Forcing pregnant people who request a C-section to see a psychiatrist is obstetric violence


It’s one of the oldest tricks in the misogynist playbook: declare that any woman who tells inconvenient truths is mentally ill. Physicians of the 19th and early 20th Century even had a name for the purported mental illness: hysteria.

That’s why it is the bitterest irony that Australian midwives have declared that women who request C-sections should be seen by psychiatrists.

The only thing more disrespectful than telling pregnant people how to give birth is declaring them mentally ill because of their choices.

Aussie docs slam mental health screening of C-section women:

Australian obstetricians have vowed to fight any move to send pregnant women booked for a C-section to a psychiatrist, as the extreme move to slash caesarean rates …

However, the Australian College of Midwives supports efforts to reduce unnecessary C-sections and believes women should have access to a psychiatrist to discuss their de-cision …

Apparently, Australian midwives believe that women who request C-sections are “hysterical” and require mental health evaluation.

In the paper The Race of Hysteria: “Overcivilization” and the “Savage” Woman in Late Nineteenth-Century Obstetrics and Gynecology, Laura Briggs explains how the mental health diagnoses were weaponized to control women:

Hysteria, we learned from feminist historical scholarship in the 1970s, was never just a disease. It was also the way nineteenth century U.S. and European cultures made sense of women’s changing roles. Industrialization and urbanization wrought one set of changes, while the women’s rights movement brought another. Together, these included higher education for women, their increasing participation in a (rapidly changing) public sphere, paid employment, and declining fertility. These cultural changes were accompanied by a virtual epidemic of “nervous weakness” largely among women, causing feminist historians to begin asking whether the diagnostic category of hysteria was simply a way of keeping women in the home…

To punish women who refused to be enslaved by their biology, misogynist physicians declared these women’s choices to be symptoms of mental illness.

Similarly, to punish pregnant people who refused to be enslaved by their biology, misogynist midwives declare these people’s choice of C-section to be symptoms of mental illness, requiring evaluation by mental health professionals. This how radical midwifery ideology makes sense of women’s effort for greater bodily autonomy in choosing how they will give birth. As in the case of hysteria, it tells us more about the prejudices of those making the diagnosis than the health of the pregnant people being diagnosed.

Moreover, requiring women who choose C-section to see a psychiatrist isn’t merely misogynistic; it is obstetric violence.

Obstetric violence is defined as:

…[T]he appropriation of women’s body and reproductive processes by health personnel, which is expressed by a dehumanizing treatment, an abuse of medicalization and pathologization of natural processes, resulting in a loss of autonomy and ability to decide freely about their bodies and sexuality, negatively impacting their quality of life.

It is supremely disrespectful to tell pregnant people how they ought to give birth and ignoring what they might want (pain relief, interventions, maternal request C-section) in labor. Telling a woman she must undergo a vaginal birth simply because it is natural is no different from telling a woman she must continue an unwanted pregnancy because that is natural. It results in a loss of autonomy, ability to decide freely about their bodies and sexuality, negatively impacting their quality of life.

The only thing more disrespectful is to label them as mentally ill and force them to be evaluated by a psychiatrist. Not only does that compound the loss of a pregnant person’s autonomy, it is an abuse of the mental health system. As in a totalitarian state, it turns the mental health system into an expression of state power. Second, it reduces access for people who actually have mental illness to the mental health services they need by diverting those services to ideological ends.

It is fundamentally unethical — and probably also illegal — to force pregnant people into psychiatric evaluation that they do not want and do not need in an effort to deprive them of autonomy to choose a C-section.

And it is a particularly egregious form of obstetric violence.