Midwives and lactation professionals, stop abusing women and calling it empowerment


Imagine a gynecologist who performed hysterectomies on every women done with childbearing — whether women wanted them or not.

Regardless of the women’s complaint (be it vaginitis, sexually transmitted disease, fibroids, heavy menstrual bleeding or pelvic pain), he always recommended hysterectomy. If the woman involved opted for something else, a D&C for example, he would perform a hysterectomy anyway when she was under anesthesia.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Empowerment comes from giving a patient what SHE seeks, not what WE seek and certainly not what we think she OUGHT to seek.[/pullquote]

Now imagine that when called on it he claimed that he was entirely justified because he had empowered them.

They would not longer have fibroids, heavy periods or pelvic pain. As for the women who had vaginitis or sexually transmitted diseases, he had empowered them by making sure they would never get cervical or endometrial cancer.

I doubt any among us would fall for such self-justifying, self-aggrandizing nonsense.

We would recognize that empowerment, to the extent it can come from any medical provider, comes from giving the patient what SHE seeks, not what WE seek and certainly not what we think she OUGHT to seek. That’s not empowerment; that’s a violation of medical ethics.

So why do we let midwives and lactation professionals offer the same self-justifying, self-aggrandizing excuse for ignoring what patients want? Midwives claim that they are “empowering” women with campaigns to pressure women into unmedicated vaginal births, whether they want them or not. Lactation professionals insist they are “empowering” women by pressuring them to breastfeed, whether they want to or not.

Consider this self-serving, toxic nonsense offered by Rachel Reed, Midwife Thinking, approvingly quoting a student midwife:

As student midwives, we begin bright eyed and bushy tailed, with a passion for natural birth, for normal birth. We believe in the innate abilities of women, the knowing that she knows her body, her baby. That the woman is the expert and we trust in the seeming simplicity of this. Our university education aims to facilitate this passion, underpinned with feminist theory, enabling critical thinking, the use of evidence and the ability to learn how to apply clinical skill with heart and soul. Then, at some point, the on-the-ground practice begins. We set foot into the hospital. Here we fall into the deep chasm between theory and practice and experience the raw and visceral realities of the midwifery culture which exists at present. Where we thought we would be supporting women and the spectacular physiology of birth, we find the technocratic perspectives in full force. At every turn, in every space, be it antenatal, birth suite or postnatal, we view women being actively disempowered, intervened with and unsupported. Every damn day.

Not a single word about what women want, only what midwives believe women SHOULD want.

What if a woman DOESN’T want an unmedicated vaginal birth? She should be forced to have one anyway so she can be “empowered.”

But a woman is no more empowered by being denied an epidural or C-section than she is by being forced to have a hysterectomy she does not want.

Or this self-justifying nonsense from lactation professional Amy Brown:

Breastfeeding is not simply a logical choice based on some health benefit, but an urge, an instinct. And breastfeeding is useful to women, not just as a milk delivery system but as a convenience and means of mothering. Just as we quite enjoy having a sense of smell, women can enjoy breastfeeding. They can feel empowered, healed and calmed by it. And wanting that – expecting that – is fine.

But what about NOT wanting that, NOT enjoying it, NOT being able to breastfeed?

Formula milk can be life saving and some women may feel it works best for their family, but for others it can never replace the experience they hoped to have as a mother. They don’t want to simply give a bottle instead. Complications and stopping breastfeeding before a woman is ready can be a huge strain on maternal mental health. Women will grieve their loss – and should be allowed to.

She’s obviously disempowered and should be pressured to be empowered by breastfeeding so she won’t “grieve the loss.”

But a woman is no more empowered by being forced to breastfeed than by being forced to have a hysterectomy she does not want.

Who is being empowered in these situations? The professionals who insist that their skills offer empowerment.

Only gynecologists are empowered (and enriched) by forcing hysterectomies on women.

Only midwives are empowered (and improve their employment prospects) by withholding epidurals and demonizing C-sections.

Only lactation professionals are empowered (and enriched) by pressuring women to breastfeed.

A gynecologist who forces a woman into a hysterectomy is abusing her.

A midwife who forces a woman into an unmedicated vaginal birth is abusing her.

A lactation professional who forces a woman to breastfeed is abusing her.

No amount of empowerment blather changes these ugly realities.

Her baby, her body, HER choices and — regardless of who is or is not being empowered — nobody else’s business.

15 Responses to “Midwives and lactation professionals, stop abusing women and calling it empowerment”

  1. mabelcruet
    April 12, 2019 at 8:14 pm #


    There’s currently an ongoing investigation into Telford and Shrewsbury maternity unit, looking into the deaths of mothers and babies (initially the review was looking into 23 cases, but that’s been expanded into looking at 215 cases. The first misconduct investigations have been concluded, I’m sure there are likely to be more. It’s interesting that one of the charges was deliberately falsifying records. I’ve seen this happen a couple of times-once was when a junior doctor was asked to review a labouring woman, and they contacted the senior doctor asking them to come and see the patient. The midwife thought this wasn’t necessary and phoned the senior doctor to tell them they weren’t needed after all: after a very bad outcome, the notes were modified to suggest that the junior hadn’t paged the senior-pretty stupid thing to do given that both the junior and senior doctors recollected the conversations and gave a consistent account.

    The second incident involved a baby that was stillborn and coming to me for an autopsy. On the consent form, the mother had asked that the hospital arranged cremation on her behalf, and that the ashes could be scattered. A few weeks later the mother got in touch asking when she could collect her baby for a burial. The consent form was absolutely clear-no ambiguity. She complained that we had disposed of her baby without consent (despite the consent form stating hospital cremation). So there was an adverse incident investigation-mum had changed her mind about the disposal, and she’d phoned the ward to ask them to change the forms. The midwife was adamant that she had phoned the mortuary and told them, claiming she’d phoned and spoken to one of the mortuary staff. However, she claimed she’d phoned at 6pm and spoke to a male technician-the mortuary closed at 5pm and there would have been no one there to speak to, the phone went straight to answerphone. Also, all calls to the mortuary were logged and recorded automatically, and there was no evidence that any call had been made at the time she said she made it. Her supervisor said, and I quote ‘She’s a christian, she wouldn’t lie about that’. So despite all the evidence, nothing came of it.

    • rational thinker
      April 13, 2019 at 5:19 am #

      OMG shes a christian and that was the end of it that is fucking horrible.

      • mabelcruet
        April 14, 2019 at 7:41 am #

        In the end the hospital paid for a bench with a plaque on it in remembrance of her baby at the Gardens where we scattered the ashes, but without admitting liability. In the UK we don’t have punitive damages, financial compensation for medical negligence is paid out depending on your financial worth (so if an adult dies, their potential future income is calculated as part of any settlement if there is negligence causing their death) or how much your future care will cost (for children with cerebral palsy resulting for birth injury etc). It sounds absolutely awful, but a miscarried fetus or stillbirth is worth nothing in the financial sense-any financial settlement will be based on the impact it has on the parents, particularly whether they have loss of earnings through being unable to work because of psychological injury.

        But I think with this mum, she wanted an apology and an acknowledgement that things had gone badly wrong. In the incident report one of the investigators had stated that the mother had contributed towards the issue by not phoning the mortuary directly herself, and by not writing a follow-up letter reiterating her change of decision. I think that upset the mum even more-she didn’t know who to phone, and phoning the ward where she’d delivered was the most obvious place to start. The absolute tone-deafness of the report didn’t surprise me-this particular hospital was plagued with incompetent and useless petty-minded, bullying managers who were moved from department to department after recurrent screw-ups, rather than being dealt with.

  2. NoLongerCrunching
    April 12, 2019 at 2:06 pm #

    It’s so ironic to say “the mother is the expert,” and then advocating denying women the choice of how to give birth and feed.

  3. Anna
    April 12, 2019 at 9:28 am #

    Oooh, I’d love to know who wrote that piece of crap. I can think of a few that think like that. The “the woman is the expert” stuff is pure Rachel Reed. I hope that student decides to leave midwifery because its too awful working with those terrible women that dont have “normal” births. Can you imagine the damage Reed’s acolytes will be doing to women who need or want medicalised births? I dont even want to think what methods they might employ to “empower” women to ignore obstetricians and avoid interventions.

  4. mabelcruet
    April 11, 2019 at 3:18 pm #

    Look up the case of Michael Neary. He was an Irish gynaecologist who undertook hundreds of unnecessary cesarean hysterectomies in the 70s, 80s and early 90s, removing uteri that were perfectly healthy. He seemed to have done it as a form of birth control, but many of the women were young and hadn’t completed their family, plus they didn’t need a hysterectomy in the first place. He apparently had an attitude that he knew what was best for these women, and in Ireland at the time, termination of pregnancy was illegal, so instead he controlled their fertility. He was struck off the medical register eventually, but his behaviour seemed to have been an open secret in the hospital that no one was willing to deal with. It’s a very difficult report to read. I hope these days there would be appropriate action taken far quicker.

    • rational thinker
      April 11, 2019 at 5:56 pm #

      .The Irish thing does not surprise me are you familiar with the Magdaline laundries.

      • mabelcruet
        April 12, 2019 at 5:22 pm #

        Yes-there is a huge issue here with historic religious abuse of vulnerable children and women. The state-sanctioned abuse of children by religious houses has affected many generations, and still is. Because there is currently no government in Northern Ireland, there is nothing being done-there are a group of elderly people who were due to receive compensation but it isn’t being disbursed. Not that the money will compensate for the abuse, but many are elderly and infirm and it would help towards their future care and comfort. It’s immoral and inhumane-they got raped and abused by the church, and now the government is compounding that.


        • rational thinker
          April 12, 2019 at 6:18 pm #

          Anytime I watch or read something about it I turn into a crying mess I feel so much for those women and children. Do you know if that doctor was catholic or was the hospital catholic? Cause that would explain his horrid behavior a little.

          • mabelcruet
            April 12, 2019 at 8:18 pm #

            The hospital where this happened is called ‘Our Lady of Lourdes’ hospital so I think its a safe bet that it was a catholic hospital. I don’t know about the OBGYN though

        • rational thinker
          April 12, 2019 at 6:24 pm #

          Has anyone tried suing the Vatican directly?

          • mabelcruet
            April 13, 2019 at 6:57 am #

            There’s reports online that people have attempted to sue the Vatican directly (a law firm called Jeff Anderson and Associates in USA has tried multiple times but never been successful). There was a ruling made that the Pope had immunity from prosecution as a head of state.

            The pope came to visit Ireland last year, and there was a fair bit of criticism of him. He apologised for the long history of clergy abuse and for how long it had continued, but he offered nothing else-no explanation of what would happen to survivors, no explanation about how the abusers would be dealt with, or what plans he had to prevent this happening in the future. We’re always going to have actual or potential pedophiles and rapists around, but he offered nothing about how he or the church would screen for them and prevent them entering the ministry, or what systems he would put in place to ensure future victims would be cared for and abusers punished.

          • rational thinker
            April 13, 2019 at 1:42 pm #

            The worst of all of it in my personal opinion was all the babies that were stolen from their young mothers after they were imprisoned by the nuns and used for slave labor.

  5. The Bofa on the Sofa
    April 11, 2019 at 12:34 pm #

    But a woman is no more empowered by being denied an epidural or C-section than she is by being forced to have a hysterectomy she does not want.

    Empowerment is manifested in the ability to make choices, not in the choices that are made.

  6. Cartman36
    April 11, 2019 at 11:13 am #

    Dr. Amy, say it again for those in the back. “Her baby, her body, HER choices and — regardless of who is or is not being empowered — nobody else’s business.”

    Thank you!

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