Laughed at and insulted, tied up against her will, cut open without permission: some mothers are traumatized by the birth of their child.
Birth is painful anyway. However, many women also experience physical or psychological violence during the most formative hours of their lives. What has long been hushed up is now being brought out into the open by more and more mothers.
Actually Sandra feels well prepared for the birth of her first child. The 34-year-old goes through a complication-free pregnancy, is informed, open and willing to try out what is good for her body. But to process what then happens to her in a Bavarian delivery room takes the teacher years. For the birth of her daughter develops into a martyrdom. Sandra is strapped to leg trays against her will. She is laughed at by the midwife when she asks follow-up questions. Without warning, a doctor throws himself full force onto her belly in order to push the child out of her. She is then stitched up again without additional painkillers. And all the time there is this helplessness, the being at the mercy, the powerlessness. "I felt as if I had been raped and had the feeling that my beloved child was being beaten out of me, she later writes about it. While her daughter looks forward to her birthday year after year, for Sandra it’s just one thing: the anniversary of her birth rape.
Becoming a mother, women have been told for generations, is a thoroughly fulfilling experience. Once the newborn is in the arms of the mother, all pain is forgotten. "The main thing is that the child is healthy, then gets to hear this. But what if the birth is so traumatic that it can’t just be business as usual?? When experiences in the delivery room strain or destroy the relationship with the newborn or the partner? Do women like Sandra have to cope with their experiences without complaint – because it’s all part of becoming a mother??
For sociologist Christina Mundlos, the clear answer is: No. What women like Sandra have experienced, she defines as violence. "I would speak of violence if, for example, the patient did not consent to a medical intervention or was not informed about it, she tells n-tv.de. And there are quite a few of these interventions: When, for example, pressure is exerted on the uterus from the outside without consent using the so-called Kristeller grip – which the World Health Organization (WHO) warns against and which is banned in some countries – partly by the midwife or doctor leaning on the woman’s abdomen with their body weight. When the placenta is ripped out, the woman giving birth is strapped down for no reason, brutally vaginally examined, unnecessarily cut open and then sewn up too tightly. But also when psychological pressure is put on the expectant mother, when she is forced to take measures that she actually does not want, when she is left alone and insulted.
Survey: more than half of women giving birth experienced violence
When Mundlos became a victim of violence and assault at the birth of her first son eleven years ago, she started to investigate. The sociologist quickly realizes that she is not alone in her experience. But she also realizes: the topic is a real taboo, at that time neither present in the media nor in scientific literature. There are still no quantitative studies. A survey by "Stern under 10.000 mothers, however, gives an idea of how big an issue this is: a full 91 percent of the women surveyed said in it that they had not been informed, or not sufficiently informed, about interventions performed during childbirth. 56 percent say: I have experienced violence.
Even if the numbers are shocking – they fit into a time when there is debate about midwife shortages and delivery room closures. "When there is enormous work pressure and a shortage of staff, the danger of abuse of power increases", says Mundlos. When a midwife has to care for five women at the same time, there is little time for sensitive discussions and education. "But lousy working conditions do not justify the use of violence."
A recurring element in the descriptions of women: The episiotomy, which is supposed to help push the baby’s head out of the womb more easily – but which is sometimes performed despite the pregnant woman’s explicit wishes to the contrary. The rate of episiotomy in clinics is around 20 percent – while in out-of-hospital obstetrics it is only 4.6 percent. "This is particularly irritating because it is now medical consensus that episiotomies have a medical benefit for mother or child in only a fraction of cases, if at all", writes Mundlos in her book "Violence during childbirth". One possible explanation: "Every drip, every incision, every suture is paid for separately." For example, cesarean sections are paid for much better by health insurers than normal births. In addition, the surgical team usually completes a C-section in 30 to 60 minutes. In the case of a normal birth, however, the midwives in the delivery room have to be paid for more than 20 working hours in case of doubt.
Perineal incisions just because someone has to practice cutting
Working conditions in the delivery room are also a problem for midwives. "Do you have to accept cuts as a woman, in the most sensitive part of your body, just because someone has to practice cutting??", asks midwifery student Solveig from Hamburg, Germany. In Mundlos’ book, she recounts the shock that some births have caused her. How she sat crying in one of the hospital’s laundry rooms afterwards. "Midwives have chosen to provide women with expert and empathetic support during one of the most formative periods of their lives, and that’s usually what motivates the profession", says Ulrike Geppert-Orthofer, President of the German Midwives Association n-tv.de. "Then, when they work in the delivery room and realize they can’t afford it at all, they turn away from it, too."
Geppert-Orthofer advocates putting the needs of mothers and children back at the center of childbirth. In England or Scandinavia, for example, she says, pregnancy and birth have a much higher social status. 1-to-1 care by a midwife during the active phase of childbirth is standard in England, while in Germany several women give birth at the same time. "What women accomplish during childbirth and what happens to their bodies is insane. We all have to make sure that women come out of this situation strengthened and do not perceive it as a traumatic experience.", so Geppert Orthofer.
Rose outside delivery room commemorates assault
Yet violence during childbirth is not a new issue, says Mundlos. However, reports from those affected gave the impression that the problem is increasing. This may also have something to do with the fact that Mundlos’ book triggered a public debate on the subject. That women are made aware that what was done to them there is violence. That through the MeToo debate, they have generally learned to break their silence when faced with injustice.
Women worldwide break their silence on 25. November in a symbolic way. On Roses Revolution Day, they place a pink rose in front of the door of the hospital behind which violence was inflicted on them. Under the hashtag of the same name, women on Twitter describe their experiences – but also that they don’t have the courage to return to the scene of the violence.
Geppert-Orthofer thinks it is good in principle that affected women speak up. "The fact that they have to do it this way is an indictment of our health care system", she says. "I can’t imagine what goes through a colleague’s mind when she sees a rose lying in front of the delivery room door after an exhausting night shift during which she certainly did her best. It must be terrible."
"It can hit anyone"
Only: How can it be prevented that women have to make such an experience in the first place?? "I am asked incredibly often for prevention tips", says Mundlos. "But the guarantee of not experiencing violence under certain conditions unfortunately does not exist. It can hit anyone." But being prepared, knowing your rights, or bringing a doula to the delivery can minimize the risk, she says.
Blaming the woman is reminiscent of victim blaming anyway. Instead, Mundlos demands that the funding for clinics be increased and redistributed: "There must be no more financial incentives for interventions." And Mundlos and Geppert-Orthofer agree on one thing: In the long term, 1-to-1 care is needed. And counseling centers to which traumatized women can turn to.
Teacher Sandra eventually learned to see her daughter’s painful birth as part of her life. The relationship with her husband, heavily burdened by his passivity during the traumatic hours in the delivery room, has stabilized again thanks to marriage counseling. Sandra gave birth to her second child at home – alone.