Denying women epidurals is “midwifery violence”


Another day, another scandal in UK midwifery care. This time it’s not dead babies and dead mothers, all though there are far too many of those. This time it’s the sadistic behavior of midwives.

According to The Telegraph:

Women in labour are being denied epidurals by NHS hospitals, amid concern that a “cult of natural childbirth” is leaving rising numbers in agony.

Mothers said they were told “It’s not called labour for nothing, it’s meant to be hard work” as doctors refused their pleas.

The problem is so widespread that the rate of epidural use is dropping overall:

Midwifery violence: bullying, pain shaming and denial of epidurals and maternal request C-sections.

Official guidelines … state that women must be able to access pain relief when they request it, including epidurals.

However, this newspaper has identified six NHS trusts where women pleading for pain relief were refused it.

It comes as official figures show the number of women given pain relief during child birth has fallen. The statistics from NHS Digital show the percentage of women in labour given pain medication such as epidurals has fallen from 67 per cent in 2008-09 to 61 per cent in 2018-19.

Rhiannon Evans of Grazia refers to this practice as pain-shaming:

…[U]nlike the arenas of mental health, other pain, or addiction, where it feels like things are starting to change and messages of kindness are starting to filter through to our collective consciousness, birth is a bizarre no-mans-land of medicine and shame.

It’s a place where the old and new collide, but women are still left worse off. It’s a strange area where the old world says, ‘Come on, this is how we’ve done it for centuries, stiff upper lips, please, women!’ and the new world says, ‘No, it’s your body, your choice, you can do this, women are amazing, but did you know breathing is the greatest anaesthetic ever and breast milk is the cure for everything you could ever imagine?!’ The place where those two worlds intersect is the place where women deal with birth and pregnancy every day. And for many of us, it’s a grim place to be. It’s where the so-called ‘cult of natural childbirth’ lives.

Maybe there would be more attention devoted to midwives’ unethical behavior if we gave it a name. I suggest “Midwifery Violence.”

What’s the definition of midwifery violence?

It is an umbrella term that includes coercion, bullying, pain shaming and denial of epidurals and maternal request C-sections.

Forcing women to labor in pain when effective pain relief is available is sadistic.

In Eve’s punishment rebooted: The ideology of natural birth, philosopher C.K. Egbert explains:

There’s something pornographic about the way we depict childbirth. A woman’s agony becomes either the brunt of a joke, or else it is discussed as an awesome spiritual experience… [W]e talk about the pain of childbirth — with few exceptions, the most excruciating, exhausting, and dangerous ordeal within human experience — as valuable in and of itself. Hurting women is sexy.

Midwives justify their sadism as “better” for babies and mothers. Egbert makes it clear that this justification is nonsense:

… We probably wouldn’t give much credit to an argument that we should strap patients to the operating table and refuse them anesthetic during surgery, even though general anesthetic is usually the most dangerous part of surgery. Rather than eliminating palliative care, we seek safer and more effective means of performing surgeries and administering anesthetic.

Natural birth advocates are not concerned with women’s welfare, because they are not advocating for safer and more effective forms of pain management; they argue they should be eliminated, because women’s suffering is itself a good…

None of this is surprising when you consider that the philosophy of natural childbirth was created by old, white men (Grantly Dick-Read, Lamaze, Bradley) and perpetuated by old, white men (Odent, Marsden Wagner) who tried to convince women that the pain of childbirth was in their heads, not their bodies. And the philosophy of natural childbirth has been perpetuated by white women (midwives, doulas and childbirth educators) who enjoy wielding power over other women and glory in humiliating them for failing to mirror their own choices back to them.

The midwives and doulas who chivvy women into refusing pain relief, who “delay” calling the anesthesiologist when a woman requests an epidural, who promote inadequate forms of pain relief (waterbirth) and praise women as warrior mamas (i.e. “good girls”) for enduring labor without pain relief are sadists. They believe that women’s pain and suffering aren’t worthy of their compassion and concern. They believe that women are improved by agonizing pain, and diminished by relief.

And that is midwifery violence.