees that they had sex, but says it was consensual. How do you establish who is telling the truth?
It is not possible.
He does seem to be under the impression that rape is a matter of opinion and interpretation. No wonder he can’t be bothered to listen to Debs about her experience, or trust women to make their own decisions.
There’s a long tradition of the medical establishment assuming that it knows better than women, and of doctors attempting to fully occupy areas that had traditionally been the realm of women (midwifery, etc). Now, I happen to like doctors and modern medicine quite a bit; if I ever were to have a baby, I would want it in a hospital and jacked up on as many painkillers as you could give me. But that’s because, for me — with my background, my beliefs and my experiences — that’s how I feel safest. And if there’s ever a time you want to feel safe, it’s when you’re giving birth. Women with different experiences and beliefs feel safer in different situations — and there’s a large contingent of women who apparently feel safest when they’re at home, with someone they trust who has helped them through their entire pregnancies, and in a situation where they feel fully in control.
It’s a tough balance, because doctors obviously have an obligation to keep their patients as safe and as healthy as possible, and I do believe that most doctors genuinely think they’re doing the right thing when they push hospital childbirth. For a lot of women — and especially women with high-risk pregnancies or histories of medical problems — it probably is the right thing. But other interests come into play in a corporate system of medicine, and the patients’ best interests are unfortunately not at the forefront (for more reading, check out Paul Starr’s The Social Transformation of American Medicine). There are systematic and institutionalized incentives for the American Medical Association to promote hospital births and to keep childbirth squarely in the realm of a self-regulating medical profession. And there is a long history of a predominantly male medical establishment ignoring women’s concerns and knowledge about their own bodies.
I don’t think it’s bad to have a healthy skepticism towards things like natural remedies, midwifery, or whatever else, just like I don’t think it’s a bad thing to have a healthy skepticism of a modernized medical system that is often more concerned with its economic bottom line than actual health care. I’m personally skeptical of the “get in touch with your body to heal all ills” line, the best example of which I can think of was Inga Muscio in her book Cunt, wherein she argued that women can track their fertility by following the waxing and waning of the moon (she also self-performed an abortion with the help of herbs and massage). I liked Muscio’s book, but in my personal opinion, staring at the moon to track your menstruation is a waste of time, and Muscio’s woman-meets-nature schtick was a little loopy.
But that’s because I like my hormonal birth control, and because my own body isn’t particularly good at telling me when there’s something wrong (or perhaps because I rarely bother to listen to it — too many other things to do). To each her own. What works for Inga works for Inga, and more power to her.
I don’t have a problem with debating the relative merits of homebirths. I’m all for women having control over their own reproductive lives, whether that means giving birth at home or in the hospital, with a midwife or a doula or a doctor (or some combination of the three), “naturally” or with drugs. I think women have a right to be fully informed of the relative risks and benefits; I think doctors, doulas and midwives have an obligation to deal with women on a case-by-case basis, and to make decisions based on the individual patient’s condition and not ideology. I’ve heard a lot of women complain that their doctors didn’t listen to them, or made their birthing experience more traumatic; I’ve also heard women complain that their birthing assistants, doulas or midwives were determined to do the birth “naturally,” and also didn’t listen when the woman changed her mind or wanted some sort of middle ground. I don’t have a problem discussing the various issues and choices that pregnant women face; I don’t have a problem with people who feel strongly on one side or the other advocating for their position (especially if that advocacy is being done out of a genuine commitment to women’s health).
But I do have a problem with invalidating and actively ignoring women’s experiences, and with telling them what they are and are not allowed to consider personally violating. Doctors are certainly not the only ones who do this, but it does seem particularly condescending and dangerous when it’s coming from people of relative power and influence, whose opinions are largely considered bulletproof. If Dr. Crippen, the UK medical establishment and the AMA think that women shouldn’t feel violated by traumatic childbirth experiences, fine — but that doesn’t change the reality that women are violated by traumatic childbirth experiences, and women who have experienced both rape and powerlessness during childbirth are saying that, to them, the experiences felt similar. It’s condescending asshattery, and it’s the reason that a lot of women are distrustful of doctors (especially male doctors) in the first place — we feel like we are not listened to about our own bodies.
And now Dr. Crippen, who runs a large and widely-read blog, has made his point on the back of a woman who underwent an incredibly traumatizing event and was still strong enough to write about it — until her words were spread ’round the internet, and she was propped up as an example of the hysterical harpie who’s willing to claim that her doctor raped her just because an exam hurt a little bit.
Women do deserve to have choice in childbirth, just like people deserve the choice to opt out of most medical procedures, so long as they are fully informed about their options and the risks and benefits. Women deserve the basic respect to be heard when they say “No, stop” — even to a doctor (assuming, of course, that the procedure is one that can be safely halted at that point). And women deserve better from their doctors than what Dr. Crippen seems to believe.
- Anti-Choicers: Punishing Women with Non-Consensual Invasive Medical Procedures by Jill April 28, 2008
- A bit more on that “one in four” statistic by Jill February 27, 2008
- The 11th Commandment: Thou Shalt Not Give Healthcare to the Women-folk by Jill September 4, 2007
- Refusing to Provide Medical Care by Jill June 5, 2008
- Naming by Jill June 20, 2007