I’ve been writing about this issue for years, but it has finally made it in to the mainstream. In a piece on Time.com, Bonnie Rochman asks Is “Birth Rape” for Real? The answer is a resounding NO!
What is “birth rape” supposed to mean? It doesn’t mean rape during birth, although that is indeed possible, and no doubt has actually occurred.
As Rochman tells us:
In a post on Salon.com by Tracy Clark-Flory, Reed explains the phenomenon: “Fingers, hands, suction cups, forceps, needles and scissors … these are the tools of birth rape and they are wielded with as much force and as little consent as if a stranger grabbed a passer-by off the street and tied her up before having his way with her.”
According to Amity Reed, the Al Sharpton of birth activists, birth rape is:
an instance during labor “when an instrument or hand is inserted into a woman’s vagina without permission, after which the woman feels violated.
Like Sharpton who cries “racism” regardless of the circumstances, Reed cries rape regardless of the circumstances. But the circumstances matter.
We have a word for medical care without permission and the word is “assault.” But childbirth activists abuse the word “rape,” and demean the experience of victims of actual rape, because they are desperate for attention. The promiscuous use of language, as when people abuse the term “lynching” or “racism” any other shocking term, is a sure-fire attention getter.
They’ve figured out that “I didn’t like the way the obstetrician treated me when he was trying to save my baby’s life” is not particularly compelling, since anyone who has ever suffered a serious medical problem knows that doctors give priority to saving lives in life threatening situations, rather than respecting emotional sensitivities. Let me be very clear about this point: I’m NOT saying that doctors are always right. Often more compassion could be shown without compromising life saving efforts in the least. But lack of compassion is not rape, either.
What is the actual definition of rape?
the unlawful compelling of a woman through physical force or duress to have sexual intercourse.
The legal definition has been expanded to include other forms of sexual touching that do not involve intercourse. And while it is true that we have come to understand that rape is often more about power than sex, we limit the meaning of rape to sexual contact. We have a different word for non-sexual harm; that word is assault. This is a critical point. We don’t discount any form of abuse or harm, but we do insist on precision in describing and punishing it.
And we do not determine whether a crime has occurred by referencing the feelings of the victim. The feelings of the victim matter not at all; what matters are the “feelings” of the perpetrator. We a name for the perpetrator’s feelings: intent.
All crimes require more than a physical act. They require intent, legally known as mens rea or the guilty mind. Consider the crime of murder. A person run down by a driver who was texting is every bit as dead as a person run down by a professional hit man intending to cause the death. But only the latter case is murder, while the former is manslaughter at most. Intent is absolutely critical to determining whether a crime has been committed and what type of crime has been committed.
It does not matter how the victim feels about the crime (or in the case of murder, how the victim theoretically would feel about the crime). It does not matter that the relatives of the victim run down by a texting driver “feel like” the victim has been murdered, and that’s not because we discount their feelings. We are actually quite sympathetic to the anger and sense of loss of the victim’s relatives.
Let’s look again at “birth rape.” Rape requires sexual touching. A man can punch a woman and it is not rape. It might be assault, but it is not rape. Why? Because it is not sexual touching.
And it’s not merely a matter of the identity of the body part that has been touched. A woman can kick a man in the crotch, but that is not rape either. It might be assault, but it is not rape. Why? Because intent matters.
The victim’s feelings about the matter are irrelevant. The woman who was punched can “feel” like she was being raped, but that doesn’t make it so. A man who was kicked in the crotch might “feel” like he was being raped, but that doesn’t make it so.
And, as I mentioned above, a woman in labor can actually be raped. Do childbirth activists actually expect us to believe that a vaginal exam without consent is the equivalent of forced sexual intercourse during labor? I can’t imagine they do. And if they can tell the difference between the two scenarios, then they are aware that they are misusing the term rape.
“Birth rape” does not exist. It is a promiscuous abuse of the term rape for the sole purpose of garnering attention. The term is legally meaningless and ethically suspect. It is morally wrong to insist that a rape has occurred when nothing of the kind happened. It is ethically unjustified to misuse the term rape regardless of how worthy the motivation. And it is insupportable to base the accusation of a crime on how the victim “feels” about it.
Does this Author MD need a remedial course in Informed Consent? Violation of a patient’s right to Informed Consent = Battery. Battery is in fact, a crime. The author is incorrect regarding “intent” with regard to the unwanted touching of a patient. The “intent” or “acting in good faith”, as healthcare workers prefer to sugarcoat violation of Informed Consent, doesn’t pass muster under Federal and State Law. Any healthcare worker who violates a patient’s right to Informed Consent, even if they “act in good faith”, puts them and their employer at risk for civil and/or criminal prosecution.
Did you actually read what she wrote? “We have a word for medical care without permission and the word is “assault.”” Dr. Tuteur agrees that unwanted medical care is illegal. What it is not is rape.
Yes and “did you actually read” what I wrote? You might want to read it again.
Uh, yeah, I did read it, which is why I concluded you hadn’t read the post carefully enough. You stated that Dr. Tuteur needed to become more educated with regard to informed consent, then explained at length that medical care given against the patient’s will is a crime.
Dr. Tuteur agrees with this, as the quote I pulled from the post shows.
What she does NOT agree with is that obstetrical care is rape, making your tirade (and accusations of ignorance) irrelevant to her post. This irrelevancy is what caused me to question whether you’d actually read what she wrote.
It can’t only be me thinking it’s fitting that your logo spells SOB because that’s what you are. Where do you think you get the right to tell anyone if they were raped or not? It’s appalling enough to see frat boys defending rape, it’s down right horrifying to see a doctor, a doctor who calls themselves a women’s health care provider especially, doing it. You are discrediting and humiliating victims of the already under discussed and under reported crime of medical rape.
I know there’s really no point in trying to change your mind on this matter, the sexist, the bigoted, and the misogynistic people of the world never change, and you seem to be the kind of person easily lumped into that group. I’m still shocked to see a medical professional behaving as a rape apologist. People like you give gynecologists everywhere a bad reputation and make them something to fear.
You didn’t actually read the article, did you.
Where do you think you get the right to tell anyone if they were raped or not?
Probably from the fact that words have meaning, and “rape” is defined in dictionaries and in each state’s laws. A thing can feel like a rape–in other words, like a major violation and betrayal–without actually being rape.
No, actually how the victim feels is ALL that matters. The legal definition of rape is not going to matter to a women who feels like she has been raped, and goes through the psychological and emotional responses to rape. Doctors always think they know better, but they have no right to tell a women if she feels she’s been raped or not. While I’ve never had children to have experienced birth rape, I was taken to a gynecologist when I was 15 to get birth control pills to contorl very heavy and painful periods, I was not sexually active, I had no medical problems but the doctor still insisted that I needed a full pelvic exam and pap test. I was uncomfortable with it, and said no several times until the doctor refused to give me my prescription without doing the exam. I finally relented, but cried the whole time I was changing into the hospital gown and getting on the table. Not even half way through the pap test I said I changed my mind and wanted to stop, the doctor told me that he was “almost done” and then proceed to shove his fingers inside me. At this point I was crying and screaming and trying to get him to stop while a nurse held my legs open. They finished the exam, regurdles of lack of consent. I’m now 26 and still dealing with the effects of that exam. It doesn’t matter if that doctor had sexual intentions or not, my body was violated, I lost my virginity as far as I’m concerned, to a stranger wearing rubber gloves, it made me fear doctors, it made it hard for me to trust anyone. I was raped, regardless of what some entitled shit head with a medical degree says. I still have nightmares about it today. Doctors have no more right to someone’s body without their consent then a stranger on the street. Also I would like to point out that the legal definition of rape varies from state to state in the USA. The definition in my state includes “forced penatration with an object” as well as “forced sexual contact, or sexual contact under duress.” If you don’t think what happened to me, and many other women who are bullied or forced into pelvic exams and pap tests were raped, then you are no better than the rapists who call their crimes medical procedures.
WRONG. this “doctor” (not one) is a RAPER. straight up. he is a sexual sadist and doesn’t want his porn of women in pain and fear taken away.
and how creative and catchy. a chalkboard with RAPE written on it. what an intellectual flea. jesus. lol.
“WRONG. this “doctor” (not one) is a RAPER. straight up. he is a sexual sadist and doesn’t want his porn of women in pain and fear taken away.”
Dr. Tuteur is a woman and yes, an actual M.D. – no need for the quotes.
And the term is rapist. Which she’s not.
If someone feels violated I don’t think that arguing about terminology and referencing a dictionary about correct usage of words and phrases is the way to deal with the feeling of hurt or abuse.
But if you ever hope for those people to get real help and make real changes in the way those cases are handled, then yes, you need to properly define what happened to these women and use the proper terminology.
Loudly claiming ‘birth rape’ is hurting both actual rape victims and victims of medical abuse. No hospital administration, no lawyer, no judge is going to take you seriously if you claim your OB ‘birth raped’ you. As opposed to making a complaint about medical procedures being done against your consent.
The victim can totally feel violated and has a trauma that is comparable to a rape victim, but it still wasn’t a rape. And if you want to publicly fight to get justice for these women and prevent similar things from happening to other women, you have to understand what those incidents really are and call them as such.
Very well said. I agree with you completely.
This.
IT IS SEXUAL ASSAULT. THE MOST SEXUAL KIND OF ASSAULT. BIRTHING IS THE RESULT OF FEMALE SEXUALITY. DON’T BE A MORON. wake thefuck up.
Let me give you a simple definition of Rape:
ANY UNWANTED AND/OR NON-CONSENSUAL SEXUAL CONTACT.
Every person has the right to autonomy over their own body. To feel safe in their own skin. Any violation of that – even if by a medical professional – constitutes assault. And if that violation includes the genitalia, it is Rape.
End of story. Get yourself educated – you clearly have a great deal more to learn.
So, then I guess I’m a serial pet rapist.
So, anyone who puts a urinary catheter on say, someone who is unconscious after a car accident, is committing rape.
Look. As much as I agree that a doctor should get your consent before touching you anywhere or doing any kind of procedures (regardless of it’s on the genitals or not) In real life sometimes shit happens, and shit sometimes happens in or around the genitalia as well and actions have to be taken immediately and you don’t have time for a 5 minutes discussion about what you are going to do.
Doesn’t make it a rape.
If it is against the patient’s beliefs or wishes for themselves, then yes, it is rape.
And, if you are a confessed serial pet rapist, then you clearly need help. (I do hope you seek that help out. Good luck to you.)
And how do you ask an unconscious person what are his wishes and believes between having a urinary catheter and pissing themselves?
Also, I’m a veterinarian you idiots. I’m just pointing out how stupid the whole ‘birth rape’ argument is since according to it, I’m sexually abusing dogs and cats whenever I take a rectal temperature.
“And how do you ask an unconscious person what are his wishes and
believes between having a urinary catheter and pissing themselves?”
1) The appropriate word is ‘beliefs’, not “believes”.
2) Did Brock Turner ask his victim if she wanted to be touched by him? Could she have responded in a cognizant manner if asked? The answer to both of those questions is ‘no’. And the absence of a ‘no’ is not a yes. This is why the jury of 8 men and 4 women found him guilty of all 3 Felony counts against him. She was unconscious and could not consent. He was also pre-med.
I saw you listed Veterinarian on your profile. I am not the idiot who called you a serial pet rapist. You are the one who called yourself that. If that is how you choose to identify yourself, then that is the way I shall address you – it is clearly your preference. If you believe referring to yourself as a serial pet rapist is idiocy, then perhaps you should reconsider your own thinking. (A way of thinking which at the very least appears to be beyond flawed.)
The bottom line is we all have the right of our own bodies. I have friends who have made choices when it comes to their own care (one in particular decided on a home birth) that I do not agree with and would not choose for myself. I can have any opinion I want about it, but that does not give me the right to force my choice onto them or their body or their experience. Just as they do not have the right to force their choice onto me. I also know women who have experienced sexual trauma due to rape and abuse. Some of these women felt re-traumatized and re-victimized by a disrespectful doctor later on. As a result, they do not go to the doctor to this day for even a regular Well Woman Exam. When told how important getting the exam done is in order to detect cancer early for treatment, their response was that they would rather get cancer and die than experience that trauma again. It is sad, unnecessary, and just plain horrible that these women feel this way. And to think, it was entirely avoidable if the doctor or doctors in question had just informed them of what was happening, why, and asked them for consent.
How difficult is it to just have a basic level of human decency and respect? Both the Hippocratic Oath, and the Declaration of Geneva have statements included in them about respect for the person being treated.
As for catheters, I have also known people who preferred taking a bath or shower to wash after pissing themselves in an accident than having a catheter inserted. Once again – that is their body, and therefore, their choice. If your choice is to let whatever anyone wants to do to you happen as they see fit, then by all means, make that choice for yourself. You do not have the right to make that choice for anyone else.
If there are some procedures you don’t want done on yourself in a setting while you are unconscious, carry with you some kind of paper that specify that.
Even if you are, say, a JW and don’t want to have a blood transfusion, you have to have papers with you testifying to that, in case you are unconscious and unable to say it.
If you are saying we should behave as all people who aren’t conscious to make medical decision would not want life-saving medical care because they can’t actively consent (to connect with what I said above, we couldn’t for example even give blood transfusion to people who haven’t written somewhere that they are NOT JW. Because of your brand of consent)… Then I suppose it has a certain logic, though I think it is nuts because of the shattering amount of lives that would be lost. The current system, in which you have to say what you don’t want to be done to you instead of the contrary leaves the vast majority of people alive and well.
People have rights to make choice. I also have a right to say when I think it is a stupid ass choice. Including homebirth which is, yes, a stupid-ass choice.
“But they have been horribly traumatized before” is not an excuse. It is, perhaps, a reason. But not an excuse.
Let’s make a personal comparison. I have mental health problems, and these problems give me serious anxiety (panic-level) when driving. My panic goes a lot lower if I use heavy anti-anxiety medications, which however makes me more or less “drunk” as a result.
If I take a lot of drugs, and then drive, and I kill somebody because I was too out of my mind, I don’t get to play the “But I have a lot of trauma related to driving!”
I do not drive, to be clear. Because I am unsafe for myself and, more, others doing so.
The point is that people DON’T have a right is, after their stupid-ass choice has brought the expected horrid results (say, refusal to give consent to vaginal exams during labor ending in a brain damaged or dead baby because the doctor wasn’t able to do their job) is to complain and expect other people to pay for them.
If your baby is brain damaged en route to the hospital because you made a stupid ass choice to birth in your living room, you don’t get to sue the doctor who in the end delivered them.
Also I was unaware that Brock Turner was trying to save his victim’s life.
Oh wait. He wasn’t.
Your comparison is invalid.
[For the record, English is not my first language, so please refrain from nitpicking it. Thanks]
I have zero problem with what someone chooses for themselves. I, unlike others here, am not looking to force my will and wants on anyone else. I maintain that every person deserves the respect of choice for their own body and their own choices. I also advocate personal responsibility. If anyone chooses to have a catheter inserted or to have a doctor perform any procedure on them, they are welcome to that. If someone chooses against said procedures and contact for themselves, they should be allowed to have that choice respected just the same as someone who wants those procedures done. If the result of those procedures not being done means their life is endangered, that is both their choice and their responsibility – not the medical professional in attendance. If the medical professional in attendance violates that patient’s right of their own body and shoves a hand into their vagina anyway – that is forced penetration, and as such, Rape.
For most people consent does not entail a 15 minute discussion in a conference room around a table with a panel of people debating over coffee. For most people, I know of anyway, it takes all of 5 seconds or less for the Doctor to say “I am going to do this…ok?” If the patient says no, and the Doctor says they could die without it (which also only takes a few seconds), and then the patient continues with a no, then the aftermath is on the patient not the Doctor. The vast majority of the time in my experience in medical examination rooms (even in the ER), the patient’s response to the very first 5 second question is a yes. If a patient can literally not wait for someone to take 5 seconds or less to let them know what is about to happen, then it is unlikely the patient would live anyway. As for blood transfusions, there are patients who refuse those based on Religion. Once again, it is about the patient’s choice.
Regardless of either choice, the point is that as human beings – not dogs or cats – we have the right of that choice. And no one, not me, and not anyone here, and not anyone with a license to practice medicine or anything else has the right to force their will on anyone else. If you do not believe me, check the Hippocratic Oath and the Declaration of Geneva – or heck, just check common sense and human decency.
If anyone else has a question about that just ask the state of Florida. They had this fact rammed right down their proverbial throats by many people and organizations as a result of not complying with a pregnant patient’s right to her own body.
As for my correction of your English – I was not aware that English is not your first language. I choose not participate on forums which communicate in any language where I do not have a complete written fluency in for the sake of not creating such errors myself. Especially since, such errors are very telling towards the level of understanding the nuances of what was originally written to begin with.
‘…complete written fluency….’
and then that final sentence-hyperbole and tortured tautology.
I may die laughing.
Touche’ – I am tired after working for 15 hours today.
Pathetic
As I have already stated, thank you.
I, at least, can show respect for those around me, and take constructive criticism. I also appreciate the rights of all. There is no one here who must abide by what I would choose for myself. (Speaking of which, no one here is even aware of what I would choose for myself, as I have not yet said what that would be.) And, no one here has the right to force their choice onto me. The medical professionals I have worked with, those who treat me, and other individuals who are close to me know what those choices are. They are the business of no one else. I expect my choices to be treated with respect. I am only saying that every person deserves to have their choices treated with respect.
No one here ever said otherwise. I hope you had fun tilting at windmills.
Then why all the disagreement? All I said was that the contact had to be something a patient would, want, consent, or agree to. If that is not respected, then that is a violation of that person’s rights to their own body.
I don’t know, why ARE you here disagreeing with a three-year-old post?
I am pointing out the need for respect of every patient. If respect is not given to a patient as a human being with the right to decide on what happens to their own body, then they are less likely to trust their care to a medical professional who has the education to know what is best for their care. This includes women, and with more than 1 life at stake, this includes pregnant women. It is troubling to think how a pregnant woman may forgo appropriate monitoring and care because of something which is so simple and basic and in the vast majority of situations does not cost a thing except for literally a few extra seconds.
I would prefer a person to feel comfortable being able to trust their medical professional with their care and to know that what is being done for them is for the best. However, when someone has been traumatized seriously enough, or their rights trampled on, their ability to feel comfortable and to trust is undermined. It ultimately hurts the doctor-patient relationship.
So what you’re saying, then, is that you’ve been arguing against a strawman that you new full well was a strawman all along. For funsies, I guess.
And no one here ever said otherwise, so why are your shorts all in a wad about it?
Unless the person in question is a doctor in surgery or working in the ER.
I was not aware that you had worked 15 hours today. I choose not to participate “on” forums when I am in any state of sleep deprivation for the sake of not creating such errors, myself.
THAT is a touche.
A Kelly, take note.
You forgot that we were talking about unconscious patients in need to urgent medical attention. It doesn’t matter if the conversation takes 15 minutes or 15 seconds – they can’t consent.
Actually, we were originally talking about people who are conscious and can consent. Then there was a topic of conversation about people who have been anesthetized, where consent should have been achieved prior to sedation. Now, we are also including people who are unconscious. I have yet to say that any life-saving procedure should be against policy on an unconscious patient. I am only pointing out that patient’s have the right to choose their course of care over their own body.
As a nurse I used to work with would tell me, “I used to have a list of Doctors who are not allowed to touch me, and I wanted to get that list tattooed onto my arm; now the list has gotten so long it would be easier to get a list of the names of Doctors who are allowed to touch me tattooed instead.”
Misplaced apostrophe in the second last line of the first para, written fluency genius.
Curious you chose to capitalise ‘doctor’ twice in your second para quote-it’s not a proper noun, you know.
Your winding back continues, complete with solecisms.
I am making an intentional choice to capitalize it.
And, if you really want to get nit-picky, “capitalize” is spelled with a “z” in the United States. Since this is a blog in the United States we could always gripe about that. However, I am guessing you are from a Commonwealth nation; so should I respect that, or not?
Is respect and a basic level of human decency really such a difficult concept for you? If so, there is really nothing anyone can ever say to you. And, as such I can only wish you luck with the remainder of such a sad existence.
Is this you flouncing?
I thought you respected everyone? Or only those who get scared by your alarmist little stories?
Is it more indecent to ask questions, as I do, or to try to frighten people with lies and innuendo (you can look it up later) as you do?
Is holding you to a standard you created for others a difficult concept for you?
I’ve had fun, thanks for playing.
Mind the door on your way out!
No lies an innuendo here. It is on the Legislative Records for multiple states. Not to mention the College of Obstetrics and Gynecology Records.
I appreciate questions, and anyone who has an intelligent one to ask; as opposed to disrespectful dismissive attitudes towards cognizant human beings and their right of choice.
I am glad you have had fun. It is so good to know.
There is no apostrophe in the second line of the first paragraph.
No, but there is one in the second to last line, as Who? said and it is misplaced, as Who? said. Perhaps you can edit it out and pretend it never happened.
I have yet to say that any life-saving procedure should be against policy on an unconscious patient.
Actually, you pretty much have. A pelvic exam prior to surgery can reveal unexpected problems, such as a mass that is not palpable in a conscious patient, and save lives. You wish to forbid that exam from being done. Hence, you are in favor of banning life saving procedures.
Turns out his reading comprehension isn’t completely fluent either.
And his attempts at gymnastics are equally flaccid.
You keep saying he? Am I a man or a woman? You do not know. Are you well trained in Language Analysis?
I was watching one of those “Trauma, Life in the ER” type shows recently, and the ambulance brought in an unconscious young woman who had been in a car wreck, She had broken her pelvis and had blood pouring out of her vagina. X-Rays were taken, and she was sent off to emergency surgery to repair her pelvis and stop the bleeding. This involved both a vaginal exam, as well as vaginal surgery to stop the bleeding caused by a broken pelvic bone. She was unconscious. Should they have waited until she WAS conscious to obtain consent before examining her, taking her to surgery and stopping the hemorrhaging?
And the only rule without exception is the rule that says there is always an exception to the rule.
The exception is not a medical professional forcing their will unnecessarily. Of course, if the woman had documentation or someone with her which withdrew their consent, then clearly they would not have been able to help her. The woman would have died unnecessarily, but that would not have been the responsibility of the medical staff.
Begs the question.
Who defines what is necessary?
And we are back to square one.
As I said in my earlier post, as soon as you acknowledge that it’s not absolute, then the only remaining question is where to draw the line. And at that point, there is no obvious answer.
I have never said anything was ‘absolute’. I have yet to use that term at all. I am simply defending an individual’s choice, consent, and autonomy; and stating that a medical license does not grant an automatic pass to be disrespectful of a person’s right to what happens to their own body. Even if that medical professional disagrees, or knows better.
But it is absolutely rape no matter what the context of a catheter placement is if the patient hasn’t given explicit consent for that very catheter placement in that very situation.
Sounds pretty absolute to me. And really stupid, to boot.
Maybe she was trying to commit suicide, but the note wasn’t found in the wreckage. So you are saying that proper consent is implied in an emergency situation if the patient has nothing or no one to NOT give consent, even if the person is unconscious?
On that note, as well: what about suicide attempts that are found before the person is dead and they have left a note pinned to their shirt, scrawled on the mirror or some other obvious place? Clearly, the person is WANTING to be dead and has taken steps to make sure this happens. They are then found by someone, who calls an ambulance and they are transported to the hospital. Should they NOT be given treatment, because they left a note? A suicide note, not a DNR. Would the doctor administering naloxone to reverse an OD or otherwise treating the wounds and damage from a suicide attempt be acting without consent?**
**Note: not advocating suicide at all. I have both lost and nearly lost family members to suicide by gunshot. One died, the other did not, but is now blind. Just curious as to how A.Kelly would view this sort of thing.
Unfortunately, we’ll never know. AK is very selective in responses-this one is in the too hard basket.
You’re probably right. Or maybe it doesn’t count, because no pelvic exams would be performed if someone is presenting with a gunshot wound to the head, or because the patient is male.
And I’ve lost track of the score; does placing a catheter count or not at this point in the argument?
I haven’t seen A. Kelly retract her early statement that it even for an unconscious trauma patient, insertion of a catheter against their unknown wishes is rape.
Who knows? Maybe she was trying to commit suicide as you have suggested. Anything is possible. Although, statistically speaking, that would be highly unlikely.
And, yes, my responses are selective, which has nothing to do with how difficult a situation is to interpret. Those 2 ideas may have overlap, but they do not necessarily correlate. In life, everything we do is ultimately supposed to be selective. Including whether or not I choose to bother with a response.
It is called CHOICE. It is called CONSENT. It is called AUTONOMY. We could get into a whole litany of varying synonyms if you would like, but I’ll leave it here for now.
I have no problem with that for myself or anyone else. You , W, do not have any obligation to respond to me, just I have none to respond to you or anyone else here. Once again, you miss the point – and eroded the value of your own position. I find that to be quite a shame, since I actually do think you have something to offer.
I have not missed the point. Just because something is statistically highly unlikely, does not mean it can never happen. And that is where the problems with absolutes lie. A piece of anecdata:
My aunt, who now has dementia, had made it clear to her children that she did not want to ever wind up on a ventilator, breathing for her, if she was ever in the hospital. Basically, she had stated that she did not want to be kept alive by machines. They all agreed.
Several years later, she developed pneumonia bad enough to be hospitalized. Her husband was further along the Alzheimer’s/dementia path, so he was no help. The doctors wanted to put my aunt on a ventilator, temporarily, so she would not wear herself out breathing while the antibiotics were starting to get things under control. Two of her children said “absolutely not” as that is what their mother has specified. The other child talked with the doctor, who assured him that the ventilator would be temporary. She had been in good health before getting pneumonia, but she had not sought help for it, so it got really bad. She was wearing herself out trying to breathe and putting her on a ventilator would allow her to rest and give the antibiotics a chance to get things under control. The one child argued for putting my aunt on the ventilator, because it was a temporary measure to help her improve. The other two were adamant that their mother NOT be put on a ventilator, because that is what she had expressed previously.
The one child prevailed over the other two. My aunt was placed on the ventilator, given antibiotics, IV fluids, pain management, etc. This gave her a chance to rest and improve and sure enough, a few days later she was taken off the ventilator and continued to recover. I think the one cousin made the right call, based on the information available. The other two were stuck on “what Mom said” and weren’t able to listen, really listen to the doctors about her condition and what they were advocating.
Circumstances change and often people do not rethink/revisit previous decisions/edicts when new information comes to light.
hmmm…no there is not…
???
From your post, above (second to last line of the first paragraph): ” I am only pointing out that patient’s have the righ…”
“Patients” in this context is a plural and does not require an apostrophe, which changes the definition to “that belonging to the (singular) patient”. This makes no sense at all in context. The apostrophe is wrong. It’s the sort of mistake anyone could make, especially in a casual post, but your insistence that it is not there is odd.
You might want to check yourself. Clearly you have not seen or read the line accurately.
I must go and get ready for work now. I am sure you will have an abundance of new unnecessary personal insults for me and many others later today. Depending on how I feel will depend on whether or not I bother with a response.
No one here disagrees that patients have the right to choose the medical care they get for their own bodies. “Pointing that out” is obscuring the point, which is that in birth, things often move very quickly and doctors do have some leeway in touching patients to save their lives (unless the patient has signed a DNR prior to going into labor).
And Molly B. absolutely did object to the placement of a catheter in an unconscious patient as “birth rape.”
And some nurses are idiots, just like some people in every profession are. This is nothing new.
As a nurse I used to work with would tell me, “I used to have a list of
Doctors who are not allowed to touch me, and I wanted to get that list
tattooed onto my arm; now the list has gotten so long it would be easier
to get a list of the names of Doctors who are allowed to touch me
tattooed instead.”
I do wonder why said nurse continued to work in a hospital where they thought so little of the other medical professionals. I would not want to continue to work in a place where I had so little trust in my coworkers.
It was her choice.
That same nurse ended up saving the life of her niece. She was working the ER at the time. Her niece came in from a terrible car accident. Her ear was in 4 pieces, her eye had been lacerated by glass; essentially half her face was gone and she had head trauma. She insisted the ER Resident only stabilize her and nothing else. This was the middle of the night and she called a specialist with the hospital at home and woke him up. He came in and performed emergency surgery. The ER resident was ill equipped to handle the situation and wanted to conduct exams and procedures that would have endangered her life. I did not follow up on the ER resident, but I hope he looked at it as a learning opportunity to gain extra insight into how to handle a case like this for the future. I hope he learned what did need to be done and how fast so that he could be the one called on for a patient like this in the future. The niece not only lived and became a medical professional herself (she is now an Audiologist), but her face was salvaged and she still has both that ear and that eye and they work just fine.
This story is relevant to the discussion how?
The CONSENT. The aunt who was an ER nurse at the time (odd, was she the designated proxy for the niece? How did she come to be the person to consent to treatment? Shouldn’t it have been the patient herself or her parents?) only let the niece be stabilized by the ER resident while she called a specialist to come in in the middle of the night and attend to her niece. Basically, she (the aunt) only consented to stabilizing measures for the niece (again, designated proxy, or assuming she could make the calls for her niece) so she could get a specialist in to take over, because apparently, the ER resident was incompetent and not fit to help anyone.
Not everyone has that privilege, so, yeah, this isn’t a good example for proper consent.
So, she got lucky that there was a specialist who could do it, and time for them to come do it instead of the ER doc on shift? That level of availability and time are luxuries in emergencies, and not at all a convincing argument.
It wasn’t meant as an argument, just an anecdote. Personally, I would say she was more lucky in the fact that the specialist was willing to wake themselves up enough in the middle of the night to come in and perform surgery based solely on her phone call request. Of course, she had been a very well regarded nurse for quite a long time by the time this happened.
But, I digress….
Yes. You do.
Right, so if I’m under for a cesarean delivery and the doctors remove my uterus because they cannot otherwise stop the bleeding, then that’s really rapey rape rape, because they didn’t ask my consent. Yup, just like Brock Turner. Got it.
On another note: Goodness. What a nasty, passive-aggressive last paragraph.
Not my intention to be nasty or passive-aggressive. My apologies.
If you go in for a cesarean, 9 times out of 10, you will be conscious. If you are unconscious, it is very likely you would have discussed with your OB what your wishes and limits are (even in the case of an emergency c-section since it is likely you and your OB have been discussing potential outcomes and risks for months by this point). Additionally, if it is another OB performing the procedure on you, whether in an emergency capacity or not, it is still likely your records will be available with your choices recorded. So, no, not like Brock Turner.
“As for my correction of your English – I was not aware that English is not your first language. My apologies. I, personally, choose not to participate on forums which communicate in any language where I do not have a complete written fluency in for the sake of not creating such errors myself. Especially since, such errors are very telling towards the level of understanding the nuances of what was originally written to begin with.”
‘I’m (barely) sorry for nitpicking’ > Still nitpicks and implies insult.
L.o.l.
Speaking of respectful and knowledgeable discourse, the above isn’t remotely it.
Of course someone who’s ESL can have complete (to the degree that is reasonably and realistically possible) understanding of a subject. A Dutch OB & PhD speaking about medical knowledge isn’t less knowledgeable due to their very occasionally barely imperfect English.
Most English speakers (I’m sure you included) are guilty of as much if not more, despite their ‘fluency’ afforded by nothing but birth (many foreign countries have as many if not more English classes than the US, and they are more focused on reading/writing fluency vs. literature).
Edit: Your defensive apology below still falls in the ‘barely’ category. No sincere apology for implied lessening or insult. Resounding ‘meh’ to that.
1: anyone who corrects grammar and orthograph has no real argument. (This is the internet, realize that english is not the first language of everyone)
2: Brock turner is 100% a rapist. But here’s the thing:
-He’s not a doctor
-He wasn’t doing a medical procedure on the woman
-His intention was 100% to have a sexual relationship with this women.
This was a rape 100%
You are also not addressing the fact that the man in unconcious and cannot give consent to anything. So your
default solution would be to let everyone soils themself and not wash
them until they wake up and tell you they want? How is that being respectful?
A doctor, doing a medical procedure, even if it touches your genital organs, is not a rape.
As I said it my first comment, I am 100% for bodily autonomy and consent. Any time it is possible, any medical procedure must be explained and consent obtained. But real like in a medical facility is different. You have unconscious people, drugged people, people who are dying and need help right now. There isn’t always the time to have a 15 minutes discussion in an office around coffee to discuss all the options, a detailed description of all the procedures and give the patient a day or two to sleep on it and ask questions. I totally get that in rushed situation, a doctor might be too concentrated on trying to save a life to explain what he’s doing. Or maybe he’s too rushed in his explanations or doesn’t properly adapt his explanation to the level of medical knowledge the patient has. Hey, maybe their doctor is an ass, there are bad people in every single job out there.
If anyone feels their doctor has done them wrong or done something against their consent, I 100% agree that they should report it to the proper authorities so they can look into it and make changes so the next time it doesn’t happen. But it still wasn’t a rape.
Birth is scary, lots of things can go wrong in a heartbeat and you absolutely can some out of it traumatized or feeling that things happened that you didn’t properly understand for a lot of various reasons. But it wasn’t a rape any more than giving full consent means you are having a sexual relationship with the doctor.
The definition of rape is not: any and all unwanted contact with sexual organs in any kind of situation.
If that was the case, as I’ve said, every veterinarians would be committing bestiality all the time, all pediatrician would be pedophiles, anyone doing CPR is a rapist. Consent does matter, but the intent behind the actions matter as well.
Your constant needs to reference veterinary practice is needless in many instances. In doind so you are effectively equating peoples rights and autonomy to that of non homosapien animals. We are not dogs cats cows horses or turtles. We are human.beings. What you do.in the vet office is not the same. Someone requesting a dnr on a pet is not the same as someone having to decide on life support for a family.member (although I do recognize some people consider pets to be like family, but try to follow my point)
There was 1 line in there talking about veterinarian medecine (and it also mentionned pediatrician btw) and like 20 about humans. Of course you didn’t talk about those 20 lines because you have no actual argument against what I’m saying.
You said performing exam/surgery on a pet without pets consent should then be defined as sexual.assault. For someone with a doctorate that is a rather childish and uneducated comment to make. That is why I didn’t respond to anything else you have had to say
You are the one basically calling the entire medical community rapists. I simply pointed out an obvious reality of medicine to counter your point.
I notice it’s been 2 days since you said you were done with this place and leaving, and yet you’re still here.
Because people.like you.keep asking me questions
You barged in to a page you weren’t even on at the time you said you were leaving, as far as I can tell. The comment you replied to was not to you, nor did it mention you, your stated positions, or anything else to do with you, and my statement to you was just that, a statement, not a question. So please, don’t try to feed me that bull.
All parents would be either rapists or guilty of severe neglect from never changing a child’s diaper.
But Idiot (because based on everything you’ve written here, that is clearly how you prefer to be addressed), some OTHER people prefer to have a catheter inserted by a medical professional in that situation rather than pissing themselves – that is their choice, and not doing so means someone’s going to have to touch them on their genitals to clean up that urine before it burns their skin. If we don’t catheterize them while they are unconscious, then by your definition we are raping THEM. Some someone’s gonna get raped in the “unconscious trauma victim needs a catheter” scenario, and it seems to me we should default to keeping the patients and the sheets clean to prevent further injury.
I do not wish to have to work for my income. OMG, economic rape!
Um, you are aware, aren’t you, that you’re responding to a vet? And that “pet rapist” here is snark? Since according to your logic, no consent = rape. Or do you accept that in that case, it’s the pet’s owner’s consent that is sought?
Oh, I know it is snark. However, if she refers to herself that way, even in sarcasm, I will be more than happy to assist her in continuing that trend.
“For every complex problem there is an answer that is clear, simple, and wrong.” – H. L. Mencken
Tell me how you feel about this after a physician has intentionally waited until after you are anesthetized to allow a parade of medical students manhandle your sensitive parts without your prior consent without any true diagnostic or educational purpose. Said parts are experienced different in the true clinical setting, when patients are conscious; therefore doing so when the patient is unconscious has no educational value. It only serves to be dehumanizing and disrespectful of the patient; and shows those medical personnel to be fundamentally without ethics or basic human decency. While studies show that if most patients were asked prior to being anesthetized they would not have a problem with it – provided they were ASKED first.
CONSENT is the heart of the matter. Anyone who thinks otherwise is welcome to allow themselves to be body slaves for the enjoyment and whim of anyone else. They have expressed their choice. The rest of the human population would like the choice to maintain our own cognizant autonomy.
That is a terrible situation, and I agree that any doctor who deliberately arranged for a patient to be sedated only for the purpose of abuse by the doctor and others deserves all the punishment that can be handed out, including being struck off and prosecuted. Any organisation where that could happen
If you don’t want your body to be handled in a particular way when you are unconscious, then you need to make that known, perhaps by carrying a document with those instructions on it. If you turn up unconscious ie by ambulance, it might mean doctors are precluded from providing some diagnostic services or treatments.
I am comfortable that if I am unconscious and unable to give consent, medical personnel will do the right thing, and I want them to do what they believe is medically necessary to help me.
Women and men go into hospitals everyday for surgery. What they are not told is that if they are in a teaching hospital, while under anesthesia, they may be subjected to pelvic or rectal examination by multiple medical students. These exams have no diagnostic purpose under these conditions. These exams also serve no educational purpose, as I have already stated the experience of conducting these exams is different when someone is conscious in the clinical setting than when they are unconscious. The excuse the medical schools and supervising physicians give is that they believe the patients would not consent if asked for consent prior to anesthetizing them. This is Rape.
I am not opposed to the education of medical students. They need practical experience under the watchful eye of someone who already knows what they are doing. That being said, it is incredibly important to know how to treat a patient as a human being to be respected and not just a bag of organs to study for technical skills and training. Asking a patient whether or not they would mind being internally examined while unconscious by students under supervision is not a difficult thing to do – and it is a very important thing to do. Not asking constitutes Rape. It is a violation of that patient’s body and rights. As I stated previously, many patients have said they would not mind agreeing to it – provided they are asked first.
I have to say, having been a medical student and a doctor in a teaching hospital, I have never seen or heard of this practice. I never did a pelvic exam on an unconscious patient. I have never seen or heard of any patient getting more than two pelvic exams (one by the resident, one by the attending) and in that situation, the patient was awake and consented actively to both.
Can you document that any medical school is doing this?
It happened recently happened in California, at least killed of similar. Of course, the guy has been charged with rape, so not sure it shows how it is common.
If the person who did it was charged with rape, isn’t that evidence that this is NOT standard protocol in med schools, at least in California?
Yep.
Again, I believe it did happen–a med student called Shawn Barnes claimed that it happened at his hospital, and thought it an unethical practice. See Practicing Pelvic Examinations by Medical Students on Women Under Anesthesia: Why Not Ask First? (Barnes SB. Obstet Gynecol 2012;120:941-3.)
I should think we could oppose and petition against this limited practice without getting hysterical about how “parades” of med students are doing this to every woman under anesthesia every time, though, and without calling them “rapists.”
Absolutely. The hyperbole is unhelpful.
I quite agree. A. Kelly is a bit hysterical.
That is an extraordinary claim. You are suggesting that all doctors, all people in operating theatres, and all medical students, are perverts, because the examinations you claim are happening are in fact of no clinical or teaching value. You imply the only reason for doing them at all is the titillation of those involved.
Extraordinary claims require extraordinary evidence. Let’s see yours.
If as you claim titillation is the motivator, how does consent help? Unless the lawyers who create consent forms are also in on the conspiracy, cunningly writing them to avoid liability for salacious examining….omg am I really on to something????
It’s just as impossible as the anti-vaxxers’ claim that all doctors, all drug companies, all nurses who administer vaccines, all pharmacists and the cat’s mother are involved in a giant conspiracy.
http://www.patientmodesty.org/ This is just a website with info and accounts of patient modesty violations up to and including sexual assault. I do agree with you that it is not ALL docs, med pros etc but none the less we.have to understand that this does happen….and when it does it is wrong.
Oh Molly B, given your perverse attitude to consent, I doubt very much that anything you post a link to will offer me anything of interest.
Didn’t you storm off in a huff? Days ago?
As far as I can tell, all Molly B wants is for us to agree to her stipulation that it *can* happen. Look at the tempest in a teapot regarding the opioids in epidurals crossing the placenta and affecting the baby and that epidurals cause a precipitous drop in blood pressure that inevitably leads to a CS.
Numerous people here told her that the reason that epidurals were used was because they were both very effective and very safe and that the amount of anesthetic and opioid agents were small, as they only had to work locally on the nerves involved. And that these agents didn’t cross into the mother’s blood supply, but given that NOTHING is 100%, there was always the possibility that they COULD get into the mother’s bloodstream. IF they did, the amount, very small to begin with, would be diluted by the volume of the mother’s blood and therefore, the effect, if any, on the baby would be next to nothing, but yes, IF any amount of opioid medication got into the mother’s bloodstream, it would cross the placenta and get into the baby.
This apparently was not good enough; she posted that she talked to her doctor at her appointment and he said that opioids would cross the placenta and get to the baby. Nothing about dosage or anything to augment that fact; just that yes, opioids would cross the placenta. Which was what we here had been saying all along.
But that was enough for her to basically say “In your FACE, people! My doctor said that opioids cross the placenta and you people are FULL OF IT!!!!”. And then attempted a flounce.
So, if we agree with her, we are wrong, because we are missing the point somehow. If we don’t agree with her, we are wrong, because REASONS, PEOPLE, REASONS!! I think she would complain if she were hung with a new rope.
How is it perverse to advocate for full disclosure in informed consent?
Surprise, surprise! I thought the name of this website was unusual: modesty is a term with religious overtones, after all. Sure enough, their stated goal is to promote gender segregation in healthcare (though they don’t phrase it that way): basically, for them, male patients should have male doctors and nurses, female patients should only be attended to by females. (They’ve never heard about gays and lesbians, obviously.) They also strongly object to abortion, euthanasia, “unnecessary” hysterectomies (can’t diminish women’s fertility, what would they do with their time) and pelvic exams during childbirth. Oh, and the website, though very sleek, doesn’t have basic info about who they are: a group of patients? Of healthcare professionals? “Concerned citizens”? Theologians? Who knows.
So, yeah, I think we can take their testimonials with a grain of salt.
I enjoyed reading their page on considering homebirth. It’s safer than hospital birth! Also, you can eat and drink and not get any nasty episiotomies or sections! And CNMs carry oxygen! (No mention of the fact that homebirths are often attended by CPMs, but then, practically every sentence in this jewel of a piece will make your eyes roll.)
http://www.patientmodesty.org/homebirth.aspx
Oh yes! And while CPMs “hold the space”, their won’t touch your private parts.
Your interpretation of the stated goal.in merely an opinion.
#1 They don’t say segregation is the only way. What I does say is if someone is not comfortable with a member of the opposite sex being present then every effort should be made to accommodate that.
#2 You asked. I provided. Rooting through the site and looking for things to nit pick instead of focusing on the question raised is childish
It’s not my interpretation, it’s what anyone with a modicum of curiosity can read on that website. And I find very amusing that you give a supposed reference and get annoyed when someone had the audacity to check!
Oh, and you’re in error, too: it was Who? asking for citations, not me.
Also modesty is not about religious overtones, its about (in these circumstances) how much of the body a person I comfortable revealing and who is allowed to see or touch.
That is privacy and autonomy. Modesty is a concept from pre-modern societies where a woman’s body had to be covered at all times or she wash ng respectable.
By the way, is English not your first language? I ask because even though English is my second language, I know enough to see that “modesty is not about religious overtones” doesn’t mean anything. I said that it had religious overtones, i.e. that it was linked to religion. Which is the case with modesty: whether it’s Christianity, Islam or Judaism, traditional religious teachings all call for women to cover up various percentage of their skin, even during childbirth. In Catholic Europe, women used to give birth covered from the neck down: the midwife would put her arms under the cloth to help deliver three baby. Today, Muslim fashion stores offer a garment that combines a hidjab or head-veil with a sort of loose pajama, with a flap opening to let a baby through.
I do not claim all doctors or medical professionals have done this. It has been standard practice for a long time. I do not claim it is for titillation. The justification used is “education”, except that argument is thin at best. Thankfully, it has lessened in the United States a great deal over the last 10 years, mostly due to additional awareness and HIPAA. Last time I checked (and I will admit, it has been a while since I last checked), it was still something that happened in Canada and various European countries. Although, I think France sought to outlaw the practice.
I have, however, had this admitted to by many doctors. Most will admit it if you ask them, because they have not seen it to be, or been taught that it is wrong. The environment of the Medical School itself along with the clerkships the students must participate in create an environment where it has been blithely accepted practice.
If you want anymore information, then please, check out the documentary “At Your Cervix”; or lookup the work of Dr. Andre Picard, or Dr. Michael Greger, or Dr. Hilary Gerber, and many others. Or even just look up non-consensual pelvic exams, and non-consensual rectal exams.
Can you document that it is done anywhere in the US or elsewhere at this time or in the last 20 years? Looking up Andre Picard did not lead me to any links about a doctor, Michael Greger appears to be a naturopath with an agenda, and Dr. Greber’s site discussion of pelvic exams seems to be limited to the debate about whether they are necessary as a routine screening test.
In the last 20 years? In the U.S.? No problem:
http://www.cbsnews.com/news/pelvic-exams-without-permission/
https://www.washingtonpost.com/archive/politics/2003/05/10/practice-vs-privacy-on-pelvic-exams/4e9185c4-4b4c-4d6a-a132-b21b8471da58/
http://www.care2.com/causes/ending-non-consensual-pelvic-exams.html
http://patientmodesty.org/nonconsensualexams.aspx
http://www.kevinmd.com/blog/2012/09/ethics-conducting-pelvic-exam-anesthetized-woman.html
http://www.capitol.hawaii.gov/session2012/Testimony/HB2232_TESTIMONY_JDL_03-27-12.pdf
http://www.ourbodiesourselves.org/2012/09/conversations-we-shouldnt-still-be-having-pelvic-exams-under-anesthesia/
http://digitalcommons.law.umaryland.edu/cgi/viewcontent.cgi?article=1102&context=jhclp
http://www.wsj.com/articles/SB104743137253942000
https://www.lawyersandsettlements.com/blog/pelvic-exams-without-consent-medical-malpractice-suit.html
http://www.ncbi.nlm.nih.gov/pubmed/16206868
http://www.livescience.com/23749-pelvic-exams-anesthesia-medical-students.html
http://atyourcervixmovie.com/
And that is less than half of what you can find on the United States alone for just the time period back to 2003. I especially appreciate the written documented testimony from the Legislative Session for the State of Hawaii in 2012. At the time, they were only the fourth state to address the issue. That was only 4 short years ago.
When it comes to other parts of the world, well, there is even more.
As for blindly trusting every medical professional to always and only do what is best for their patients and with full respect for their patients as human beings…well, I do hope no one here was a patient of Dr. Nikita Levy of Johns Hopkins. I realize he is the exception and not the rule, but it does go to the heart of knowledge, trust, and consent.
So basically you’ve got a long list of examples of women refusing to have medical students examine them under anesthesia and that refusal being respected and a discussion of whether pelvic exams under anesthesia should have specific consent, as opposed to the general consent for all necessary procedures during surgery. In each case, the pelvic exams were performed for a specific reason and in no cases that I could find was more than one student requested to perform the pelvic exam. While I agree that including specific consent would be a good idea, I am not seeing the slavering rapists that you apparently are.
Very mean of you to actually read what he posted-I doubt he has, what with the long work days and the effort that goes into complete fluency in written english-and then call him on it.
I’m sure AK finds that extremely disrespectful.
Not at all.
And please, Who and everyone else who prefers to engage in nothing more than hurling personal slurs, keep it up. Keep sending all the personal insults you want to me and anyone else on here who came for the benefit of Educational Debate. It only undermines yourselves and your own arguments. So please, keep it up. You are doing a much better job than I ever could at showing how little respect you have for others, especially women and their bodies. The more you show that of yourselves, the more it will show everywhere.
You know what else shows you up? The fact that just last night you claimed you had had your “fun” and you were done. No one who cannot or does not keep their word can ever be taken seriously. So, thank you. Once again.
The women were not given the opportunity of refusal. That is the point. They were not given the option to accept or refuse. And even many in the medical community have come tor recognize how wrong that is. If these women had been given the opportunity, many would have agreed to these exams. It is because their right of CONSENT was not HONORED. That is where Rape comes in. They were intentionally put under anesthesia and penetrated by personnel they did not know or recognize without their permission. That is exactly what a date rapist does when they use a roofie.
A medical license does not excuse the right of consent.
Even the Hippocratic Oath and the Declaration of Geneva both have lines in them about not only respecting the rights of your patients as a whole, but also that no physician is a ‘god’.
No, they were given the opportunity to refuse and did. That’s kind of the point of the articles: They signed a general agreement for surgery, including whatever the surgeon felt was necessary. Then they found out that a pelvic exam, possibly including a pelvic exam by students, was part of the procedure. They refused that and that refusal was respected. I admit I rather skimmed your links, so if there was a different outcome in one or more of them, do let me know. I might have missed it.
The debate in medicine is over whether to make the pelvic exam under anesthesia an explicit part of the consent instead of including it under the general consent. I support this concept, but find the comparison to someone being roofied not at all apt. In each case, consent for surgery, which is going to include people putting their hands in a lot of places you would normally not want them to, was given. In each case, if the woman refused the additional pelvic exams, the refusal was respected. Again, if I missed something, do point it out to me, but what I got from the articles you linked is that medicine has not thought through the social implications of pelvic exams and how they are different from pretty much any other procedure in the past and is now doing so. High time and past time, but not comparable to date rape.
When I had an appendectomy I consented to a lot of procedures (including pelvic exams, where I was asked if it was okay each time) but when I woke up from the surgery I found my pubic hair had been partially shaved. As a young person with no experience with surgery, I was surprised and embarrassed (I didn’t know that my body would be exposed to that extent during surgery). Was I birth raped? NO! Had the situation not been a dire emergency, then yes, it would have been better to fully explain the procedure to me. But it *was* an emergency, and I consented to the procedures needed to save it.
So, sure – it would be nice if pelvic exams and other genital touching during the course of surgery were explained beforehand. I’ll sign a petition to have those added to the general consent form before surgery (that not everyone reads fully…). But if there’s no time for consent I expect my doctors to still be able to do their damn jobs without people calling them rapists.
Absolutely! And your choices were agreed to. However, if a patient (for whatever reason) has said that they do not consent, or if the right of consent was not even granted, then the medical professional is guilty of a crime. I would prefer it if we could avoid that from ever happening.
No. You missed the point. I was not informed of what was going to happen, so I didn’t directly consent – this is what you have been arguing for, that pelvic exams should have a separate consent. I was touched on my genitals without being aware that that would happen under a blanket consent (the kind YOU find inadequate). I’m saying it’s not rape. But in your very first comment, you claim that it is. You *don’t* agree with me – or else you’ve changed your position since you started.
No, you have missed the point. I am defending the right of patient choice. Your choice is just as important. You have made the decision that you have no problem being penetrated without your prior consent by multiple strangers while unconscious under anesthesia. Therefore, the contact was not unwanted. That is your choice for you. I will absolutely defend your choice and your right to that choice. For every person who makes that same choice you have for themselves, there is a person whose choice is that of required express consent. Their rights are just as important and valid as your rights. I will defend their right of consent just as much as I will defend your right of non-consent. Each patient has the right to decide for themselves what they will allow to have happen to their body. And with each right comes a responsibility. The patient who refuses examination, treatment, or procedures may well be endangering their health and their life. That is on them. That patient is responsible for that. The medical professional who conducts an exam, treatment, or procedure on a patient who has refused has committed a crime. They have also undermined the trust and faith that patient (and potentially others) have, not only in that professional, but also the medical community as a whole.
It’s really not that simple. Doctors have to act quickly sometimes. The debate is about whether they can ever touch a person’s genitals (or give them any treatement, really, since bodily autonomy goes far beyond sexual organs) WHEN THERE IS NO TIME TO GET CONSENT, OR THE PATIENT IS UNABLE TO GIVE IT.
Trauma surgery saves lives. Are you willing to sacrifice those lives in the name of consent? Because I didn’t consent to my treatment, but there was no time to get that consent – I am alive because they didn’t wait for it.
If other people would prefer to choose death over treatment in that case, you can’t make it a policy that consent must always be obtained first without taking away my choice to live rather than die over the question of a pelvic exam I didn’t consent to first.
No one is taking away your choice. In case you have not noticed, I support your choice. I also happen to support the choice of someone who chooses otherwise for themselves. This is about body autonomy. Whatever conditions you set for your body autonomy is up to you, and no one else.
And please explain to me how medical students saved any woman’s life by performing their first ever pelvic exam on a woman who was intentionally left unaware and anesthetized during a routine surgery? I think I can say with complete confidence that not a single one of those students pointed out something the attending missed that saved the patient’s life. However, if that patient discovered what happened and objected to it, they might feel so violated by not being asked that they then did not seek treatment in the future. This would then potentially endanger their life going forward. So, in fact by not asking the patient in that case, the ultimate result was that the medical professional ultimately put the patient’s life in jeopardy. On the other hand, if it were an emergency situation in a trauma setting, that patient may be grateful and have their trust reinforced. They might even seek those particular physicians out in the future for extended care.
The original statement I made appears simple, but it goes down to a much more complex and complicated issue.
NO ONE HERE has suggested that it’s okay to do an exam on a woman who has explicitly said she doesn’t want it. Yet you keep arguing with us under the assumption that we do, and making statements to the effect that no medical care can be provided without getting prior consent. We’ve demonstrated repeatedly why this isn’t always possible.
We’ve had doctors here saying that they’ve never heard of the practice you describe, but you’re acting like it happens 100% of the time. Go find a specific hospital where it’s actually being done and set up a protest in front of it and you’ll get a lot less pushback.
Where exactly did guest say that s/he had no problem being penetrated without prior consent by multiple strangers while unconscious under anesthesia? That was in no way expressed in guest’s post.
This was going to the State of Hawaii Legislative session for 2012. Clearly in 2012, in Hawaii, lack of consent was still going on. And at that time, they were only the fourth state to discuss the matter. Many women and men agree to allowing medical students to participate, believing that they will not be manhandled by those students. Expressing that a student will be allowed to examine you internally is a very different thing indeed. Maybe not for that student, but for the patient it definitely is. There are many people who would agree to it – provided they are asked first. There are many who have, once learning of this practice, said “absolutely not”. The point is, it is the right of the patient, not the medical student or their attending. There have been times where I have been more than happy to include a medical student in training into my care; and only maybe once or twice when I have not been comfortable. As a patient that has been my right. As someone who has worked in the field I have promoted the training of medical students as much as possible, but always with respect for the rights and choice of the patient involved.
Well you wound that back pretty fast: so it’s not everywhere or everyone, it’s not in the last 10 years, and the reason, if it ever happened, was education.
Your intimations of an everyday, exploitative practice for titillation-after all, in your world, education was the ‘pretend’ reason-have been debunked by you.
Take a moment to read fiftyfifty1’s informative post about why you are wrong in such examinations having no value. Or is that a little too much reason for you to deal with?
Do you get a thrill out of trying to frighten people who somehow don’t realise what a fraudulent blowhard they have the misfortune to be dealing with?
I didn’t wind back, you have simply remained uninformed. I have tried to shed some light on an important issue. Keep reading if you would like more information; don’t if you wish to remain uninformed.
Either way…it is YOUR CHOICE.
I’ve read about this. It’s not “blithely accepted” anymore. See http://journals.lww.com/greenjournal/Citation/2012/10000/Practicing_Pelvic_Examinations_by_Medical_Students.28.aspx
It still sounds quite common, judging from that article. Or at least it sounds like it was 4 years ago when that article was published.
I think to say ALL is taking a bit of an extreme. I dont think anyone said ALL. I think what is being said is these people exist and these things do happen.
Are you actually claiming that when I was put under anesthesia for an appendectomy at a teaching hospital, I was then subjected to pelvic and anal exams that had nothing to do with the surgery? Because I don’t believe you. Citation or it didn’t happen.
(If it *does* happen without prior patient consent, it’s a gross violation of medical ethics, obviously, though before you can call it rape we’re going to have to define “sexual” contact in a hospital setting.)
I don’t think s/he is claiming that it happened to you, but it does seem to have happened fairly regularly in the past, and maybe there is a good argument to be made that those practices need to be clearly recognized as unethical so that there is no ambiguity for patients, students, and doctors alike.
Violation of Medcal Ethics and Not Rape
How about having finger(s) inserted into your vagina and anus without your consent (for a reason other than a life saving one in which you were unable to give consent.)
What if my life is not in danger, but it’s necessary to prevent the loss of my uterus, Molly? WHAT THEN????
And please recall that everyone here agrees that unnecessary pelvic exams on a patient done without consent are a violation of ethics. Whether or not they are rape or sexual assault will depend on your definition of those acts, which we haven’t delved into. But you keep on acting like none of us think sexual assault or other abuses happen in medical contexts, and none of us think that. So it’s really unclear what you are arguing about.
I am arguing what is considered sexual assault in a medical setting. See you keep calling in ‘unethical’ many would call it ‘sexual assault’.
Your uterus? If we are talking in the context of you being pregnant I would hope this is something you and Doc had discussed beforehand. “Hey I do/dont/ dont know if I want more kids. If something happens please save/dont save my uterus or do/dont do full hysto
And what if I’m not pregnant? Or I show up unconscious in the ER and my OB-GYN isn’t present? It’s okay for me to lose my uterus then, just because I’m unconscious, and saving it would require touching my genitals without consent, because I’m incapable of giving it in time?
That is such a stupid argument!!! If your unconscious all bets are off. They will do whatever is necessary because you forfeit consent when unconscious. You and I BOTH know that. Why do you insist on making up such crap for the sake of arguing something when you get trumped?!
And you have not responded to the ethics vs assault portion.
“That is such a stupid argument!!! If your unconscious all bets are off.”
THAT’S ALL ANY OF US EVER SAID. Refer back to what I said about how you move the goalposts.
Sexual contact in a hospital setting outside of lifesaving treatments provided to the unconscious or in a medical emergency (doctor insert something into vagina of woman severely hemorrhaging to stop her from bleeding to death on the way to OR…just a example) is sexual assault.
A persons rights do not change because they are in a medical setting unless a Judge has signed a court ordered.
I’d like to see your evidence that anyone here is arguing otherwise.
Me, too. This seems to be Molly’s mode: Make outrageous claim (“All doctors are raping their unconscious patients”), then keep moving their goalposts until the issue is so muddled no one knows what she wants anymore. But whatever it is, she’s certain that our view is Wrong and hers is Right.
Bitch quote me then!!! Where did I EVER say that ALL doctors do this????
If that’s not your position, why are you arguing with us? It’s true that I get you and A. Kelly mixed up, because you sound the same and these threads are hard to untangle over time. But at least I haven’t gone around calling you a “bitch.”
No you have just made multiple untrue accusations about me and refused to show evidence to back up your accusations on all occasions and now admit that its because you are confused!
Foulmouthed and rude.
The entire argument is what constitutes sexual assault during pregnancy/childbirth in a hospital/medical setting.
Your continued insistence, as if you have to convince anyone that assault is wrong, ethically or otherwise, implies that someone here has said otherwise.
My insistence is NOT simply that assault is wrong. Its that sexual assault in the medical setting is real and wrong and more common than many people choose to believe.
Thanks for your time and energy. You can let the dead horse go now.
What that its sexual assault? Thats what everyone is arguing on here! What constitutes sexual assault in a medical setting…that IS the argument
Guest wrote:
“…though before you can call it rape we’re going to have to define “sexual” contact in a hospital setting.”
That’s not me arguing otherwise, it’s just saying that I can’t call something rape until I know how *you* are defining it.
Can you not think for yourself? You cant call something rape until you know how I define it??
#1 How you define it for yourself is important
#2 I have previously posted more the once the federal definition of Sexual Assault/Rape and stated that in cases of a unconscious patient and life saving treatment consent rules are different (by law)
http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=200320040AB663
California enacted a law in 2003 specifically outlawing pelvic exams on anesthetized or unconscious women without consent. AB 663 2003
So what’s the problem, then? Why are you going around saying this happens all the time and all doctors are rapists?
I NEVER said all doctors are rapist. Quote me on it hun? Where is it???
A. Kelly said it, which started this whole thread – and you’re the only one left here defending her position.
QUOTE ME where i said that all doctors are rapists. And for that matter Quote A Kelly saying ALL doctors are rapist
I’m a doctor and what you are describing was NOT my experience in training at all. I did do a number of bimanual pelvic exams on anesthetized women, but these exams were never stealth exams and there was never a parade of medical students and they were never done without diagnostic or educational purpose.
Your assertion that “Said parts are experienced different in the true clinical setting, when patients are conscious; therefore doing so when the patient is unconscious has no educational value” is dead wrong. A pelvic exam on a conscious woman IS different than on an anesthetized woman, but that is the point. With anesthesia, the abdominal and pelvic floor muscles are totally relaxed, which means that the organs will shift. This is why your OB needs to do another bimanual right before the surgery when you are anesthetized rather than just going off the position that she documented when you were examined in clinic. The whole angle of the uterus can be different, and the doc needs to know where to “aim”. In addition, with the muscles relaxed you may be able to feel additional finding (masses etc) that can’t be felt with the abdominal muscles tensed.
The ethical guideline that we went by in medical school is this: The patient will meet you prior and be aware that you will be doing part of the surgery under close supervision. If she declines, that is her right, and then you are not allowed into the surgery, no questions asked. As a student or resident, you can do the same things that the OB needs to do to do her job right. You DON’T do things that the OB doesn’t need to do in that case. So in other words, if the OB needs to do a pelvic to do the surgery right, then you can repeat the pelvic. This is important both for your learning but also because when it comes time for you to do your part (e.g. do a couple of the scrapes during the D&C) you need to know where to aim also. But if the surgeon does NOT need to do a pelvic (e.g. if it is a breast surgery etc), then neither she, nor you will be doing a pelvic (obviously).
Now I trained 20 years ago, so perhaps the protocol has changed. But I seriously doubt that in the last 2 decades they have scrapped the policy and started inviting in “parades” to “manhandle your sensitive parts” for no reason.
One question: Did the patient consent to you or another student repeating the pelvic exam beforehand? If the answer is no, then yes, that is sexual assault. All you had to do was ask. If you didn’t ask, then you showed no respect for the patient.
So anytime anyone touches your genitalia, that’s sexual contact?
Rape. Has. Nothing. To. Do. With. Sex
It usually has to do with power and control.
I didn’t say it did. Standard medical exams also have nothing to do with power and control.
Context, Brooke, context.
Ask Iguodala?
Yeah, that’s exactly the sort of thing I had in mind. I am very anti-rape, but context does matter. I accidentally touch a woman’s boob at least one occasion. I am not a rapist – I simply didn’t realize where her secondary sex organ was in relation to my hand as I reached for something. Was it embarrassing for everyone involved? Yes. But it was not rape.
My boobs were accidentally touched and grabbed many times when I was cut out of one of my favorite shirts while the ER folk tended to my broken collarbone. Consent was not asked each time, but _context_…
When I worked in the ER, we cut lots of clothes off of the unconscious. Short of medic alert bracelet or some other way for us to know the person was a DNR, we did whatever was necessary to hopefully save their life. I jabbed unconscious people with needles to get important bloodwork done. I witnessed a nurse get a drill out to drill into a person’s bone marrow when an IV wasn’t possible. I didn’t consider myself to be committing heinous violent crimes. Now if I did that to healthy, conscious people at say the grocery store, that would be a whole different story.
Exactly this! We once had to run a code on a woman who collapsed while visiting a patient. Her husband was screaming “help her!”, then proceeded to yell at the staff who was removing her shirt because he didn’t want her clothes to come off “in front of strangers”. Trying to explain that we needed to put patches directly on her skin on her chest so we could check her heart didn’t change his opinion. It was completely appropriate for the situation but he couldn’t get past the fact that his wife’s shirt was removed.
And the majority of people in the world are immensely grateful to you for doing what you need to do in these situations. I don’t know why it’s so hard for certain commenters to understand that.
Because commenters just arent talking about life saving treatments towards an unconscious person, they are talking about Birth Rape….hence the title of the article
There is no such thing as birth rape. There is only rape.
CONTEXT. You were providing lifesaving medical treatment to someone who was unconscious.
Oh, so now you agree with us that in a medical context, touching someone’s genital is not a rape.
See, you’re making progress.
I agree that when an unconscious person arrives at a hospital and requires resuscitation the need to place equipment directly on skin of torso/chest area is not sexual assault.
Good, that’s a nice start.
Next maybe you’ll understand that in a life or death situation, a 10 hour discussion about ‘full impartial consent’ is not possible. And that doesn’t make it a rape.
Life or death is different that a routine cervical check during labor hun. I never said life saving treatment should be witheld
oh so now routine cervical check is rape? I’m pretty sure in the very vast majority of cases, women are asked before a vaginal exam and can absolutely say no. Or are you going to claim that nurses are regularly using force to spread a woman’s legs against her will so the doctor can do a vaginal exam against her will?
Well, in the NCB world, doctors are all-powerful and poor nurses are in thrall to them.
But you’re still not okay with catheters. Lol, okay. Enjoy your bedsores.
When did I say I wasnt ok with Catheters?? Quote me! Although you probably wont, because very single time i say quote me you never do….cuz its not there!
“I agree that when an unconscious person arrives at a hospital and requires resuscitation the need to place equipment directly on skin of torso/chest area is not sexual assault.”
You made an allowance for touching of the torso and chest only, not the genitals.
THAT HAS NOTHING TO DO WITH CATHETERS!!!!!
URINARY CATHETER YOU NITWIT.
Molly, we’ve been trying to show you how context matters for over a week now. Don’t act like you’re enlightening us on our own argument now.
I REALLY think you are looking at the wrong stuff. My CONTEXT comment wasnt referencing someone in labor it was a woman who was talking about resuscitating a UNCONCIOUS person on arrival at hospital.
And yes context has been a topic of discussion but people disagree on under what context certain act or permissable
And many of us think you’re “looking at the wrong stuff.” Looks like a draw.
Your definition of what is ok and not ok based on context and what is really going on in the medical setting seems to differ from mine. Yes context matter I never said it didnt
Wasn’t responding to you, Molly B.
No I was commenting and pointing out a flaw in your argument.
No, there was no flaw in my argument because there was no argument.
I will mention that the “FBI definition of rape” that YOU keep spouting says nothing about “context”
One time at beepball practice, one of the partially sighteds was doing a count off. Most of the guys he just tapped, but he wanted to give a good thump to his friend’s chest. He got me instead. I laughed so hard at his beet red, horrified expression.
My friends slap each other in the boobs. I doubt that they would consider that they are sexually assaulting each other. So yeah context is kind of important.
That is context involving intent. You did not intend to touch her beast.
I think you’re right on this occasion, but it surprises me to see you say it.
All your remarks to date have taken the position of the person on the receiving end: suddenly, you’re interested in intent of the actor. Doctors don’t do medical investigations with the intent to rape, they do them to provide them with the information they need to do their job, or to do their job.
Why is intent of the actor (as opposed to how the ‘receiver’ feels) so important in this particular case?
Because is this case the actor did not intend to touch the private area of the receiver without consent. It was an accident.
And in a medical setting, context also involves the need to touch something to provide medical treatment. We don’t not treat injuries because we would have to intentionally touch genitals.
“We don’t not treat injuries because we would have to intentionally touch genitals.” Can you rephrase this please? Are you saying that because genital would have to be touched you dont/shouldnt provide treatment?
No, that’s what _you’re_ saying should be done. Guest is saying the opposite – that they don’t withhold treatment if genitals would be touched in the course of providing it.
Like a doctor may make the decision that the life of a neonate is going to have to take precedence to getting full informed consent for each touch, if the timing is not right for it.
Is this your new campaign to ignore having to think about your hypocrisy re: epidurals?
Unles you said No Mr (or Ms) OB I dont want a rectal exam during my pap…and he/she did it anyway. That is still sexual assault.
You stated that the definition of rape has been expanded to include sexual contact. In 2013 Attorney General Eric Holder announced a revision to the Uniform Crime Reports Definition of Rape @ https://www.justice.gov/opa/pr/attorney-general-eric-holder-announces-revisions-uniform-crime-report-s-definition-rape. The new definition is “The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.” That’s right…penetration of the Vagina or Anus, with ANY body part or OBJECT without consent of victim. Vag exam, episiotomy, forceps, or any other mechanical device inserted into vagina or anus without consent or after declining by a woman is rape by legal definition. If a woman who is not pregnant had a finger or object inserted into her without consent this would be considered sexual assault or rape. The right of autonomy, bodily integrity, and peace do not change when a woman is pregnant. Her rights are not lessen or obscured by her pregnancy. Period. End of story.
I haven’t replied to your statement here yet, so please allow me to do so now.
Absolutely effing right! THANK YOU for stating this! A Medical License does not grant a doctor unchecked autonomy over another person’s body; just as pregnancy does not lessen a woman’s right of autonomy over her own body. So, THANK YOU again!
So…I suffered a cervical laceration during my first delivery. By your definition, I was technically raped because my CNM did not ask for consent prior to beginning the procedures that saved my life. She told me that they were giving me pitocin and cytotec (the former via injection, the latter rectally). She told me that she was going to have to do a manual examination of my uterus. I did not have a heplock or I.V., so this was more painful than childbirth itself (she was in up to her elbows). My husband ultimately consented for the surgery to repair my cervical laceration, including hysterectomy (fortunately, not needed) because blood loss, shock, and pain had left me incapable of informed consent.
Was this experience traumatic? Absolutely. I relived the complications for weeks, and our older son was very nearly an only child as a result of the fear and anxiety. BUT…I NEVER believed that my healthcare providers had any intent to violate me. In an emergency, things have to be done quickly. There is not always time for informed consent. To equate this with rape is repulsive. Stop making this comparison. It is obscene.
Your husband, who presumably knows your wishes, consented on your behalf. Additionally, this sounds like this procedure was done by healthcare providers who have treated you before, and would know your history and what you would like for yourself.
On the other hand, take a pregnant woman in labor who had previously specified for a particular Doctor not to touch her, and instead he rammed his hand into her vagina. She continues to scream for him to stop and finally, somehow, manages to kick him in the head. This Doctor did commit Rape.
I am glad for you that you were under the care and watchful eye of not only medical professionals who were familiar with what you would want, but also your husband with whom you clearly have shared a great deal. There is a difference between a patient who has had their rights and their bodies violated and one who hasn’t. It is good that your experience was a respectful one. I am only looking for every patient to have a respectful experience. After all, when patients have been treated with respect by their medical professionals, they are more likely to trust their medical professionals and to go to them for appropriate care.
Is the woman prepared to die rather than have that particular doctor touch her?
I have already provided an answer regarding personal responsibility and consequences in a previous post.
Yes, but it is obscured in the plethora of other blather emanating from you. A quick RE: or other indicator of exactly which post you are citing would make sorting through this quagmire a bit easier.
On the other hand, take a pregnant woman in labor who had previously
specified for a particular Doctor not to touch her, and instead he
rammed his hand into her vagina.
Is this a real case or something you made up? Was the doctor the only one available? Did he “ram” his hand into her vagina to stop a hemorrhage or to pull out a distressed baby or for no obvious reason? Are you aware that a life threatening emergency may not be obvious to the person who is in the situation, even if she has medical knowledge? In short, the situation you describe could be anything from a horrific violation to absolutely appropriate and life saving. I just can’t tell from what you’re saying and my guess is you don’t know either.
You’ll note the doctor loses either way-gets sued for ‘raping’ the patient saved, or gets sued for ‘letting her die’ if she wasn’t told, in words of one syllable or less, that she would die if the procedure wasn’t performed.
He’s a mealy-mouthed ass: that’s the American spelling, here in Oz we’d call him an arse.
From that basic conclusion, all else follows.
Ah! So you’re in Australia. Yeah, I should have guessed. I have lived there. I have also lived in New Zealand.
The medical professional does not lose either way – only if they forgo patient rights.
And, THANK YOU again for the personal insult. Every single one you send my way you only show lack on your own part. I know many medical professionals at many levels of patient care. Not one of them wants someone who reduces their arguments to personal attacks and name-calling defending them. So, thank you so much for reducing the value of what you have to offer for anyone who is an actual professional.
If you are not in America, why does it matter to you what American medical personnel do or don’t do? Unless it is a “compare and contrast” exercise for you.
I was asked earlier in the thread about policies and practices in the United States over the last 20 years. At some point, I pointed out that this blog originates in the United States. There is a post from Who making an assumption that I must be an American or in America.
(Just trying to clarify things)
I do know. That is not the point. It does not matter if this case is real or not. It does not matter whether or not there was an emergency in the opinion or knowledge of that particular physician – he was told not to touch her…at all…by her…a woman of sound mind…who has the right of autonomy over her own body. Yet he forcibly penetrated her body against her will and wishes forcing his own will, authority, and control onto her.
By the way, it was real. There was no emergency, and the child was fine. The mother would also have been better off if she had not been interfered with in that particular situation. As a result it caused a much greater issue getting her to trust the medical community in that area again. (He’s lucky he didn’t end up in prison or with his reputation ruined – the mother almost pressed charges.)
How do you know that she and the baby would have been well, and that in fact there was no emergency? Were you there, in your role as a medical professional, fully apprised of the situation? Or did you hear about it through a prism of outrage?
Does this doctor make a habit of ramming his hand into patients’ vaginas for his own titillation? Because that is what you are suggesting-whether you mean sexual gratification, or some power trip, as you allude to.
No one denies a person’s right to autonomy.
Anecdotes masquerading as hard cases do not take the discussion forward.
You have denied autonomy on occasion here for all when you were simply referring to yourself. Take a look earlier in the discussion.
No, it does not matter if it is real or not. These discussions are meant so we can all gain clarity to prevent any situation which compromises anyone who may end up being caught in them.
How do you know it wasn’t just a contraction the patient was experiencing? Contractions can be painful, but they are an expected part of childbirth. I do not suggest, nor have I suggested titillation or sexual gratification on the part of anyone who may be caught up in these case – so why consistently bring it up?
I do state plainly when a patient’s right to their own body decisions have been expressly violated or defended – including those defended by medical personnel. And I do so without unnecessary personal attacks.
Why should we believe you when you star by saying that it doesn’t matter if you made up your examples or not? By the way, even if your story is true, something is missing: did that patient give informed consent or not? Meaning, was it explained to her that in case of emergency, the doctor may have to touch her pelvis or even put their hand in her vagina, and that it may be a question of life or death for her and/or her baby? Only if she acknowledged that and stated that she’d rather die or lose her baby than be touched would it make a case of breach of medical ethics.
Oh, and about your argument that “the baby was fine” so it was no real emergency: check the recent article on “Integrated seatbelts” and think again.
You seem to have a very narrow definition of medical ethics. Autonomy is a vital principle, but not the only one. There are three other principles: justice, beneficence and non-maleficence.
Furthermore, you consistently ignore the fact that the patient has entered a relationship with the provider and has generally signed documents that codify that relationship. The patient typically agrees, in writing, to procedures not specifically enumerated and the participation of hospital personnel not specifically named.
The provider patient relationship is NOT a business relationship of seller-buyer. It is a fiduciary relationship in which the doctor is ethically bound to preserve and protect the patient’s health. The doctor is not the patient’s employee and is not bound to do exactly what the patient wants.
You might want to have your leg amputated but that doesn’t make a doctor ethically bound to amputate your leg. You might want the doctor to neglect the basic tenets of safe patient care, but that does make the doctor ethically required to do so.
One of the cornerstones of medical care is informed consent — not simply consent. It can’t be considered informed consent if the patient is not informed. The definition of informed is not the patient’s definition; it is a standard that varies from jurisdiction to jurisdiction, but patients who believe lies told to them by natural childbirth advocates aren’t informed and therefore have a difficult time giving truly informed consent. They’ve been told that their doctors’ recommendations are lies when, in fact, their doctors’ recommendations are medically accurate and natural childbirth advocates beliefs are lies.
That puts doctors in a very difficult position. We know that patients often lack the factual information needed to give or refuse informed consent and we know that we have ethical obligations of care. That makes these situations quite complex. They’re not nearly as simple as you seem to believe.
I have never claimed any of the above was not the case. And, yes, it does put medical personnel at all levels in a very difficult position indeed. This is why these discussions are so very important. As I even stated in a previous post about how one person I know made the choice to have a home birth. This would not be my choice, and I could definitely have my opinion about it all I wanted. I could even try to convince her otherwise, which many of us did try, but to no avail. At the end of it, we all had to respect her choice. Of course, if something had gone wrong, it would also have been her responsibility having made that choice. And although informed consent is generally considered a cornerstone, there are too many cases where it was blatantly and intentionally left out and had to be brought back in through a legislative or other lawmaking process – where it should have been considered common sense. This applies to in varying degrees depending on where in the world we look. Unfortunately, because there are so many things that can happen and that patients must consent to, it can all get to be way too much and get lost in the mix. Does that mean we stop trying to inform? Does that mean that we stop trying to gain informed consent? Once we start making assumptions, we all start getting into dangerous territory.
I have not seen you mention any other principles of medical ethics. I’ve not seen you acknowledge that reaching an ethical decision in patient care is not simply a matter of doing whatever the patient wants.
I’ve written in the past about the fact that I’ve experienced episodes of losing a patient’s trust specifically because I DID follow the patient’s stated demands and the baby suffered as a result. The patient subsequently claimed that I had not been forceful enough in insisting that the baby would die without a C-section and therefore she had delayed it until the baby was nearly dead.
The central problem, which you have ignored, is that many patient demands come from patients who aren’t merely uniformed, they are misinformed. What’s the ethical obligation of a provider who knows that the patient doesn’t understand what is at stake?
Of course it matters whether the case is real or not. If something never happened, it’s hardly necessary to argue about how horrible it is that it happens all the time, now, isn’t it?
No, it does not matter if the case is real or not. Even in a case that has not yet happened, as many here have already pointed out – anything is possible, and almost anything can happen in a given situation. There are many things you and others have brought up that may not have actually happened as you have described. I honor and respect the idea of those discussions, because through those discussions we can hope to attain a better understanding of what is acceptable practice for not just the patients, but just as importantly for the medical personnel involved. Medical personnel need legal protections too.
Actually, I had met the nurse-midwife who delivered my son once prior to delivery. When you go through a practice, you are assigned a primary midwife, but will be delivered by whoever happens to be on-call. I trusted in her expertise, but I can’t say that she and I were “familiar” with each other. I certainly did not know the L&D nurses or the attending OB who did my surgery.
A husband cannot ever give consent for a sexual relationship in place of his wife. Same goes for a child, a parent cannot give consent to someone to have sexual relationship with their kids.
So no, sexual consent and medical consent are not the same thing. The absence of consent to a medical procedure doesn’t mean you were raped, it means you had a medical procedure done without consent. That’s it.
You can complain about the treatment, you can file a complaint against him for doing medical procedures against your consent, but it wasn’t a rape.
The situation you are describing is also lacking an important
information: Why is the doctor putting his hand inside the woman’s
vagina? Doctors don’t do that for funs and giggles, if he’s doing so,
it’s because he has a medical reason to.
I had missed this comment. She’s basically saying that a husband can consent to sexual activity _for his wife_. That is some creepy shite.
Only if she is unconscious.
This. I am just unwilling to call the majority of doctors rapists for placing catheters and removing clothing and whatever else they have historically done to patients who can’t consent when they are doing it as a necessary part of treatment. It doesn’t mean we can’t say, hey, let’s see if we can return some control to the patients through consent forms that provide more information or whatever else. A doctor can rape (anyone can), and that’s a breach of ethics, not not all breaches of ethics are rapes.
As I sit here recovering from my episiotomy last week, I really appreciate reading this post. My OB never asked me if I wanted an episiotomy; she told me about it after the fact. My chunky baby descended through the birth canal so fast (10 min) that she exercised her best judgment to keep us both as safe and as healthy as possible.
I have no regrets over having an episiotomy, and am 100% thankful my OB did everything in her power to ensure both my little boy and I would be safe. I’m glad to have had one.
While your trust in your OBs decision is great, and they are.many women, I’m sure who would agree with you, not everyone feels the same. I think this is the point here. What if someone didn’t want to be cut and.the doctor did it anyway, without consent? They have to live with the pain and recoup of an unwanted procedure and all the doc had to do that situation was ask.
Because 3rd and 4th degree tears never happen and if they do, they always heal up better because they are “natural” (as many in the NCB crowd claim).
So, theoretically, would you be in the right frame of mind to consent to an episiotomy if you were exhausted from a long labor and pushing and were currently experiencing crowning? How about the pain from an OP baby? Or if a shoulder dystocia occurred and things needed to be done, and done quickly, to free the baby?
That is why docs should discuss things like episiotomy during prenatal.visits to ascertain the mothers wishes and allow mother to have prior knowledge to make.an informed decision while in labor. Also, refusal is always an option and I my opinion if a patient refuses a treatment/service/procedure they are solely responsible for the consequences directly related to that refusal.
Of course refusal is an option, who would suggest otherwise.
Given your attitude to informed consent though, I would not feel confident that you would, as you suggest, take responsibility for your refusal. More likely you would claim that you were not given all the necessary information, and that led to your refusal, therefore it is the doctor’s fault you refused.
Not to mention that if such things are brought up by the doctor during a prenatal appointment, then the doctor is fearmongering and trying to push the mother into interventions she doesn’t want. Or want to think about, in the entire scheme of things. The doctor wants to talk about and plan for a “worst case scenario”, because s/he knows things can go wrong in a hurry and often there is precious little time to act. The mother views this as fearmongering and trying to force interventions on her and her fantasy birth scenario.
Crying after the fact because you didn’t want to listen or to plan for a worst case scenario is not the doctor’s fault, although plenty of people try to make it so.
If someone is refusing, the doctor had the obligation to try to provide information about risks and benefits. If the person still refuses it the patients responsibility for any consequences directly related to refusal.
‘“Birth rape” does not exist. It is a promiscuous abuse of the term rape for the sole purpose of garnering attention. The term is legally meaningless and ethically suspect. ‘…. What’s got her knickers in a knot? I understand taking a stance on an issue, but she is really angry about something…
Birth Rape is a term that has been coined to bring needed attention to the lack of respect and autonomy given to childbearing women. Many of the concerns are those of sexual assault per the legal definition.
And it does a disservice to both those who have suffered due to the lack of respect for autonomy and to those who were raped.
The federal definition of sexual assault/rape is any body part or object inserted into a vaginal or anal opening without consent.
Now we know that you are just making things up.
https://www.justice.gov/opa/pr/attorney-general-eric-holder-announces-revisions-uniform-crime-report-s-definition-rape
But you have already admitted that she doesn’t have to give consent herself, and that her husband can consent for her because he “presumably” knows what she wants.
In the same way, the doctor presumably knows what is medically necessary. So why can’t he be a proxy as well?
Once you’ve introduced the option of a proxy, the only question is where the line is drawn, and your absolutist claim means nothing.
[enter special pleading]
When did I say a husband can consent for wife? If she is unconscious?
That was AK who said “Your husband, who presumably knows your wishes, consented on your behalf.” I know, it’s hard to tell them apart. :p
By law if the woman is unconscious or incapable of making a decision and the husband is present then the decision legally reverts to him.in the absence of a living will or directive that list someone else.
Then an episiotomy doesn’t count…..
Does refusing an MRCS? :p
Not unless they are going in vaginally or anally. Neither of which is considered standard of care, I believe. ;P
But if you want a c-section and you are refused one, then the baby is going through your vagina without your consent. Your baby is raping you!!!
I meant, doctors or insurance refusing to do a wanted CS for a woman, thus forcing an unwanted penetration of her vagina from the other direction…
Ha, good point! If the “patient modesty” and “birth rape” crowd were genuinely concerned about vaginal violations, they would would advocate CS on demand!
How does an episiotomy not count?
“birth rape is not for real” says the birth-rapist
I don’t think so Viola
I think it is mostly simple assault but can occassionally be… something closer to sexual assault or a lesser degree of rape.
Punching someone in the crotch and pulling their pants down first and then punching them in the crotch are not the same thing. They are more minutely different than a punch to the crotch and insertion of a hand to the crotch (all of the above non-consensual, oc course) but they are still different.
Of course, you pull your own pants down when you go to give birth, so intent would be a factor for the OB to be committing a higher degree of sexual assault in most cases. But take something like nonconsensual pelvic exams during surgery. You only ‘pulled your pants down’ for the people and procedures actually involved in your surgery. Even if you consent to be a teaching patient, that is for the surgery, not additional procedures unless expressly spelled out. And the med student’s intent – again, in most cases – is to do what his superior told him to and not be failed out of the unit. He may even feel bad, or have been told the patient consented, or not to worry about it. That is most assuredly assault, but I would also agree with it being even more of a violation. Perhaps an enhancement (similar to a hate crime) or as stated before, a lesser degree of sexual assault.
And of course, competence must come in to play, in both directions. Competence to make medical decisions and / or consent.
Also, I know why it was likely done (talking about birth, it was the official us definition for a long time and still is in some ways) but I would be remiss to not state that rape can be gender neutral. It can be slightly different, and the stats can be and often are different (though many factors there) but it absolutely can be and often is gender neutral.
A woman in labor only “pulls her pants” down to.birth her child. Not to consent to multiple vaginal exams. Intent is not a factor in laboring women just because.their pants are off. This exact thinking is part of the problem.
I expect whether one consents to multiple vaginal exams is individual. Unless you are there, you have no idea what someone else consents to–or doesn’t.
Exactly. You stated so vulgarly that when a woman pulls her pants down to birth her child consent to other things is implied. But as you just pointed out whether one consents to multiple vaginal exam is individual, so if it individual then consent cant be implied. And as you stated you have no idea what someone consent to if you are not there.
So…by your own statement consent to.multiple vaginal exams is and individualized things and consent therefore can not be implied.
You might want to actually read before commenting, as your comment seems to be intended for Wombat. I didn’t say anything about pulling down my pants or anyone else’s. I said that consent is individual, and that unless you are present you have no idea what has or has not been consented to. I consented to any damn thing that would keep my son and me alive, vaginal exams, IVs, whatever. If you didn’t or don’t, that’s entirely up to you.
Hello year old comment and article.
Regardless, pelvic exams are a normal and expected part of said ‘birthing (and carrying) her child’ process. You cannot separate the two only when it’s convenient.
My point was not that bad things never happen in labor (they absolutely do, with both professional and lay providers) nor that those bad things are /never/ rape.
Merely that the lack of pants in this situation does not automatically make it felony rape, especially when intent is considered. A doctor continuing an exam after consent is withdrawn is committing assault in almost all other situations, assault should be the default here too. It goes without saying that assault is awful and bad, especially in such a case where it destroys someone’s trust in their doctor and even the system – but it’s still legally distinguished from rape, and rightfully so.
A woman has every right to discuss her situation with her doctor and attempt to avoid or minimize vaginal exams. A doctor forcing one at that point would be guilty of at least aggravated/enhanced assault charges, if not (again, at that point) sexual assault.
A woman also has every right to withdraw consent for a medical procedure, even one that’s in progress (presuming it is stoppable/she is conscious and competent). The fact that that procedure is a vaginal exam is not irrelevant, but it’s not an automatic upgrade to the first situation either. If a woman wants to stop her vaginal exam -only- due to pain (exact same way she would want to stop a toe shot) and the doctor continues, is he automatically raping her merely because it involves her vagina? Not to be crude, but is a dentist who fails to stop an examination upon request a rapist? Mouths can be raped (or at least sexually assaulted, depending on who’s definition you take up) and fingers and instruments can do the raping. The context is important there, why don’t OBs get the same consideration?
There is such a thing as swinging the pendulum too far in the other direction. My attempt to keep it patient’s side of the middle was purposeful.
If a person was manually arousing a woman’s vagina in an intimate situation and the woman said stop and the person refused to stop, would.that not be sexual assault?
Is the dentist using his penis to count teeth??? How does the dentist comment even.work???
1. Like Ina May did? Or are you implying a membrane sweep is meant to be stimulating? Are (actual) rapists trying to stimulate their victims? Or are they just trying to exert power and get off themselves (ding ding, if you really were confused)?
Perhaps you’re the one misguided on sex assault.
2. “Mouths can be raped/assaulted” and “Fingers and instruments/implements can be tools of rape and assault”. Really, I spelled it out. You’re advocating for any and all failure to stop that involve the vagina to be rape. Why leave out the other assault-able orifices? Perhaps because they clearly have medical (or even everyday) contexts – just like childbirth and other medical situations involving the vagina do.
Because my comments were based on federal definition of rape and sexual.assault which I have posted link to on here more than once. The bottom line is if someone says No….then No.means No period
No one is arguing that second point. Literally no one. They are arguing that there is a difference to saying no (or simply not saying yes, to be more accurate) to a sexual invasion of your body and a medical procedure (even if it happens to involve your penis, vagina, anus, or mouth).
There are differing definitions of either term within the Federal Government (Justice Department, FBI, etc). Many of those are only defining it for statistical purposes, since charges would almost always fall under state law. Several state laws support rape by instrumentation. Hence, an object inserted without consent into the mouth of an unwilling victim could be rape in several circumstances. It could also be battery or assault – such as someone doing it during a fist fight – or, as you so rightfully pointed out multiple times, our asshole dentist.
Again, no one is arguing that these OBs who refuse to respect the revocation of medical consent aren’t assholes (outside very very rare circumstances). No does mean no, and no one deserves to be assaulted. Duh. That doesn’t magically make medical-procedure assault during birth rape, though.
First off you need to go back and read some of these posts. My dentist comment was in response to someone who brought up a dentist, not me.
SECONDLY, no… any medical-procedure assault in not automatically rape or sexual assault. But when it involves a woman or man saying NO DONT TOUCH MY PRIVATE AREAS and IT IS DONE ANYWAY….that, my friend, is most definitely sexual assault or rape no matter if a person is in a hospital, medical office, car, bus, train, plane or at home. No matter if the offender is a friend, spouse, boyfriend, stranger, nurse or doctor. Rape is more than just someone forcing a sex organ into another orifice.
Also state law can not EVER trump federal law or leave out portions or federal law. State can add to it, but not take from it. There is no exclusion in a persons right to not be violated by someone, even if MD is at the end of their name.
That person was me. It was my analogy, that you refuse to consider or even try to understand /roll eyes. Perhaps familiarize yourself with Disqus before you tell me to ‘read some of these posts’.
Is “STOP DOING THE MEMBRANE SWEEP” or “STOP CHECKING MY CERVIX” equivalent to NO DONT TOUCH MY PRIVATE AREAS? Because if so you haven’t actually acknowledged the difference or drawn a line at all. Yelling either of the first two easily happens out of pain for frustration, not a woman who feels she’s being raped. If those are rape merely because they involve genetalia (despite the woman only wanting the pain to stop, not the touching) then “STOP KICKING ME IN THE BALLS” is rape.
You’re the one focused on insertable sex organs. I’ve discussed touching and even rape by implements (that you refuse to acknowledge) already, multiple times. In fact, I’ve never brought up penis previous to this (since I agree with the original article that a penis getting involved is obviously much clearer cut). You have. Multiple times. Discuss what’s actually at hand and lose the fixation, maybe.
State law can and does trump Federal law as long as it is stricter in many circumstances (especially medical ones) and/or if Federal law would not be applicable. Rape is majority a state law issue, since rape tends to occur entirely within a state’s jurisdiction. Especially applicable for the so-called ‘birth rape’ discussed in the article (outside of on-base military providers, unless off-base falls under a Rodney King style elevation I am unaware of). Federal elevation after the fact can sometimes occur (if the crime can be made into a hate crime or other extraneous factors apply). So yeah, state law is rather relevant.
And Feds /are/ (mostly) collecting statistics. The (awesome) updated definitions (at the FBI among others) are for statistical gathering purposes (they go over that and make it very clear here: https://www.fbi.gov/about-us/cjis/ucr/recent-program-updates/new-rape-definition-frequently-asked-questions ). It’s to ensure that even lesser state level crimes (due to lacking or non-updated state laws) fall under rape in national statistics.
Again, for the nth+1 time, people can ABSOLUTELY be violated by MDs! That violation is called assault. In exceedingly rare circumstances (in the developed world*) it may be sexual assault (the factors that lead to this are not simply the action having to do with the vagina). The instances where it is actually /felony rape/ at the time of delivery (in the developed world*) are infinitesimal. Especially if you’re only applying this to hospital practitioners (as Natural Childbirth Advocates and Lay Midwife Supporters almost always do).
What I recall is you saying a dentist inserting a dental toolinto a patient mouth should constitutes rape, which i disagreed with. I said it does not unless he inserted his penis. I mentioned that one time. And did respond to your comment. I am not focusing on insertable sex organ. A single comment in response to your comment about instrument being inserted into a dental patients mouth is not obsessing on insertable sex organs.
YES if a woman tells a doc to stop doing a membrane sweep or a cervical check regardless of why it is assault. So what if its from pain? Only a non painful reason for a demand to stop being inside a persons sexual organ is assault???????
So if you tell your partner to stop during sex or fingering you or whatever he/she doesnt have to if the only reason is because its painful????
I never said state law wasn’t relevant only that it doesn’t trump federal law and can not usurp federal law. BTW court marshal would fall under federal law.
Just because something has a low rate of report or sentencing doesnt mean it is irrelevant or unimportant
Now we’re coming full circle, whether you realize or acknowledge it or not.
Simple point by point this time because I’m honestly a bit over this parachuting crusade and feeling lazy.
– You are advocating that an OB touching a woman’s vagina after consent for a procedure is revoked is always analogous to rape via fondling or insertion of fingers. So why isn’t a Dentist inserting instruments into a woman’s mouth after consent for a procedure is revoked always analogous to oral sodomy via implements?
The point is your own framework is flawed. If I were you, I would imply that means you are against advocating for rape victims, repeatedly. Good thing I’m not you, since I’m pretty over that subtle(ish) attack on my openly but also rational feminist stance.
– You brought penis into it here and here:
“Is the dentist using his penis to count teeth???”
“Rape is more than just someone forcing a sex organ into another orifice.”
– Regardless of why is too damn broad, and that’s the point. What if she says no because she’s worried it costs too much? Unlikely, but so are most aspects of ‘birth rape’ or even medical assault. Still rape, apparently.
Even in the much more likely situation of pain, there are confounding factors. Many women in emergency situations may scream things like ‘No it hurts too much’ but also ‘Save the baby’. Consent in the form of ‘no’ as a brightline is great for most medical or sexual situations, but on the fringes of either (safewords often make no not mean no, for just one simple example on the sex side) there are exceptions.
– Obviously the fingering is different. Because there is no medical purpose and there is sexual/power intent (sexual, not nec. pleasure). Glad we’re finally at least semi-agreed on that /sarc /snark.
– Federal law doesn’t trump state law in these cases, /because it doesn’t apply at all/. Literally. OK proved that with their controversial oral sodomy ruling just the other month, if you really doubt literal centuries of legal theory and practice. Article Three and the 10th Amendment sure do trump the definitions (that again, are predominantly for statistical purposes) you’re citing as some kind of ultimate answer, though. I’ll give you that bit of (ultimate) Federal say. SCOTUS could further tailor the scope of the intent of the 10th (etc) but they have not done so so far.
– Court Martials, yes, are Federal. That’s why I noted it as a possible very rare exception (I’m not actually sure it would apply/has been tested in practice vs judicial theory). However, they would not be subject to your law/’definitions’ (aside from said statistical reporting, depending on scope) as Military Justice has it’s own framework and laws. They’re an exception for both of us.
– Again, no one. No one. Not one literal soul here, is arguing that these situations are unimportant or irrelevant. Medical assault is despicable in almost all situation (barely defensible and still obviously bad in the rare few affirmative defenses, such as over-handling emergencies with good outcomes). It is under reported and that’s an awful thing. There are rare providers out there who should not be practicing. Held responsible or not, they damaged someone in a vulnerable state. Both mentally and physically.
We are arguing that what you call these situations – despite the superficial similarity – is incorrect (and arguably devalues the term, but that’s another post). It is incorrect practically and especially incorrect legally.
Stop the false comparison. Stop implying we’re heartless, careless, or ignoring victims (especially when told flat-out that’s not the case). Stop implying we’re bad rape victim advocates (obviously can’t speak for all but I can assume statistically and personally that most are in fact quite concerned with rape’s sorry state in our country). I feel for a woman who personally feels her situation was ‘birth rape’. I feel for her deeply. I am sad she is influence and used as a prop by NCB advocates who want to imply all doctors are that way, but that is on those NCB advocates, not remotely her. I do not at all care if she personally and privately considers what happened to her rape. Her experience, her call. That does not mean she gets to apply the term publically (it’s slander/libel – even if against an asshole who did commit a different crime – if nothing else, and helps propagate falsely trumped up experience and legal claims) and it especially doesn’t mean she gets to apply it legally (she’d really be shooting herself in the foot there because the proper charge is much more likely to be successful and provide the outcome she apparently wants due to pressing charges in the first place).
I think I may need to clarify something. My question regarding manually arousing a womans vagina in an intimate setting was not to say that the intimate setting was a hospital or doctor office. I was meant to say at home, in hotel, with someone you love or care for or want to be intimate with.
If you were ok with it at first and then said stop and they continued that would be assault.
So, no. I am not saying that a physician is trying to stimulate a woman during an exam. I am saying that if she says no or stop to exam he has a legal and ethical to immediately stop.
as to your other question/comment I has been determined that some rapist get off on stimulating their victims as a way of having power and control over the victims responses to the assault.
I am strictly focusing on vaginal assault because this is an article about Birth Rape. Unless women start birthing through there rectums, mouths etc on a regular.
Prostate exam rape coming up next year. The doc put her hand up too far!
Forcing your hand up someone’s vagina would actually meet the FBI’s definition of rape. It does not have to be a penis inserted in the vagina to be considered rape. And perhaps “birth rape” is the wrong terminology: I think it would be more accurate to call it ASSAULT, because that is exactly what it is.
Gotta love the Internet… always finding all kinds of new things on it! Never heard of this site. Stumbled across this article after Googling “birth rape” after a pro-homebirth friend used the term. I agree with the author of the post that the term rape should not be used so loosely. What are the best posts or places to look at on this Skeptical OB site to get a feel for what goes on here?
I think just scrolling down on the home page, and reading the stories that catch your eye, is probably the best way to go. All the stories have lively comments sections, too.
Please don’t think that just because you are a woman, that you can get away with assaulting me when I come into the hospital to have a baby. Shoving your hand up my vagina, without any warning at all, and continuing to do a cervical check while I am begging you to stop because I am in pain, is really an ASSAULT. Yes, even if you are a woman doing it. Hospitals only hire women to work in labor and delivery, because if a man did some of the things these women nurses do, they’d go to prison for it. But its time for us to view these things as what they really are: ASSAULT. Its the reason why I now have a MALE ob/gyn because he is much kinder, and more conscientious about not forcing things on his patients.
the changes, published on Wednesday , have been made because women who give birth under midwife-led care have less chance of being asked to undergo medical interventions such as episiotomies, caesareans and use of forceps or ventouse.
just like the weird, undocumented stuff i so often read/read.
http://www.theguardian.com/lifeandstyle/2014/dec/03/low-risk-pregnant-women-urged-avoid-hospital-births
I’m sure this has absolutely nothing to do with the NHS’s need to cut costs.
yes, because only the low risk women will be having homebirth. IIRC, first time mothers are not allowed to homebirth. Many need help with the first baby and subsequent babies are easier.
Not to mention NO effective pain relief!
The results of not having easy access to c-sections, forceps and ventouse are sometimes not readily apparent. I wanted my kids to have all their brain cells.
of course it comes into it just like usa hospitals/medical system are trying to get as much money as possible.
last summer i poked myself in the eye with a twig while gardening. it was the weekend and i wondered about going to casualty but searched the internet first.
all the american sites told me to seek medical help immediately, only the nhs counselled patience and waiting a little.
you might say they didn’t want to waste money on people over unnecessary visits but you might also say they don’t invite unnecessary visits because of greed.
i went with their advice, gave my eye rest with a homemade patch, and was ok the next day.
really, it’s a minefield that needs clear thinking and as much info as possible.
But their babies are more likely to die, so it prioritises process over outcome.
It also takes for granted that Epidurals are unnecessary, negative interventions, rather than wanted, necessary analgesia.
Women cannot access Epidurals at home or in a birth centre.
NICE thinks of this as a pro, many women see it as a con.
NICE, bless them, aren’t always right, and sometimes the authors of guidelines have agendas.
In the area where I work there is a birth centre which has a 20 minute transfer time to the nearest maternity hospital. It was supposed to deliver 1000 babies a year. Women, however, voted with their feet and the unit delivers only a fraction of that number.
A large suit against the Trust, that was successfully defended on the basis that with such a long transfer time a serious birth injury or death was “inevitable” if something went wrong, didn’t make the unit more popular either, once the verdict was made public.
NCB prioritise “normal birth” over safety. Very few families do.
rape is about power, not sex, using your power during birth, against the will of the birther, is therefore rape! it makes perfect sense to me.
” using your power during birth, against the will of the birther, is therefore rape!”
You mean like when a doula or a lay midwife ignore “the will of the birther” and requests for legit pain relief or transfer and use their power of ignorance to offer rum or lie about the progress of labour?
You mean like when a lay CPM midwife uses her power of manipulation to convince a mother that the test result showing her baby is imminent danger is nothing to worry about and kills a baby?
No, that is not rape, and neither is a medical assault.
those would apply as well.
Yes but what CPMs/NCBers define as birth rape the rest of the world calls standard obstetric interventions for the well-being of the mother and baby.
if it’s needed it’s ok unless of course the need has been created by malpractice in the first place.
A need created by malpractice? What does that mean?
A “pit to distress” C-section I would guess.
Oh yes, I forgot, because they “want more money”. Good grief, if malpractice insurance creates a need which in the end is a very safe way for a baby to be born, what kind of need does an unlicensed midwife with no malpractice insurance create?
created by doing things or omitting things that would have led to a problem free birth.
Such as? Can you provide us with a single example of something done or omitted that would have “led to a problem free birth”? A SINGLE example, accompanied with a peer-reviewed publication indicating that doing or omitting said procedure increased the risk of complications in labor.
Just ONE.
see, that’s why i didn’t bother with that other reply. search yourself but i doubt you want to know, really.
Actually I really do. Not a single person that has parachuted in to this website claiming to know which interventions are needed has been able to provide us with a SINGLE evidence based example.
I was hoping you’d be the first.
Just ONE. You know which are needed and which are malpractice. Where did you get this knowledge? That’s all I’m asking for. You learned it somewhere. Share it here.
And here you are again being a lovely example of your kind of vicious nonsense. You know all this stuff, but are what-too superior to share? Or do you fear that it will be systematically pulled apart by people who have spent years training and seen more pregnant women and deliveries than you can imagine, which would force you to perhaps wonder about your beliefs?
Just one example-you could be a ground breaker-no one has managed to do it yet.
Much easier to sit in the echo chamber.
i haven’t the energy or will to reply to none to pleasant people who demand proof of things that can easily be found and that they want to rip apart because they don’t actually want to hear anything different to their opinion.
i certainly don’t respond well to demands in that tone.
But that is looking at the wrong end. Having a baby positioned OP or breech has nothing to do with what is done for prenatal care or during labor. Having gestational diabetes or preeclampsia is also not something you invoke, you either have it or you don’t. Some women will need Pitocin to dilate and others will never be able to dilate even with it. Interventions are there to help the end result-healthy baby and healthy mother-possible.
not things i’m talking .
I mentioned situations where women might have to be monitored and treated more and where labor and birth could have complications. What did you mean?
i mean situations where superfluous interventions as well as stress through rushing the birther creates the need for intervention.
There is no need to rush if there is no indication, but there are indicators that might seem like nothing to a layperson and mean very much to a medical professional who is caring for a pregnant or laboring woman.
Superfluous interventions are usually things like herbal remedies, because they do nothing yet they are being relied on to produce a result that doesn’t come, delaying real medical help.
Still asking – please provide us with ONE example of a “superfluous intervention” causing a negative outcome, with literature documentation.
Why is this so hard? You are parroting the same lines…but can’t seem to actually provide something substantial for us.
Guess we should just read more.
“i mean situations where superfluous interventions as well as stress through rushing the birther creates the need for intervention”.
Asking again: Please state SPECIFICALLY what you mean by this statement and provide clear examples to back it up.
I don’t understand. If you know they exist, *how* do you know? If it’s one of those “oh, everybody knows that” things that are just unquestioned in certain social circles (like ghosts, or homeopathy, or crocodiles in the sewer system) then where is “everybody” getting their information from?
If it’s supported by good data, then you can be assured that the people who’ve been studying the data for decades as if lives depend on it — because they do — know it too. Whatever it is.
If it’s supported by data, then the data exist and we can all look at it.
If the data do not exist even though “everybody knows” it, there’s no reason to believe that what “everybody knows” is factually true. Maybe “everybody” ismwrong.
i’m sure the data exists and you can look it up if you want. i’m not hiding it.
but between all of us we’re getting a nice comment count, are we not?
You are talking to professionals here. Doctors, obstetricians, anesthesiologists, NICU nurses, academic statisticians and nurse-midwives. They know the literature very well. They do not know the data you are referring to.
It might be interesting for you to go back and question your sources. They have told you X is true but how do they know? Do they really know? A lot of people believing and saying something untrue doesn’t make it any truer. If they do know, then they have a data source that the professionals here are unaware of and would like to know about. Saying “look it up” is unhelpful because they have looked it up, many times, and they haven’t found it.
how do you know who everybody is, is there a club?
it would explain why they might feel threatened though and wouldn’t want to know different.
There is no club. I’ve just been reading for a while. Dr Kitty, for instance, is a doctor.
They honestly don’t feel threatened. Professionals are constantly updating their knowledge based on new information. If you have access to information they don’t, they would be genuinely thrilled. Really.
It’s more likely that the data you have always assumed exist, don’t. That should make you think and question. But if the data is there, you can share it and they’ll be happy.
”Professionals are constantly updating their knowledge based on new information.’
not actually an impression i’ve got from most doctors. but doc kitty is a cute name.
how we’re doing for comment count?
Let’s see
I read the BMJ cover to cover weekly, RCGP Journal monthly, weekly educational meetings in practice, monthly education meetings out of practice, online and e-learning at least twice a month.
I have an annual appraisal in which I have to prove a minimum of 50 hrs of continuing professional development, with proof of how my practice has changed as a result of new knowledge.
Your impression is wrong.
But hey, you don’t seem to understand much about obstetrics or medicine generally, and believe ER is some sort of authoritative source on medico-legal issues, so I’m not exactly shocked.
That’s a reflection of your ignorance, nothing else.
Sabelmouse, why don’t you come and join us in the comments on today’s post?
Once your comments drop off the most recent comments bar, no one is going to want to search through 1000 comments on a year old post to talk to you.
Dr T really has a very open comments policy, we can talk about whatever you want, but maybe we can do it under today’s post and not by making an old comment thread even more unwieldy?
If you want to engage us and inform us, then that’s probably the best way to do it.
WHAT are you?
The same way when you go hang out at the local bar a lot you get to know the people there by what they say.
Just like we know a lot about you by what you say. For example, we know you are pretty ignorant of midwifery in the US because you don’t know basic facts about it.
And threatened? How can anybody be threatened? You haven’t actually said anything with any substance. Vague claims about unnecessary procedures don’t get far, when you are talking to people who are actually doctors.
On the whole, I think they are being very generous in giving you the opportunity to support your claim instead of calling you a clueless moron and laughing you off.
“calling you a clueless moron and laughing you off.” Well, not posting it at least. It would be nice if JUST ONCE, someone came here with the actual evidence that convinced them of their stance. Not “someone said” or posting a link to some nutty layperson’s website that has no data either and is shilling some herbs and woo. Actual data that made them believe that home birth, alternative medicine or whatever is safe and effective. Even posting a link to the MANA study would be enough for me. But not even that happens.
You are quite found of shifting the burden of proof I see. However, try as you might, the burden of proof is still on you. You know why? Because you are the one making claims and it is up to you to prove them. Telling other people to look up the information to prove you claims for you is just lazy. Stop being lazy.
Unless it is because we do “know different” and have seen plenty of women whose midwives dump them at the emergency room when their home birth starts going badly, after “not rushing” birth and wanting comfort instead of safety.
Like what?
So, let’s say a woman is laboring at home with her CPM. She’s been pushing for 6 hours and no progress is being made. She asks to go to the hospital. On arrival, the team finds the baby’s heart beat is dropping with each contraction. The Obstetrician examines her, (with full informed consent, of course!) and finds the babys’ head still high in the pelvis and the swelling on the baby’s head. What is your assessment of this situation and what are the needed interventions?
why are you asking me?i’m not a midwife and would hope that any midwife would have had this figured out.
that’s why i had competent, experienced midwives for my birth and to my joy in the netherlands they have their own full practices, full status [no bowing to docs] and do all pre and post natal work and if moving to hospital is needed they come with and continue there unless the birther wants someone else.
i was ecstatically happy with my 3 midwife practise , more so than with my experience in germany where i was forced to see a gyno for the pre natal checkups as midwives are only allowed to do homebirth with a doc on standby.
only 1 in the whole town was willing, nice enough guy but no bedside manner, no communication skills, and an obsession with machinery. so those visits were torture.
whereas in a’da they were actually a pleasure and nobody went inside my body until the very last day when my dd was 9 days overdue and the midwife twiddled my cervix [with my consent of course] to check and get things going. hospitalisation was thus avoided.
“i’m not a midwife and would hope that any midwife would have had this figured out. ”
You’d hope that would be the case, but sadly in the US midwives aren’t all held to the standards of those in the Netherlands and struggle with the basics of midwifery and caring for mothers and infants.
but why is that?
Good question. Free market? Libertarian tendencies? Caveat imperator?(sp?) More areas where people are 1 hour+ from a hospital? A relatively late start in real medicine?
Because the Midwives Alliance of North America and member midwives actively campaign AGAINST any and all restrictions to their practice. Any single admonition to test mothers for risk factors, risk out mothers, provide dedicated back-up, have malpractice insurance, report on case outcomes – ANYTHING. MANA has campaigned against it.
Prior to 2012 homebirth midwives in the United States were not even required to have a high school diploma. Still, there is not a single college level course that a midwife is required to take prior to attending births. In most places they can see a mere 25-50 births and then practice independently.
Which is why homebirth in the United States is 3-8 times more likely to result in a dead baby than is comparable risk hospital birth. Uneducated midwives.
strange!
Why are we asking you? Because you posted and stated that there are some procedures in labor that are needed and some that are created out of “malpractice”. We would simply like a little more information about that.
“, no communication skills”
Did you communicate with that doctor who had ” no communication skills ” in his mother tongue/first language or yours? If he was communicating in a foreign language, was his language training adequate for communicating professionally with native speakers of that language, or was he merely to a degree equipped to use it as common means of communicating with native speakers of other languages? Were you aware at the time when you made that assessment of his communication skills of any and all cultural differences between his culture and yours that will influence communication in such a way that your communication skills assessment criteria must be adjusted and localised?
Privilege ( even linguistic) skews perception.
read widely!
I do. But obviously you have found some information that I haven’t yet. Why do you want to withhold that information from me? Simply because you don’t like my tone I am not worthy of knowing?
You have read something I haven’t. Please provide documentation of your opinion. It really shouldn’t be that hard.
Dutch midwives are university trained, which is not the case with the midwives we talk about who attend the majority of US homebirths. Dutch midwives do have terrible stats though.
lol!
Why laugh? There is peer-reviewed evidence for this claim. Low risk out of hospital birth with a Dutch midwife is more likely to get you a dead baby than HIGH risk hospital birth with an OB.
“if it’s needed it’s ok unless of course the need has been created by malpractice in the first place.”
I’m asking you to back up your statements. Tell me what’s needed in the situation I described and what would be considered malpractice?
Silly me. Going to the doctor in a first world country for medical review, before you take your and your unborn baby’s life in your hands to satisfy an ideological urge is torture now? Any wonder you and the doctor couldn’t communicate-you speak woo, he or she would speak reason.
I thought torture was, you know, fingernails pulled out, hooding, all carried out on someone who is compelled to be where they are by people who wish them harm and want something out of them.
Obsessed by machines hey? Did you turn on the dishwasher and washing machine in the last month? Drive to appointments or a friend’s house? Thought so.
have you never met a doctor with bad bedside manner? not something you need when you’re pregnant the first time.
what silly things you say. what do washing machines [don’t have a dishwasher] to do with getting an ultrasound and being attached to a heartbeat monitor for an hour at a time for no reason.
and calling me vicious!?!
Is he or she an expert in their field? All I want to know. I have enough friends for now, I want an expert in a medical situation.
And why is your idea of appropriate technology the only standard?
For no reason you understand, sabelmouse, not for no reason. Remember about how you didn’t know about US midwives? There’s a whole world out there you don’t understand and you don’t seem to care. And when you push nonsense, in ignorance, that is vicious.
And of course YOU know in every single instance without being present at the birth or having a medical degree just exactly which intervention is “needed” and which is “malpractice”? Please, enlighten us. OBs everywhere want the knowledge you have.
I’ve seen this argument before, but it doesn’t makes sense to me. By this argument, beheading someone as an expression of power is rape. Robbery is about power, so robbery is also rape? A person makes an executive decision at work because they have the power to do so, and has raped the committee? By making the definition so vague to include everything, you’ve rendered it more or less meaningless.
Yes, the idea that rape is about power, not sex, is ridiculous. Rape is about power AND sex. The intersection of the two. Why there is a certain line of thinking that denies this baffles me. That it comes out of feminist philosophy is particularly disappointing. Is it supposed to be less stigmatizing or something for victims to be told that rape is basically no different than being mugged, or punched? That doesn’t seem comforting to me, it seems invalidating.
I have worked in the prison system. I have a friend who is a forensic psychologist who spends 80% of his time evaluating rapists. During medical school I was a co-facilitator of a men’s sex offender therapy group. Rapists would laugh at the idea that rape isn’t about sex. They will tell you straight up that they do it because they love violent, nonconsensual sex.
I generally say something like using sex to express power.
That distinguishes it from other expressions of power like those I mentioned above.
“I generally say something like using sex to express power.”
Which is a fine compromise, I suppose. And probably captures situations like rape as a war crime. But for serial rapists, I bet they would still laugh at that. All they know is that they find rape really stimulating sexually.
Rape is using sex as a weapon, regardless of the goal of the rapist (sexual gratification, terror, subjugation, etc).
Like stabbing/cutting is using a blade as a weapon. It doesn’t matter if the attacker’s goal is intimidation, robbery, or they just like seeing blood.
But I still see a big difference. A weapon is a tool used to attain a goal, whether that is self defense, or money in a robbery, or status in a dangerous neighborhood. The person using the knife is not typically* obsessed with knives and does not find the use of the knife supremely pleasurable. Robbers don’t fantasize about their crimes, or masturbate to memories of their crimes. The crime is not the point of the crime.
This is how rape is different. Raping is the point of rape. It’s its own thing. Serial rapists have a rape paraphilia. To tell them that their “real goal” is power, or that what they are doing is “really” like a robber using a knife, is nonsensical and naive. The belief that it is the same sort of thing as armed robbery, just with a different weapon, can lead to problems like believing that rapists can be rehabilitated by the same sort of therapy as robbers can.
*There are rare exceptions where criminals do find the use of the knife extremely pleasurable. These criminals have a murder paraphilia. It is no accident that many of these killers target women they find attractive and often (although not always) combine the killing with a rape, and masturbate to snuff porn.
Mixing sex with violence or even real (as opposed to playful) submission takes you to a dark place, and how that can be rehabbed is hard to imagine.
And this is another reason why being mindful about how we talk about rape is important, so as not to trivialise it.
Rape during wartime can be a military strategy.
http://en.wikipedia.org/wiki/Wartime_sexual_violence#Military_strategy
yep, see my comment above (reply to Bofa)
They say that on Law and Order and similar programmes.. ‘It’s about power not sex.’ It’s like it’s become conventional wisdom amongst people in the know but I find it highly questionable. Why can’t it be both? Surely rapists choose victims they find sexually appealing in most cases? Although I do remember there being an investigation when I lived in Denmark when a girl reported a stranger rape and many of the locals saying she must have made it up because the girl they thought had made the complaint was overweight so who would want to rape her.. which was of course ridiculous. So maybe it is meant to counter stupid opinions like that
I’m in two minds about this birth rape subject. Some obstetricians do get sexual gratification from brutalising their patients e.g. Clifford Ayling and the other doctor he was in cahoots with. makes sense if you’re in med school and have predatory tendencies that you would choose gynaecology or similar as your speciality.
The problem with this attitude is that it begs the question of what is “sexually appealing.”
“Sexually appealing” does not require traditional attractiveness, it involves an ability to have sex.
See for example prison rape. These guys aren’t homosexual, yet are raping other guys. Not because they are sexually appealing, but because of the appeal of sex.
The point is that women aren’t raped by nice men who get too turned on, they are raped by rapists. This is important because if it’s about ordinary men getting too turned on then women can prevent rape by not turning men on. You know, dressing modestly. A woman who dresses provocatively is bound to turn someone on too much and get herself raped.
And that’s an incredibly important point. But unfortunately I think the saying utterly fails in getting that point across, and instead leaves an impression that whoever says it is totally oblivious and naive about the motivations of rapists.
I struggle with the label here, which is why it is important to be mindful of how particular things are described.
It is possible to be a fine upstanding member of society who does the washing up when it’s your turn, and still think that women are or should be subject to your sexual whims. In this culture and time, that’s a rapist, in another it’s called a husband.
Or, perhaps a 20 year old misreading signs might do something his 30 year old self wouldn’t consider.
Or perhaps the nice girl is too young to consent and for whatever reason the nice guy doesn’t know it, and her parents aren’t happy.
The complication, as always, is at the edges.
It’s true, some cultures don’t have a concept of rape. (Read the bible and try to figure out which women and girls having sex with someone other than their husbands were willing and which were raped.) Women are the property of their fathers or husbands and if a husband loses control of his wife, either because she willingly steps out or because another man usurps him, he’s dishonoured.
That doesn’t mean that when men force themselves on unwilling women or girls that it’s because they were too sexy and the men were overcome with lust and couldn’t help themselves.
As you say, the clear issue is never the challenge.
In many places it is legally incomprehensible to suggest a man can rape his wife, regardless of the violence involved.
In others including mine, it is legally impossible for a girl of a particular age to consent to sex, regardless of how keen she is while participating.
It can be complicated, is all I’m saying.
i’m not bothering!
Flounce away then, rather than defend your argument like a rational individual. Why should we care what you think, if you can’t even defend your beliefs?
i’m not bothering because of your attitude.
Very well then. But still, why should anyone in the world pay attention to anything you say if you cannot defend your arguments? Only the “nice” people deserve the secret information about birth you have?
they don’t have to. i’m giving an opinion, i’m not trying to bully people.
On this forum arguing your point by citing examples from TV shows will only get you mocked, and that is not bullying, that is people who do make an effort to have a decent discussion getting frustrated with completely irrelevant nonsense . I understand that we have opposing views on safety of homebirth and medical assault during childbirth, and that we can probably agree on a very few points down the line, but I also appreciate how you agreed that lay midwives are also guilty of the behaviour that you define as “birth rape”. It’s a start, and I am sure that if you tried to remove personal bias from your argumentation that we could agree on a few more. You could read a couple of other post where you will find that most of the people who comment here as well as the author of the blog in agreement with you on truly important issues, like this one: http://www.skepticalob.com/2014/05/you-cannot-perform-a-c-section-on-a-woman-without-her-consent-period.html
what is the problem with mentioning that a tv show addressed the dilemma that medical staff face when a woman refuses treatment that they deem necessary for the foetus but that would violate her person?
my daughter and i recently watched ER and were amazed to see this addressed especially considering the present climate in the usa surrounding the issue of the rights of the foetus vs the rights of the ”vessel”!
i’m not familiar with lay midwives myself. over here in europe we have midwives who are fully trained professionals though their status, autonomy, and pay varies from country to country.
as for consent [ and that is of course part of what ER was addressing]; big reason to not be alone, to be informed , and have an advocate for your interests. it’s not easy to make those decisions in the throes of labour, let alone in a difficult labour.
one ought to be able to trust the medical professionals to work in the best interest of mother and child.
IT’s a TV show, it is a filtered fictional representation, it is not a valid source of anything other than entertainment and maybe a few lingering questions that if you wish to address answering properly you will need to consult real life things like studies, reports and competent professional opinions.
I live in the part of world which is often portrayed as a side plot in TV shows, and if your opinion on this part of the world and what goes on in it was based on or reinforced by what you picked up on TV shows well, you’d be in serious trouble with things like reality, common sense and objectivity. We laugh over here in despair at every new example that pops up, and unfortunately every TV show out there that runs longer than a single season in any genre seems to have an urge to “address” the dilemmas of my part of the world.
Now I’m curious- what part of the world do you live in?
Central / Eastern Europe.
what, you expect a medical drama not to address issues of ethics?
I don’t expect it to be raised as valid argument when discussing the actual issues of medicine and ethics – ” I saw it on TV” is ..well…it’s not a real argument. Really, it’s not.
who raised it as an argument and for what?
Seriously?
yes, seriously! an aside about a tv show addressing somthing is not raising an argument.
Quite so.
You are a lovely example of the reason it is so hard to take seriously the anti-medical viewpoint.
All sorts of people are asking you questions, trying to investigate your position. You ignore those, and either make a remark or aside, like your comment about ‘serving’, or create a your own-like your bit of ER trivia-to attempt avoid facing that what you actually want isn’t to have a discussion or challenge opinion in a forum, but to be agreed with and supported, even when your position is factually incorrect.
And then you back down and wobble, or go on the attack about attitude or tone or whatever, deny what you said means what you said, then flounce.
You are at the wrong party.
do you know what a conversation is or are you trapped in a nerdfighter ”we’re all trying to win a school debate” attitude?
Granted, the questions are all rhetorical because they know darn well you can’t and won’t answer them, but in terms of a conversation, you are the one who keeps saying “look it up.”
You make some vague statement, people ask, “Can you provide an example of what you mean?” and you duck, dodge and avoid it, all the time complaining about them asking you.
Now, if this were an actual conversation, you could say, “Yeah, like when this type of thing happens” and then go on to provide an example. Or, alternatively, when we are faced with the situation in real conversations, we could say, “Well, I don’t know of anything in particular, but I’ve heard other claims of such things, but I really don’t know if there is anything to it.”
Nothing wrong with it at all. You’re establishing common ground. You’re demonstrating that you are aware that the ethical dilemma is commonplace, well-understood and has long since been resolved in favour of the mother (except, apparently, in Ireland, as Savita can not testify). It’s not a big secret or something that each individual practitioner has to figure out for themselves at each individual disaster.
The reason folks are getting all frothy here is that many of them have faced this dilemma themselves. Women who have been taught by untrained american homebirth midwives to distrust obstetricians show up in the emergency ward with dead or dying fetuses, hemorrhaging dangerously or with severe tearing, wanting help but afraid of their helpers. The staff know that the disaster would have been completely preventable with appropriate medical care. They know that untrained us midwives are allowed to practice and lie to their patients about risks
They know that the woman in front of them has been lied to, has a distorted view of risk and may refuse interventions that could help her and her baby. They know that the only ethical thing they can do is honour the woman’s autononmy even if they believe she is acting based on false information. They do respect her autonomy. And it’s terrible to watch catastrophes unfold and to know there’s nothing they can do about it.
That’s what this blog is for. So that pregnant women will have better information, and so that they realize that no, the opinion of an untrained high school graduate is not just as valid as the opinion of someone who understands physiology and has delivered thousands of babies with colleagues always present to call them to account.
well, allowing untrained midwives to practise is very strange indeed. you mean doulas, right?
strange country you’ve got over there.
No. I don’t mean doulas.
In every other industrialized nation, midwives need professional training. In the US they do not.
The US is a very strange country indeed.
you have NO professionally trained midwives in the usa? not even in hospitals?
Midwives are regulated state by state. Some states require that anyone calls that calls themselves a “midwife” meets standards that would be close to equivalent to other midwives in 1st world countries. Some states, however, have no regulation about who calls themselves “midwife” and what they are permitted to do. Also, some states have legalized midwives who do not have sufficient training to call themselves “midwives” in 1st world countries–for example, you could call yourself “midwife” if you took an online class and observed homebirths under someone who was also trained outside of any formal schooling program.
They exist. They are called CNMs — Certified Nurse Midwives. They usually practice in hospitals and rarely attend homebirths.
The midwives who attend homebirths are usually CPMs — Certified Professional Midwives. They have extremely limited training.
again, weird!
Yep!
Something all the regulars here agree on.
and are they doing anything to change that? other than claim that hospital births are best and that netherlands has mountains of infants die?
why not work toward proper midwifery outside of hospital?
i sure can’t see any bias in any or you/se comments towards defending hospital birth at all costs.
The author of this site is working to have untrained, uninsured midwives not licensed to charge money to attend homebirths.
Hospital births are safest for both mother and baby. It’s up to mothers to decide how much that matters to them when evaluating what’s “best.”
Mothers can’t decide and choose meaningfully if they believe things that aren’t true. This site is about ensuring that mothers have access to accurate information.
The claim about the Netherlands’ perinatal death rate is based on data. Source is here:
http://www.ncbi.nlm.nih.gov/pubmed/19192585
Discussion is here:
http://www.skepticalob.com/2010/07/netherlands-homebirth-and-high.html
Yes, the regulars here are biased towards facts and reality. Aren’t you?
No, not weird, sabelmouse, different. You show your deep-seated prejudice and ignorance with that one word.
And that is the frame of reference that informs this discussion.
You believe you’re sharing an informed opinion. When people are ask you to defend your opinion they aren’t bullying you. If your opinion is truly informed, they will revise their opinions. If you discover your opinion isn’t as informed as you thought it was, you have an opportunity to revise yours.
Not all opinions are created equal. That’s why it’s beneficial to scrutinize them.
some are bullying. i know that type from other discussions.
I’m sure some are. You can respond to the ones who are honestly asking you to defend your opinion.
You might not be used to being asked that, but it’s not mean.
If by “bullying” you mean that they are pulling down your figurative pants and running your figurative undies up the flag pole for everyone to see, then I have to say, I kind of agree.
Of course, the way they did that was to call your bluff and let you expose yourself. So not so much that they pulled down your pants, but more that you did it for them.
There was a really disturbing trend on Facebook, not long ago, that if someone hijacked a thread conversation, they had “fraped” (a portmanteau of “Facebook” and “rape”) the people involved. People were THAT pissed off by having their conversation derailed that it was equivalent of rape.
I found that term very offensive, as did a lot of other Facebook users. Eventually, it fell out of favour.
Income tax = rape. Speeding tickets = rape. Me imposing bedtime on my primary school child = rape, obv. Do you think Patricia works with 5-year-olds?
I always assumed it means rape is about power, not sexual *pleasure*
You’ll struggle to find anyone here who would support a woman being forced into medical treatment against her will. Very occasionally women who meet a legal standard of incompetence will be directed to have treatment-perhaps a cs-because a court decides they are not capable of making a lucid decision.
Same as you can’t be forced to have your infected toenail off if you don’t want to, despite the fact that it might kill or disable you if left alone.
‘Rape’ comes into it because the action is happening around the sex organs, and one way to access the baby is through the vagina.
How would you describe the trauma felt by a medical team who are refused consent to save a baby? Is that a form of rape too, or does this party only happen in one direction?
The women I find most interesting are those who refuse all treatment until their own life is clearly in danger, and then take it, even after death of or serious injury to their baby.
the medical team is there to serve, that’s part of the job they took on.
So they stop being people once they agree to ‘serve’. Nice.
lol, where did i say that?
Who? asked:
“How would you describe the trauma felt by a medical team who are refused consent to save a baby? Is that a form of rape too, or does this party only happen in one direction?”
sabelmouse replied:
“the medical team is there to serve, that’s part of the job they took on.”
Right, so no pity for them at all that they have to assist in extracting a dead baby out of a mother that chose to homebirth. Suck it up buttercup! You chose to serve! No feelings for you!
as i’ve said, serve. there’s a couple of episodes of ER that deal with such things. they obvs still addressed that then.
besides, i didn’t say no feelings. but no right to dictate.
Oh, well, if it was on ER.
Providing recommendations, even strongly worded recommendations, based on medical evidence is not dictating. Telling a woman “if you do that, you increase the risk your baby will die. You need a C-section” is not “dictating” if it is the truth.
Doctors are supposed to just passively stand by and let their patients direct them? Why bother with all that medical training?
I guess they needn’t have wasted 12+ years on specialized medical training, since they shouldn’t be able to tell us what they know more about.
I’m *so* glad I don’t deal with medical professionals who take their cues from a TV drama.
what are you even talking about. if i mention that charlotte bronte mentions typhus in jane eyre does that mean i take medical advice from novelists?
i merely said that the ethics of a women having say about what is done to her body was brought up by ER and that it was quite amazing considering todays climate regarding these issues. do any of youse have any degree of reading comprehension or ability to reason?
On ER they have a 90% code survival rate. Should we take this to be reflective of real life?
Of course not.
So why should an ethics discussion on ER have any place in a real life ethic discussion?
This article, written about a doctor facing terminal cancer, says pretty much the same thing – that the low rate of code survival is why many of them, knowing about it, choose to have a DNR when faced with a terminal illness. http://www.nytimes.com/2013/11/20/your-money/how-doctors-die.html?pagewanted=all&_r=0
I am very honest with folks about this in the veterinary setting. We ask every client when a patient is admitted what their resus wishes are. Many ask “what would you do” and I’m honest – if a pet codes in my hospital they have <5% chance of surviving to discharge. I have NEVER had a client, after hearing that, elect resuscitation. Once folks really know the odds of survival, they aren't interested in asking me to beat on their poor dog for 15 minutes in futility.
A couple of weeks ago, we had to put my cat to sleep (old age-related health problems; she was 18). It was hell emotionally, but it was the right decision.
I was recently at the vet having a well dog checkup-well the dog was having one but he can’t push the button to cross at the lights so I take him-and there was a lady calling in to see her sick cat. The lady was about to travel to another city-2 hours by plane-and instructed the vet to call if the cat took a turn for the worse and to keep the cat going, by whatever means, until she could get back.
So sad for the lady and the cat, and really hard on the vet to I imagine.
And if it’s the same episode I saw a few weeks ago-my daughter and I have a bad ER habit around her exam times-the baby was born brain dead, abandoned by the surrogate whose baby it was not, and abandoned by the natural parents who had paid for a whole one. Lovely.
And since you’re quoting ER, what did you think of the episode where the boy died of measles? Propaganda?
Oh, and ‘youse’ is bad when you say it, it is outrageous when you write it. The plural of ‘you’ is ‘you’.
You’re welcome.
I remember that episode. IIRC, the woman refused a c section when her baby was in distress, and the baby was born profoundly brain damaged. Is that the example you’re holding up for us?
i’m not holding anything up. the fact that nobody on this thread can tell the difference is telling.
Just as you have no right to dictate to THEM. You have the right to refuse care, but YOU are RESPONSIBLE for the consequences of YOUR decision. If there is a bad outcome because of a choice YOU made, that is not the fault of medical professionals.. even the ones on TV!
”Just as you have no right to dictate to THEM. You have the right to refuse care, but YOU are RESPONSIBLE for the consequences of YOUR decision.”
OBVS!
They chose to work in a field that they knew would result in them coming in contact with death and tragedy.
No. They are not there to “serve.” They are there to provide medical care. It’s not Burger King.
And even if it were Burger King, they don’t even give customers what they want if they know that it is bad practice. For example, you can’t go to Burger King and order a raw hamburger. They won’t give it to you, because consuming raw meat is too much of a risk, and if they were to serve you such and you were to get sick, they would be responsible.
The short answer is that you are just completely wrong about this.
This is a useful analogy, because even someone there to serve-which medical providers aren’t-won’t do it if it creates an unreasonable risk to themselves.
Which is exactly why medical teams don’t knock women out and do cs on them against the woman’s wishes to save the baby: the getting struck off and insurance issues would just be too great. Though with the baby’s life at risk they are likely getting sued anyway as Mum, when she realises the gravity of her decision, will claim they didn’t explain well enough. Which is why keeping good contemporaneous records is crucial.
Medicine is not a job where the customer is always right.
If your lawyer, electrician, plumber, architect or accountant advised a course of action would you say “I understand that you have specialist knowledge, so I will defer to your judgement” or would you say ” I don’t want to do that, I want you to do it my way” and expect them to do what you demand against their better judgement and all their professional guidelines?
I’m betting you would understand that you take their suggestions or you’re on your own.
Your doctor cannot demand you follow their advice, but no, you don’t get to demand they treat you in a way which they feel to be antithetical to good practice.
You still can’t assault someone.
Maybe the customer isn’t always right, buy the customer always has legal rights that say short of a court order or being unconscious upon arrival they have the final say in what does and does not happen to their body.
Er, no. That’s your ill qualified, ill prepared homebirth midwife and her woo-ridden sidekicks.
Actual professionals have an obligation to tell the truth and act in the patient’s best interests.
as do qualified midwives. all my midwives were very well prepared, no side kicks. you seem to be stuck in that hierarchical medical system and can’t even imagine what something better looks like! google midwifery in the netherlands!
hey, you might even watch ” call the midwife”! that’s english though.
That would be the system which gives the Netherlands the third worst perinatal mortality rate in Europe- better only than France and Latvia?
http://www.bmj.com/content/337/bmj.a3118
great, an article i can’t read. i would dearly love to know how the sunk so low, not that the usa is not still worse.
Actually, the USA’s perinatal mortality is better than the Netherlands or Britain, although not as good as Sweden. The USA’s stillbirth figures are very very low. Look it up!
lol! there’s really nothing else to say an apparently you/se don’t have any proof other than an inaccessible article.
infant mortality isn’t just stillbirth,
Infant mortality is the wrong metric- you need to look at perinatal deaths.
This is perfectly accessible and very interesting reading, and again shows Dutch perinatal mortality as not that great. It is 233 pages long though.
https://premup.org/media/documents/european-perinatal-health-report_2010.pdf
You don’t see any irony at all that you say we should do our own research to check your claims, yet you apparently don’t want to do any research of your own (or pay to read good quality research) if we cite something?
You’re right, infant mortality isn’t just stillbirth.
If my 9 month old pulls the dresser down on her head and dies of the crush injury, that is “infant mortality”. What, pray tell, would dying that way have to do with whether she was born in a hospital or not? If I had an epidural or not?
Nothing at all. And educated people know that infant mortality is not a measure of birth safety. But you don’t. Despite “reading widely’.
Why is France so bad? I went to university there and, apart from their encouragement of homeopathy, I was impressed with the (non maternity) care I received. I’ve heard no complaints from friends who delivered there and I know they are very generous with epidurals. That was in Paris though.
Sablemouse is one of the most ignorant antivaxxers on the net. I would even bother to argue with it
Wow, you are so right about that..
You are an idiot! Of course a.medical team being refused consent to save a baby’s life is not rape! WTF kind of question is that?
I have deleted no posts. And just because I refer you to a website does not mean I subscribe to its philosophy. But I might delete my posts. They have been so distorted in your own little minds. Some of you people are really not nice. I pity any mother under the “care” of people who would use such foul language and sling names around as I have seen here. Really gives me an even more negative view of the medical field. You all hide behind pseudonyms so that you can be ugly anonymously. Icky, icky, icky. Ugly, ugly, ugly. Such a pity that anyone would treat anyone with such callousness.
Patricia Robinett, “I have deleted no posts. And just because I refer you to a website does not mean I subscribe to its philosophy. But I might delete my posts. They have been so distorted in your own little minds. Some of you people are really not nice. I pity any mother under the “care” of people who would use such foul language and sling names around as I have seen here. Really gives me an even more negative view of the medical field. You all hide behind pseudonyms so that you can be ugly anonymously. Icky, icky, icky. Ugly, ugly, ugly. Such a pity that anyone would treat anyone with such callousness.”
Delete away. In addition to my copy and paste, I have a screen shot.
You claim to defend women who have been bullied, yet much of the content you have posted over the past few days could qualify as bullying ME.
But since I have pointed out some of your errors, you are no longer interested enough in me to find out why we disagree.
Oh, and if you’re going to call out others for namecalling, don’t continue your comment by doing the same.
You? I would not call you a name. I don’t stoop to that kind of talk. Even when I talk to my friends about the most dastardly of dastards… I call them “naughty”.
I can’t tell that you have a name. Surely you are not really a “box of salt”. Let me know who you are and I will be happy to engage you in a real conversation so you don’t have to continue to speculate, theorize and gossip about me.
In general, I suspect that most of you here are very nice in person… but on the web you feel that you can anonymously “let ‘er rip” at anyone who voices concern over medical industry practices and ethics. Your energies would be better spent if you were to direct them at cleaning up the industry. I was appalled by Amy’s ugly rant against mothers… You could start there by encouraging her to be kinder, gentler and more fair… but then I guess she wouldn’t have such a “busy” discussion group. I have begun to wonder if she might not be paid by ACOG to put down natural birth and other issues.
She would have to hide her head, since she had natural births with a couple of her kids. Anyway, screen names ARE names. This is a real discussion forum and don’t flatter yourself, we aren’t fascinated with or gossiping about you. You just keep putting it out there and get responses. You must know how to stop that. Don’t worry, despite your hilariously uninformed opinions, we aren’t going to talk about you when you leave.
Patricia Robinett, ” Surely you are not really a “box of salt”. ”
“Salt.” Salt is an ionic compound. Most often when folks use the word “salt” they refer to sodium chloride, but it’s actually a generic term for ionic compound. Look it up. Sometimes, “salt” is included in colloquial expressions, such as “I’ll take that with a grain of salt” or “pouring salt into the wound.”
My salt is iodized, for my thyroid. Plus I like the color purple.
I am sold by Morton’s, and I have a really great umbrella.
“Your energies would be better spent if you were to direct them at cleaning up the industry” What industry? The salt industry? Chemistry in general?
Can I call you Patsy?
No?
Because you, Madam, attempted to bully me by messing with my “name” after I questioned you directly, and you’re still bullying now.
No, Patricia Robinett, the bullying is not just the the namecalling you think you didn’t do.
It’s your total lack of empathy for anyone whose experiences don’t align with your worldview.
Hold on a second-‘kinder, gentler and more fair’ to whom? What mothers-other than those who try to either pretend the death of or damage to their baby was unavoidable-is Dr T unkind to? Loss mothers come here and are horrified when they learn the cause of their terrible loss was entirely avoidable had they taken medical advice.
And then we have the conspiracy balloon put up. Only the impure of heart could disagree with you, hey Patricia? And what do you and your angry heart charge for calming/woo nutrition etc classes these days?
i would not be surprised. the web is full of shills.
I’m glad Dr. Amy isn’t “kinder, gentler and more fair”. Completely changed my mind on the homebirth issue.
Delete away! I’ve got screen shots.
This is something I lecture my students on frequently. Here is what I tell them. Every time you cite a source you are consigning your name to the source. You are telling your reader “I consider this good information.” You cited an anti-semitic website as a source. This leads the reader to one of two conclusions.
First of which is that you lazily google searched for information that will support your point of view and picked the first result without even looking it over. If this is the case, you should offer a mea culpa and explain what happened.
Second case would be that you are an anti-Semite. I’d like to clarify that calling you an anti-Semite in this case is not “bullying.” It is calling a spade a spade. You co-signed your name to a disgustingly anti-Semetic source. What did you expect people to think?
Speaking of names, your preoccupation with people using there real names is a defense mechanism that you use to deflect criticism. The thoughts and ideas are what matter not where they are coming from. I use different pseudonyms for different sites because I value my privacy and I know how easy it is to locate troubling things like where I live and who my employer is based sole on my names. People have had cranks call there employers in order to get them in trouble at work because they hurt these cranks precious fee fees. I
Sorry my iPad decided that I was no longer allowed to type or edit that comment. My last sentence was going to be ” I would like to avoid that if possible.”
I just want to put this up top so that everyone knows what we’re dealing with here with Patricia Robinett:
She has deleted the comment, but I got it sent to my email notifications. In response to her stating that ALL the wars of the past 2 1/2 centuries were caused by “circumcising cultures,” I asked her how they were responsible for WWII. This is what she replied:
“Well, you might be sorry you asked… http://guardian.150m.com/jews/…”
This is the site- warning, you may need to shower after you go there…
http://guardian.150m.com
It has such charming articles such as: “The Genocidal Gods of the Jews,” and “Jewish Terrorism,” “Some Zionist/Jewish Fairy Tales,” and “The Psychopathic Israeli’s Strategy for Conquest of the Middle East.”
It’s also full of 9/11 conspiracy crap.
Oh, let’s not forget about it’s best article of all…”A Quick Proof that the Holocaust Story is A Lie.”
So, that’s what we’re dealing with, folks. Beneath her guise of just wanting to help and protect women, we have a rabid anti-Semite who is a Holocaust denialist.
I think Patricia’s anti-semitism comes from her intactivism, not the other way around, but she still got to a really creepy place in the end.
I’m mostly just sad for her that she doesn’t have the insight to know she needs help, and as her entire belief system pretty much ensures she will never get it, she’s going to keep peddling her crazy crap to any sucker willing to buy it.
You know the old saying.. “there’s a sucker born every minute”.. and Patricia’s income depends on it!
Samantha06 “and Patricia’s income depends on it!”
But ever since yugaya and I pointed out that she has a business and a book for sale she’s been insisting she’s retired.
She’s also antivaccine. Crank magnetism at its finest.
(Although I’m not sure about her stance on global warming, and I’m going to guess she’s not actually into creationism because it’s Judeo-Christian.)
Very amusing. All of you. LOL… sorry, but you are just too amusing. I can’t help but laugh. I guess this is why I used to think poorly of women.
Patricia,
You link to a disgusting antisemitic website which posts holocaust denying rubbish as a response to a specific question about how you think circumcision led to WW2.
You then feign shock and outrage that we think you’re an antisemite and a holocaust denier.
Those letters my great uncle wrote while interned in a camp and which he managed to have smuggled out to his wife are obviously fake.
Presumably his death in Auschwitz was faked too.
And hey, even if it wasn’t, he probably deserved it, because he was a doctor, right?
If that website isn’t an accurate representation of your view of why WW2 started, do feel free to post, in your own words, exactly what you believe, so there can be absolutely no misunderstanding.
…sadly, I think we’ve all understood her just fine.
You used to think poorly of women…until you realised they could help make you rich. Now you regard them as so many geese laying golden eggs …. sorry, I mean victims of ob$tetrical abu$e.
You seem to still think pretty poorly of women Patricia.
Actually, creationism is very specific to a subset of English-speaking Protestants. It’s pretty well established in both the Jewish and Catholic traditions that Genesis 1 is written from a divine perspective and cannot be taken literally.
SporkParade: agreed.
The world is warmer because circumcising cultures are the greatest polluters, of course.
Dr Kitty, why do you always have to choose the most generous explanation?! It’s almost as if, despite being a shill for the medico – pharmaceutical machine, you possess compassion and an open mind… most bizarre.
The end justifies the means – strip away her/their holier than thou human rights advocate rhetoric, and what is left is a nasty pile of machiavellian narcissism.
We should have known there was something amiss when she was suggesting the documentary made by the dolphin birth woman.
I have to say that few posters that are in here trolling over the past few days have given me the creeps as much as these ones.
Name calling is a logical fallacy.
Amy Goodman interview with Former Israeli Minister Shulamit Aloni;
http://youtu.be/Nex-oSKPX2w
I was actually still able to find the comment. The contents are just as you described, though.
Oh, good. I’m glad she left it up for all to see.
I’m Jewish, and I feel really sick after reading that.
I’m not Jewish, and I also feel really sick after reading that.
I’m a damned atheist and I feel physically ill after reading just the first page.
To all, even those outside the USA:
Happy Thanksgiving!
Feed your loved ones, not the trolls.
Thank you!
Happy Thanksgiving to you too and to everyone!
And what if your loved ones are trolls???
Hey-I have a concern troll and tone troll coming to dinner tomorrow night (family so I guess they have to be fed)
Bombshellrisa, in your shoes I’d try to put more emphasis on food than thought.
Bomb, how did the troll night go? Did you feed them to – what passes for a troll’s heart anyway? – s satisfaction? How is your BP?
I should preface this saying these trolls earned their titles for their concern over me getting vaccinated while pregnant (flu and whooping cough). They prefer to use prebiotics, “nature’s flu shot” (I have discussed this here before and shared the recipe) and eat organic food. Tone troll earned her title because I was obviously using the wrong tone with her. Turns out both got the flu and couldn’t make it. It was an awesome night-my ten month old and his two year old cousin played together while dd and grandma danced to hits we have on vinyl. Dad and I cooked and my friends helped me clean as I went so I didn’t have a messy kitchen. Loved it.
Ah, so nice to hear it.
Helping clean sounds so familiar… Last week, I was to my hometown and went to celebrate the 1st birthday of a friend’s little troublemaker. It was quite the party and as she was putting him to sleep, we started cleaning the kitchen, so it wouldn’t fall to her to do it. At the end, it was just I and her mother in-law left when she entered and ordered us to stop. When we didn’t want to, she declared that it was not MY job to clean her kitchen but sit down and talk to her since we saw each other just a few times a year. MIL soon gave up as well and in a burst of genius and goodwill decided that she could just go home and let us talk for half an hour or so. We really thought it would only be half an hour. Instead, it ended up a bottle of wine later. Sooo pleased.
That sounds so nice. Time flies when there is something nice to sip and a good friend to talk to!
Thanksgiving is a really special time for my family-we don’t do traditional turkey, we do German, Austrian and Slovenian foods since my dad is Slovenian (or Austrian depending on where the border was then). Ten month old tried everything and loved it. Dad and I go to the German market to get supplies earlier in the week and cook for two days.
Invest in good mousse and spray in color, and make sure their hair stands up straight!
Smile and nod a lot. No one agrees all the time.
Mousse as in hair product. Not chocolate, and definitely not salmon.
May your true thoughts about your loved ones not come out of your mouth at the dinner table.
What does Patricia Robinett mean by “the Rockefeller medical system?”
Some kind of paranoid fantasy about doctors-I think since the 19th century-jumping on the capitalist bandwagon so they can ply their evil (former) trade as professionals as part of the maintenance of the capitalist system. Science seems to be a key ‘cover’ for this process. I googled it, made my brain hurt so I stopped looking.
I don’t want to link as there is a book and I don’t want it to jump up the rankings because all Dr T’s readers go in for a look.
All the time and energy that goes into identifying conspiracies is such a waste-if only it could be harnessed for good.
I’m not sure. Maybe it means based on ability to pay???
Possibly she thinks it means 50’s style, or just harsh, as in Rockefeller drug laws?
http://youtu.be/X6J_7PvWoMw
I’m not updating my Adobe Flash for someone who recommends two hour granola documentaries as often as Patricia.
I googled “Rockefeller Medical System” so that you don’t have to. The first hit is whale.to.
It is possible that the Holocaust deniers so vile that MDC (*MDC*!) banned links to their site have stumbled by accident on some kind of valid thesis or reasonable argument, but that’s not how the smart money bets.
It’s part of a conspiracy. Rockefeller, Rothschilds and Bill Gates are all out to poison and sicken the common man. Jews are usually involved in some way.
Conspiracy Theory 101.
I love people like Patricia. They make their “side” (the anti-vax, alt-med side) look like the batshit-crazy people they truly are.
I guess prostate exams must be “prostate rape”, too, eh? And rectal exams. Oh, and bulb syringes to suck mucus from baby’s nose and mouth. (Obviously I think “birth rape” is ridiculous – I just wanted to say so to make sure nobody gets the wrong idea. Sarcasm can be hard to detect when all you are seeing is words typed on a screen.)
Women who are violated, who feel violated, during birth can – as far as I am concerned – use the term “birth rape”. There are different kinds of rape and they can each one have a defining prefix. Or… call it medical assault and battery. Either one seems to be appropriate to me. Doctors who are accused of being overly intrusive and rough might want to learn manners and communication skills.
Here’s the thing though – Yes, I felt violated during labor, but I didn’t feel violated because of things that other people did. I felt violated because I was in extremis, physically and mentally. I pushed for five and a half hours, and by the end, the combination of pain, exhaustion and the fever I was running massively skewed my perceptions of the people around me. When the OB held my son up and told me I had a beautiful baby boy, I mistook his umbilical cord for his legs, concluded I had given birth to a horribly deformed child, and believed that I was in the Twilight Zone, surrounded by a conspiracy of liars who meant to hurt me. Seeing the clamp on the umbilical cord helped me snap reality back into perspective, and reinterpret many things that had been making me angry. For example, the nurses said “one more push,” not because they meant ONLY one more and they were skanking liars bent on torture, but because they were using English in the way people do when they aren’t temporarily incapable of all but the most rigidly literal thinking. And then, while I was hemorrhaging, I felt panicky about the room and what the medical staff was doing to me, not because there was anything actually wrong, but because blood loss makes people feel panicky.
I don’t mean to justify everything that every doctor has ever done – I’ve certainly run across cases where I feel that doctors should be censured and booted out of the profession – but “the patient felt violated” can’t be the final word on whether or not an action was appropriate for a doctor to take, because labor, illness and pain can distort both perception and comprehension.
When I was in hospital a couple of months ago my nostril was raped by a nasogastric tube – it was horrible. It was a prolonged assault, lasting nearly 48 hours. And my veins were repeatedly violated when healthcare assistants tried to cannulate me. Their efforts left me black and blue. I wonder if I need Patty’s services to help cure the trauma I endured? I was also given deep sedation by an evil anaesthetist; perhaps Trish can help me recover the memory of whatever atrocities the surgical team subjected me to?
LOL
I think if someone feels they have been in some way raped it is equally valid to someone who the law or other governing body deems to have actually been raped. The meaning of words changes all the time. And it seems ridiculous to me to say that how the woman feels doesn’t matter. I’m sure not all of these instances happen in moments of dire need and could be the work of overzealous or compassion deficient docs.
“Rape” is a crime with a specific legal meaning.
Therefore yes, it does matter if you use that word to describe something that is not rape.
A woman could feel violated or assaulted, but if she was not raped, then she wasn’t raped. No one dismisses her feelings,.
Just like we say that people can feel that they have been robbed, but we know that unless they have actually been robbed, then they don’t say “I have been robbed” and expect their feelings to turn something unpleasant but legal into a crime.
FOR IMMEDIATE RELEASE
Friday, January 6, 2012
Attorney General Eric Holder Announces Revisions to the Uniform Crime Report’s Definition of Rape
Attorney General Eric Holder today announced revisions to the Uniform Crime Report’s (UCR) definition of rape, which will lead to a more comprehensive statistical reporting of rape nationwide. The new definition is more inclusive, better reflects state criminal codes and focuses on the various forms of sexual penetration understood to be rape. The new definition of rape is: “The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.” The definition is used by the FBI to collect information from local law enforcement agencies about reported rapes.
This was already hashed out with your cohort- Ms AgainstMedicalRape..
It needed to be said, even if twice. The author of this article provided a definition that was absurdly exclusionary (excluding men and children as possible rape victims). The definition she provides for her own argument is outdated, narrow-minded, and irrelevant, as is the rest of the article that surrounds it.
No, no, no.
It makes everything meaningless if you can call something whatever you want, because it makes you feel validated. Of course feelings matter, but they don’t tell the whole story and you can’t bend the world to your will in that way.
Madam, intent IS the problem in medical abuse as well as street assault. The intent behind rape is power-over and disrespect. Your article exemplifies the narcissistic medical personnel attitude that is finally coming to light, thanks to some very courageous women who have found their voice.
It appears that the medical attitude in this situation – as well as others – is: “I am the power and you should neither have nor voice an opinion in opposition to mine. I am the authority. You should bow to authority. Shut your mouth and bow to me! I am a doctor! I am smarter than you are! You can teach me nothing, for I know everything. I know more than you do about how you perceive my treatment of you.”
In both your article and your responses to comments, you are trying to justify the rude, crude, disrespectful, deceitful, angry, vicious, malicious treatment of women – and children – in the most tender time of their lives. The depiction of medical treatment as rape is not the problem. Your attitude IS the problem. And I am not trying to say that it is yours alone, for if it was, only your clients would be complaining, but it is a systemwide problem. And the prevailing obstetric attitude and practices are a HUGE problem for parents and children.
Birth is supposed to be a joyous time. Birth is not supposed to be on a timetable. Birth is not supposed to be in a hospital under bright lights with dozens of strangers’ eyes peering at a woman who is strapped down to a table, attached to IV lines, with her legs wide open and vulnerable to intrusive procedures. Birth is not a disease. Birth is not a medical procedure, to be quite frank.
Birth is supposed to be a private, peaceful time when a woman can feel more pleasure than she has ever felt in her life – after all, doesn’t the baby come through the same tissue as the penis that impregnated her… only isn’t it much larger and in motion? Nature seems to agree that both mother and child should have a pleasant journey, complete with their own personal doses of oxytocin – not manmade Pitocin, but nature’s own oxytocin.
If a woman was not frightened to death by the fear of the doctors, nurses, society… she would simply lie down in a soft, warm, comfortable, probably dark place, and let her baby wiggle out of the birth canal and up to her breasts and they would lie undisturbed until both were ready to carry on.
Are all the bells and whistles really necessary? Are our great doctors and magical hospitals with horizontal birthing tables, birth drugs and implements, premature cord clamping and cutting, yanking out of the placenta, high c-section rates – and also circumcisions – a few of the reasons why the US has such a high rate of maternal and infant deaths? Might we have gotten it all wrong?
Amy Tuteur, someone who was part of the solution would say, “I am SO sorry you were treated like that by one of my own fellow MDs.” And then you would do something to end this type of abuse, not defend it and rationalize it away. Face it, the medical profession is abusive to its own med students and then they pass on the abuse to patients; I have heard this complaint from several MDs. Have you ever heard of Operation Paperclip? Hundreds of Nazi doctors and scientists were imported into the US after WWII. They taught at med schools. And they did NOT teach kindness, gentleness and compassion. They taught callous disregard for the patient… much as they practiced in the concentration camps. Be part of the solution, Amy. We need you to have a “Scrooge moment” and turn around and do just that – become an advocate for mothers and children. Thanking you in advance.
How would you know the intent of obstetricians? How many have you interviewed in depth on the subject? I’m going to go out on a limb here and guess: zero! You just make it up as you go along.
Nazis? You sound like a fool.
“And we do not determine whether a crime has occurred by referencing the
feelings of the victim. The feelings of the victim matter not at all;
what matters are the “feelings” of the perpetrator. We a name for the
perpetrator’s feelings: intent.”
Could you kindly enlighten us on how we can empirically measure the perpetrator’s feelings, whether it is medical rape or traditional rape, seeing as this is the basis for defining rape, as per your own argument?
How can we prove that OBGYNs do not have an “intention” to enter the field because it allows them access to sexual power over women?
That is seriously sick thinking, considering that most OBs are women. I guess we should question the motives of female urologists too.