Obstetrical Violence

Open Letter to Health Units, Politicians, Policy Makers & Medical Practitioners in Regards to the Institutionalized Abuses of Pregnant Women and Newborns in the Name of Covid-19

Pregnancy, childbearing and labour are transformative passages in the life of a woman, and her newborn. Every human life, and the moment of its birth, is sacred. The process from conception to childbirth should be treated with the dignity and care it merits, putting the physical, mental, and emotional health of the mother and her infant as the top priority.

In regards to public health policy concerning maternity and labour during Covid-19, it has been heavily critiqued for the failure of its policies to deliver.

The Oxford academic article Going solo: the law and ethics of childbirth during the COVID-19 pandemic, states that “the spread of the novel coronavirus put a strain on another aspect of women’s reproductive lives: childbirth.” It goes onto explore “the ethical and legal issues raised by hospital visitation rules that require women to give birth alone.”{1}

It also cites the protections put in place in 2007 in Venezuela to prevent ‘obstetric violence’.

“The term ‘obstetric violence’ is defined as ‘…the appropriation of the body and reproductive processes of women by health personnel, which is expressed as dehumanized treatment, an abuse of medication, and to convert the natural processes into pathological ones, bringing with it loss of autonomy and the ability to decide freely about their bodies and sexuality, negatively impacting the quality of life of women’.”

It is easy to make the case that obstetric violence, including dehumanized treatment, the conversion of natural processes into pathological ones, and loss of autonomy in maternal decision making has been the standard during the coronavirus pandemic.

A woman victimized by Andrew Cuomo’s NYC ban of any support members during labour, which gained so much backlash that it was expelled within four days, details her traumatic experience of giving birth alone.{2}

She received a phone call informing her of the new policy:

“My mind racing, I took a deep breath and tried to hold onto logic and practicalities. This meant nobody else could accompany women in labour – no partners, no doulas, no grandmas-to-be. I asked if my husband would be allowed in the hospital to fill out the paperwork and carry my heavy hospital bag, or if I’d have to do that alone. She said he wouldn’t even be allowed in the building. He would have to drop me off at the curb.

“I hung up the phone, my husband hugged me, and we both cried. He would miss the birth of our second child – our baby girl.”

Upon entering the hospital:

“Thirty minutes later, I had been hand-sanitized and masked and questioned and set up in a delivery room. I sent my husband a photo of me smiling behind the mask, and one of the small clear plastic bassinet that would soon hold our daughter.”

Through her contractions:

“I FaceTimed my husband and managed to prop the phone against one of my bags so he could see the side of my face. He talked me through the contractions as they became stronger and longer. The nurse let me take the mask off through the worst contractions, and my husband reminded me to breathe.”

Through labour:

“It was time to push. There was an urgency in her voice. I was fully dilated, and I felt nauseated from lack of sleep (and lack of food, and lack of calm, and lack of partner). It was just after 2 a.m., and I knew I was going to vomit. I tore off the mask and threw up – violently. Then I realized I could no longer hear the baby’s heartbeat through the monitor. The nurses quickly adjusted me. Nothing. They adjusted again, and still nothing, and again, and still nothing. They rolled me over, and I wondered how I would tell my husband our baby girl was gone. Finally, after a frantic minute of adjusting me and the monitors, they found her heartbeat – it had slowed significantly when I vomited, but it was still there. Still steady. I grappled clumsily for my phone, called my husband on FaceTime at 2:16 a.m., and at 2:18 my doctor told me to push – now!”

To cutting the umbilical cord herself:

“At 2:19 I was holding my baby girl. I cut the cord myself, with her resting on my chest, and held the phone so my husband could see her. She cried and I cried, and the doctor assured me that she was OK.

“The next day in the hospital was a bit of a blur. Trying not to feel bitter or lonely, I returned to my mantras: My son was happy. My daughter was safe.”

I wonder if any of the policy makers or enforcers of these policies would accept these conditions themselves. I wonder if Christine Elliot would have considered this a healthy birth experience if she had been at the mercy of her own abusive policies, or if Andrew Cuomo would have obeyed his own orders.

Despite health units having updated their inhumane, unscientific policies to include one support person, which has still been proven detrimental for women who wish to include doulas, family members, or friends in their support team, the effects of those traumatic birth experiences will echo on.

They are also not the sole traumatic policies being inflicted upon the maternal process.

The climate of fear of the virus, exacerbated by the media, the stress of income loss caused by lockdowns, the police sirens patrolling the streets in places with curfews, is paired with the lack of ordinary support for pregnant women who are actively encouraged by the government to self-isolate:

“Stay home as much as possible, except for important medical appointments, and work from home if possible.

“Talk to your doctor, obstetrician or midwife about the possibility of telephone or videoconference appointments.

“Avoid visitors to your home, unless for medical purposes.

“Avoid crowded places and peak-hours. Make limited trips to the store for essentials.” {3}

Studies have also begun to emerge, detailing the negative experiences and health outcomes of pregnant women during the pandemic:

“Women in this study had twice the odds of hypertension compared to prior studies, which showed a 10% rate of hypertension in pregnancy. Anxiety was reported by over a third, compared to 20% of women in previous studies. Depression was also reported in nearly a fifth, compared to the usually cited figure of ~13%.” {4}

From the same report,

“Over a fifth of the women reported feeling unsafe in the maternity unit. In contrast, an earlier study reported that only ~13% said they would feel safe delivering their baby out of the hospital, whether or not they planned to give birth in or out of the hospital.

“Again, over 60% of the women in this study said they were not well supported during childbirth, perhaps because they could not have their friends, doulas, or family members with them. It is noteworthy that this finding cropped up despite the fact that most women could have their birth partners with them.”

If her one birth partner accompanies her, he better play nice by sporting his PPE, and following all the guidelines, including “…that the support person remains compliant with physical distancing and infection control instructions.” {5}

The strict mask policy for her sole birthing partner, in many cases the father, strips parents of not only their dignity, but dehumanizes the first and most irreplaceable moments of connection with their newborn. The enforcement of a ‘non-medical cloth face covering’, which multitudes of studies have proven completely useless {6}, during the sacred moments of birth, can only be described as vile and pathological.

The completely asinine and inhumane practice of compelling labouring women to wear masks until the “hard part”, as I was told by the maternity ward at my local hospital, is not only objectively absurd, but medically harmful to both mother in labour and her baby. It goes beyond the psychological humiliation many people experience when muzzled in normal circumstances. In the setting of childbirth, it is barbaric.

A French group of maternal activists, “Stop aux Violences Obstétricales & Gynécologiques (Stop VOG) published a report in July that linked women wearing masks during childbirth with complications such as fevers, abdominal pain, the need to use medical equipment such as forceps, having to use epidurals, and post-natal depression.” {13}

One woman recounts how “(she) took (her) mask off right at the end because (she) really could not breathe. But (she) was made to put it back on right after.”

Another woman was told that if she did not wear her mask, she would be refused medical assistance. Her partner, viewing her obvious distress, removed her mask at some point, but the staff told him off. {14}

“I had the same mask during the whole labour; I was unable to breathe properly and therefore unable to push for 12 hours. I suffered a lot and the gynaecologist had to use medical spatulas to help my son out.

“As a result, my son was born with a lump and with amniotic fluid in his lungs and he was transferred to another hospital. As for me, I have a tear that is still healing and trauma for me and my partner. I don’t imagine I will ever be able to give birth again.” {13}

If that is not institutionalized abuse, I do not know what is.

The horror continues, with irrational, fear-based policies for labouring women who have either tested positive for Covid-19, tests that are proven to provide highly unreliable results {7}, or women suspected of having covid-19.

According to procedures by Ontario Public Health, echoing the practices of the CDC, these women are put into isolation rooms after delivering their babies, and of course must be wearing a mask, as well as “keeping infant two meters from mother when not providing direct care, including use of a barrier (such as a curtain or incubator) to protect against droplets due to coughing.” {5}{8}

If this sounds like torture, consider that earlier in the pandemic, known essential practices for the well-being, development, bonding and attachment foundations for mother and infant were thrown out the window even further.

“…immediate isolation of the newborn and breastfeeding avoidance was routinely carried out in some centers, rather than immediate skin to skin contact after birth, early breastfeeding, and rooming-in. The Center for Disease Control (CDC) in the US recommended such a temporary separation.” {4}

Even the WHO, whose public health guidelines during the pandemic have been demonstrably corrupted under current leadership by an accused war criminal {9}, recommend keeping mother and newborn together in the same room.

In contrast to Ontario and the CDC, Manitoba Public Health guidelines state that “To date, there is no evidence that a pregnant person with COVID-19 can pass the infection to her baby during the pregnancy or at delivery. The virus has not been found in samples of amniotic fluid or breastmilk.” {10}

In a recent study of 64 pregnant women with confirmed Covid, none of the newborn infants tested positive. {11}

Yet, newborn babies of mothers with a positive Covid result are being tested “regardless of symptoms”. {5}

Public health policy must always take a balanced approach, and the practice of those policies in medicine should always follow the maxim, first, do no harm.

Does it follow the doctor’s hippocratic oath to stick a q-tip far up a newborn’s nostril without significant evidence showing the benefits outweigh the trauma? Should this be the first experience in human life?

When I voiced my serious concerns over these voodoo practices taking place at the hospital I am due to deliver our first child, I was told that these policies were in place to “protect the medical staff from the patients”. I anxiously wonder, who is going to protect me and my newborn baby from them?

Our current pandemic of fear and pathological health policies can be compared with the WHO-declared world health crisis of Zika.

“Fear of infectious disease can create a variety of problems not the least of which is fear itself.” {12} (Self-regulation of emotional responses to Zika: Spiral of fear)

This study found that “Women who are currently pregnant, or planning to become pregnant in the near future, bear a disproportionate risk due to the possibility of microcephaly in the infant. Assuming that they are aware of this danger, it is possible that fear and emotion regulation are more tightly intertwined than for those who are not pregnant and do not plan to become pregnant.

(…)

To the extent that fear is damaging to the individuals who experience it, these values may be worrisome. It is of particular concern that fear in mothers can negatively impact the well-being of infants. To this point, Lederman et al. reported that physical proximity to the World Trade Center (a proxy for fear) was associated with reduced birth weight of infants who were in utero at the time of the 9/11 attacks.” {12}

Pathological public health policy and practices by medical experts surrounding maternity during Covid begins at the moment of conception, and continues until the very first sacred breath. It damages pregnant women physically, emotionally and mentally, and puts their babies at extremely serious risk. It is the very definition of obstetrical violence, and borders on sadistic.

The significant and life-altering experience of childbearing should be treated with the care, dignity, and respect it deserves. It must always be supported by well-balanced and beneficial health policies for both mother and infant. The French Minister for Health buckled under the pressure of traumatized mothers who suffered the abuses of its policies, and in November 2020 provided a clear statement reminding health professionals that “giving birth must remain a privileged moment” and that mask wearing could no longer remain compulsory. {15}

We are dangerously past the due date with our current policies. It’s time to kick the irrational, inhumane and abusive whims of bureaucrats and ‘experts’ out of the maternity ward, and bring the doulas back in.

{1} Going solo: the law and ethics of childbirth during the COVID-19 pandemic – https://academic.oup.com/jlb/article/7/1/lsaa079/5918380

{2} I was forced to give birth alone because of coronavirus – https://www.todaysparent.com/pregnancy/giving-birth/giving-birth-during-coronavirus/

{3} Pregnancy, childbirth and caring for newborns: Advice for mothers during Covid-19, Govt. of Canada – https://www.canada.ca/en/public-health/services/publications/diseases-conditions/pregnancy-advise-mothers.html

{4} Mollard, E. et al. (2020). Experiences of Women Who Gave Birth in US Hospitals During the COVID-19 Pandemic. medRxiv – https://www.news-medical.net/news/20201022/Study-looks-at-childbirth-experiences-during-COVID-19-in-the-USA.aspx

{5} Ontario Ministry of Health Guidelines – http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_labour_delivery_%20newborn_guidance.pdf

{6} Masks – https://thefederalist.com/2020/10/12/cdc-study-finds-overwhelming-majority-of-people-getting-coronavirus-wore-masks/

{7} PCR – https://cormandrostenreview.com/retraction-request-letter-to-eurosurveillance-editorial-board/

{8} CDC guidelines – https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

{9} Tedros – https://ecadforum.com/2017/05/05/tedros-adhanom-played-a-key-role-in-kidnapping-of-prominent-dissident/

{10} Manitoba Public Health – https://manitoba.ca/asset_library/en/covid/factsheet_pregnancy.pdf

{11} No mom-to-baby virus spread noted in late-pregnancy COVID-19 – https://www.cidrap.umn.edu/news-perspective/2020/12/no-mom-baby-virus-spread-noted-late-pregnancy-covid-19

{12} Self-regulation of emotional responses to Zika: Spiral of fear – https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199828

{13} Unimaginable’: French women criticise childbirth in masks – https://www.connexionfrance.com/French-news/Unimaginable-French-women-criticise-childbirth-in-masks

{14} Forced during labour – Photo credit @realpress via https://www.google.com/amp/s/www.dailymail.co.uk/femail/article-8834045/amp/Women-France-felt-like-suffocating-forced-wear-face-masks-childbirth.html

{15} French hospitals told they can’t force women – https://www.google.com/amp/s/www.modernghana.com/amp/news/1041946/french-hospitals-told-they-cant-force-women-to.html