'I begged them to stop. They didn't listen.' The reality of women's experiences of 'obstetric violence'.

Content warning: This story includes detailed depictions of birth trauma, and discussions of suicide that may be distressing to some readers.

Three years ago, Charlotte* was getting ready to give birth. She wasn't feeling too nervous or worried; she knew what to expect as she had done it before, previously undergoing two C-sections with her older children. 

So when she was given the anaesthesia, she knew immediately it hadn't worked. It didn't feel the same as her first two experiences. In fact, it felt like it was barely working at all. 

"During the C-section, I felt everything - I told the doctor to stop, that I could feel her cut me and she just said it was 'pressure not pain' and continued to cut while I cried in pain," Charlotte told Mamamia.

After the birth, Charlotte was in serious pain but healthcare providers thought she was "drug seeking". It's been a few years since she the birth but the impact has been long-lasting. Charlotte still has flashbacks to that moment and is seeing a therapist. 

Rachel* also endured a traumatic birth. Earlier this year, she was coerced into having an induction - despite her feeling like there was no concern for either the mother or baby's health.

"I had a stranger digging up around my cervix with no meds and it brought on a rapid dilation. My water had already broken, but the staff kept telling me I had just wet myself. I certainly had not," Rachel told Mamamia. 

"I begged for a C-section as there were complications, but the OB forced me to push for two hours and my baby became stuck. I was then whisked into an emergency C-section. The midwife told me I was not pushing hard enough and that it was my fault." 

Watch: the truth about birth trauma. Post continues below.

Rachel feels intense shame about the entire birth process. For the first three months of her baby's life, she cried every single day. She experienced suicidal ideation - something she had never had prior. And she has since been diagnosed with post-natal depression and anxiety. Because of complications during birth, Rachel has a prolapse, and now cannot bear to have anyone touch or hug her. Her partner is also traumatised after witnessing what Rachel had to experience. And the birth was incredibly expensive as well, totalling $8000 in private hospital and OB fees.

Rachel knew that what she had endured was not okay. But she didn't have the words or terminology to fully articulate what happened. Then she came across the term 'obstetric violence'. And it hit close to home. 

Obstetric violence refers to any act or action that makes the woman giving birth feel as though they've been dehumanised, abused or violated by a healthcare provider, According to Liz Wilkes, the Managing Director of My Midwives. 

"For some women, they unfortunately experience disrespect during the birth process to the point where it's caused harm to the women - whether that be psychological or physical. And we do see a large number of women coming to us in a subsequent pregnancy after experiencing obstetric violence in a previous birth," Liz said to Mamamia.

In Liz's almost 30 years in midwifery, she has witnessed some horrific births - non-consensual vaginal examinations, forced deliveries using forceps and more.

"The trauma for not only the woman, but for those healthcare providers who have had to watch on despite telling their colleague they've done wrong, it can be really horrible. Even the midwives I've worked with, we have seen bad things happen within the system and felt helpless and scarred by it."

A recent study conducted by Western Sydney University found that one in 10 Australian women reported that they have experienced obstetric violence. Over 8,800 women took part in the largest birth experience survey conducted in Australia to date, sharing experiences of bullying, coercion, non-empathic care and assault as part of their birth experience.

Mamamia spoke to 10 mothers about their experience with obstetric violence. One was not given pain relief medication, despite asking for it in the lead up to the birth - and during. She was told by her midwife to stop screaming during labour, and once the baby was delivered without pain relief, the midwife "smugly" said "aren't you glad you did it this way?"

Another woman was forced into birthing her child via a forceps delivery, despite voicing that she did not want to do this. There has been found to be a high risk of forceps-related injuries for the child during birth. This woman was also given an unnecessary episiotomy and was sent home with infected stitches. She then had to be readmitted to hospital as the infection was so bad. 

A third woman told Mamamia of the disrespect she encountered from her obstetrician. The OB refused to come into the delivery room until she was pushing, and then the OB refused to speak or engage with the woman giving birth - even rolling her eyes. The following day the OB told the woman, "I thought you were going to make me miss school pick up. Some women are really good at beating down and pushing - you not so much."

This experience happened over a decade ago yet the woman is still "brought to tears" when recounting it.

"I felt humiliated and entirely responsible for the trauma experienced by my baby and me. The hospital staff didn't also follow up with me later and I had no support there. I have had years of psychotherapy as a result."

View this post on Instagram

A post shared by mymidwives (@mymidwives)

Research lead of the study Dr Hazel Keedle and study co-author Professor Hannah Dahlen AM said despite growing international recognition, obstetric violence remains largely unrecognised in Australia.

"This is not just about obstetricians but can be perpetrated by any health provider involved in the care of women. A multi-level approach is needed involving consumer organisations, healthcare professional organisations and individuals, academics and health authorities in order for obstetric violence to be recognised, reported, reduced and legislated against in Australia," they said.

It's what MP Emma Hurst is working towards legislating.

"Women in Australia should be able to access safe and respectful health care always, and especially during this time, but the evidence suggests this is currently not occurring," she told Mamamia.

"In 2023, I will be seeking to introduce legislation in NSW which criminalises obstetric violence, to bring awareness to this critical human rights issue and to bring these numbers down, or even better, to eradicate obstetric violence and the subsequent risks altogether."

The proposed legislation would follow the lead of other countries like Venezuela, Argentina, Panama and Mexico which have already criminalised obstetric violence. 

"We need systematic reform, which starts with legislation to protect women from a form of abuse that appears to have become all too common."

For the women who have had a traumatic birth, there is a path to emotional healing. And this is the work that Liz is particularly passionate about.

"There's a two-fold approach. First of all, birth debriefing is so important, especially for women who have been violated. Being able to speak to the people involved but also to a third party who can help them through the trauma is key. 

"Secondly, for women who are preparing for their next birth, there's another step. When there's been a trauma or violent activity, the woman needs to have a midwife they know and trust who is also well-prepped. And boundaries need to be discussed prior and actioned - because we never want to re-traumatise a woman who is giving birth."

As Liz explained, the more control the woman feels over the situation, the better. When it comes to reporting or escalating recent cases of obstetric violence, Liz noted that each state has a 'watchdog' or health ombudsman and complaints process, which women are encouraged to reach out to if needed. And in some particular circumstances, contacting the police is also available.

"I think as a society we're getting better at these conversations - not only on obstetric violence, but gender-based issues more broadly as well," Liz said. 

"This isn't an individual issue, it's a system issue that the whole healthcare industry needs to address - emphasising the importance of care, consent and respect. Whether it's private or public, there are cases of violation across the board. And we need to work towards a better future for these expecting mothers."

If you find yourself needing to talk to someone after reading this story, please call Lifeline on 13 11 14.

For help and support, contact PANDA (Perinatal Anxiety & Depression Australia) on 1300 726 306.

*These women are known to Mamamia. Their names have been changed for privacy reasons. 

Feature Image: Getty.