My Hardest Experience as a Doula: Obstetric Violence and Birth Rape - The Harsh Reality

“Rape is defined as an act of plunder, violent seizure or abuse; despoliation; dishonest acquisition of a goal or goods.”

I had just attended my first homebirth, which went off without a hitch. One of the attending midwives joked and said, “You’re never gonna wanna work in a hospital again after this.” The energy and reverence in home birth is unparalleled. It truly is a magical and humbling experience. I’d attended about 20 hospital births, all of varying circumstances and durations prior to that birth. Truly, nothing compares.

I was still riding that lovely high when I received the message that my next client was in early labor. She and her husband let me know that they were going to the hospital. It was one of my favorite hospitals, too. I’d had several other clients with very positive birth experiences there. Little did I know how drastically different this one would be.

When I arrived, I was greeted by my client’s partner. He said they were prepping her for an epidural. They had all but just arrived at the hospital, so this was very odd. During all of our prenatal appointments she’d expressed wanting to hold off on getting an epidural unless absolutely necessary. Being that they’d only been there a short time, this decision seemed extremely premature. We didn’t get to use any pain management techniques that we’d discussed during prenatal appointments. I dismissed that concern to provide whatever support I could. While in the waiting room, my client’s husband inquired about my experience and my education. I thought he was making friendly conversation with me. The following series of events and interactions indicate that this was not the case. He was looking for ways to somehow discretely discredit me.

We joined mom in the delivery room. She seemed in good spirits. I asked her if she wanted me to get the peanut ball to keep her pelvis open so that baby could keep descending. Her husband answered for her and said, “We’re good. I think we are just going to have a moment together” with a curt look in his eyes. It became clear to me in that moment just who likely initiated the decision to get the epidural. So, I dimmed the lights and let them have an intimate moment. Then the nurse came in and said she was going to start Pitocin. I asked my client if she wanted to talk to the doctor before consenting to this. She’d been dilating just fine so it was not medically necessary. The doctor came in to speak with my client, sighed and said, “Ahh, a nice controlled environment.” She verified that my client was at about 6cm dilated and did not actually need Pitocin. The comment about a controlled environment may seem innocent enough, but those of us who know and trust the physiological process of birth understand that “control” is an illusion. Surrendering to the spontaneity of the process, and only intervening when absolutely necessary, is what allows us to create the safest and most supported environment for a birthing mother. But, I digress as this story is sadly not about how this mother was honored in her physiological or emotional autonomy.

My client said that she was ready for the peanut ball. Things were calm and quiet. The most I was really needed for at that time was simply to make sure mom was comfortable and hydrated.

After a few moments her husband said that his father-in-law, my client’s father, would be joining them. He went to receive him at the hospital entrance and left me and mom alone for a bit. She looked at me earnestly and said she did not want her father to join them. She seemed very uneasy about this idea and it was clear the husband had not discussed this decision with her beforehand. But, I was trained not to overstep and speak for my clients. She declined to express this herself, so I didn’t say anything. Her father joined us. Her husband and father engaged in casual conversation about golf while mom laid in bed laboring. You wouldn’t have known anyone was about to have a baby in this room as a bystander.

A few hours passed and the doctor came in after my client expressed that she was feeling some pressure in her rectum. Baby was coming. The doctor rushed in and set herself up to coach mom to push. Barely a few minutes passed before the doctor, created alarm in the room, moving swiftly calling for the neo-natal pediatricians, grabbing tools, calling on nurses, somewhat confusing everyone around as she gave no reasoning for these directives and demands. All the while, my client’s color in her face faded and she looked like she was about to faint. She was lacking oxygen and her husband looked worried. Mom’s father was no longer in the room, of course. I asked the doctor if she wanted me to tilt the head of the bed up so that gravity could help her get the baby out faster. My client was completely flat on the bed. The epidural medication seemed to be pooling in her upper body instead of being evenly distributed, which was causing mom to feel very light headed. The doctor angrily grunted, “NO, the baby needs to make it over the hump”, as if I was foolish for even suggesting otherwise. She was referring to mom’s coccyx/tailbone. I knew that her practice was antiquated and proven to cause pushing to take longer and be harder, but she was the one in the white coat and it was clear I couldn’t question her. I also didn’t want to create any more tension in the room for my client. It was evident that the doctor wanted me to “know my place”. The doctor proceeded to manhandle my client’s cervix and shove her hands into her with zero explanation or consent. She then began to vacuum the baby out and still was not explaining anything to mom or dad. Mom might as well have been a medical school cadaver. I noticed that my client was struggling to push with her contractions because she couldn’t breathe. The doctor was only focused on the cervix and birth canal. It was like she had tunnel vision as she recklessly maneuvered her hands into my client to stretch her wider, which would’ve been extremely painful without the epidural and could’ve resulted in pelvic floor damage later. I asked my client if she was ok and gently fanned her face, hoping that hearing the weakness in her voice would prompt the doctor to be more aware of her state. My client was slow to answer and her voice was so frail. Thankfully, it worked and finally, the doctor called for a nurse to give mom some oxygen through an O2 mask.

The reason for all this was that the doctor noticed a mild fluctuation in the baby’s heart rate during contractions. This is not abnormal, to a certain extent. It can sometimes mean that baby is in distress or that the cord is wrapped around the baby’s neck. This is called a nuchal cord and actually happens in about 20-30% of all births. This is another reason I suggested to tilt the bed to let gravity help to get the baby out faster as well as to cut the risk of the pressure of sitting on mom’s tailbone to tie the cord even tighter, further preventing baby from descending. Sometimes when the cord is wrapped about the baby’s neck, when mom is flat on her back, the cord can wrap tighter around the baby’s neck due to getting caught on the tailbone. But again, I was not the one in the white coat and I couldn’t question her without mom’s communication or consent. Even the nurses, who could clearly the see the fluctuations in heart rate, looked confused about the level of alarm in the doctor since it was not far out of normal range.

All the doctor said to either mom or dad was that she needed to get the baby out fast. She didn’t say why, or explain any action she was taking in this woman’s vagina, despite the fact that baby’s heart rate was within normal range when mom was not contracting.

As the father’s face stayed frozen with worry, all I could do was continue to gently fan mom’s face and tell them that all would turn out fine and that they would soon meet their miracle.

The doctor continued to thrust tools, fingers and vacuums into my client’s birth canal with no consent or cause to get the baby out. Finally, their little baby boy emerged earth-side. The cord was indeed wrapped around the baby’s neck, but the baby was fine. He let out a healthy cry and was given to the nurses to evaluate him. The neo-natal pediatrician stood with gloved hands and a puzzled look. She was never needed.

Baby was perfect. The doctor quietly stitched mom up, still not explaining any of the stress that just happened. I comforted and congratulated the new mom and took pictures of dad hovering protectively over the shoulder of the nurses to watch as they swaddled his boy. He kissed him and I was able to photograph their first few tender moments.

The doctor said to the father, “Meet me in the hall in a few minutes and we can recap.” They placed the baby quickly in mom’s arms and everyone left the room. Dad followed the doctor and spoke privately outside the delivery room door. The new mom looked confused and mildly shocked, as if she was struggling to process the whirlwind of events that had just transpired. I explained the likely reasons the doctor handled the situation the way she did, being very careful not to criticize the doctor’s choices unless my client had questions or expressed concerns. It was only “my job” to help her process her own experience, not to make her aware of any potential trauma unless she explicitly asked or expressed distress. All that mattered at this juncture for her was that she was ok and so was her baby. She laughed and began to feel the oxytocin flow. We began to put baby to breast to see if he wanted to latch.

Just as she began nursing her little boy, my client’s father came back in along with her husband. There was a bit of an awkward silence when she asked me to stay to help with nursing, as we’d agreed upon during her prenatal appointments. Her husband was aware that these were her wishes. However, her husband seemed like he was waiting with bated breath to say something. After about 10 minutes, the husband asked they could have a moment alone. I agreed and stepped outside the room. I paced the halls for about 15 minutes. They sent my client’s father out to tell me that they were “good”. It was extremely awkward. I told him that all my things were still in the delivery room. I went to retrieve them and found dad holding his baby. This was beautiful, but mom looked like all she wanted to do was get him back in her arms and continue nursing him as he was rooting—looking for her breast.

I asked if they wanted any more breastfeeding assistance, looking directly at mom as I did so. Her husband answered for her once again and said curtly, “We’re good”. Mom didn’t say anything even though moments ago she asked me to stay. So, I reminded them that because it was somewhat of a precipitous labor and birth that, per our contract, they could convert the rest of service into some extended post-partum support and that I’d contact them in a few weeks to check-in. After about 5 hours of being with them, I took my leave.

I got to my car and began to sob. I’d witnessed this woman’s bodily autonomy be callously stripped from her and it was obvious that in the father’s chat with the doctor, I was made out to be the scapegoat. Not only was I left to process her trauma for her so that she wouldn’t have to, but I was also clearly going to be circumvented from providing the service I was hired and driven to provide, as well as fulfillment of final payment, due to her husband’s lack of understanding and unwillingness to communicate honestly.

I texted the midwife with whom I had just worked the home birth. I told her she was right and I truly never would be able to look at hospital births the same again. That was all I said. This could’ve meant that I simply preferred the home birth experience. She responded by telling me that the reason she had to stop training doulas, which she did for 11 years, was because she could no longer ethically put doulas into a system in which they may be traumatized by having to be complicit. “The trauma they witness and have to reframe for clients is soul-sucking… we need more midwives”. She didn’t even know one single detail of the birth to know what had just transpired. She said she could just hear it when she read my words.

This had been my only truly traumatizing experience in 5 years, up to that point. Most birth experiences bring joyful tears to my eyes when I think about them. I used to say there is no wrong way to give birth. But there is. And the wrong does not fall on the mother, but is thrust upon her by practices that cause her autonomy to be taken from her; practices that protect the care provider before they protect the mother and child under the guise of safety; practices which make mom a bystander instead of the active participant in an event that she is going to remember for the rest of her life.

After a few brief text messages about 3 weeks after the birth, I didn’t hear from this client again. Both she and her husband said they thought they were ok and declined further service. They’d taken it upon themselves to decide the worth of my work without discussing it with me, as if it wasn’t clearly outlined prior to her birth. But that’s a topic for another time.

I share this story, not to spread negativity toward OBGYNs. Of the almost 20 babies I’d helped bring into the world up to that point, most doctors shook my hand and I was able to express gratitude for all that they do and for the opportunity to work with them. They in turn also thanked me for my services and we provided a united front for the growing families with whom we worked. I share this story not to scare mothers. There is no wrong way to give birth if your right to informed consent is honored at every juncture. There are always ways to get the support you want, need and deserve. I share this story to shed light on the ways the industrial birth complex and our capitalistic health system, as it currently stands, can utterly fail expectant mothers in ways that we’ve sadly normalized.

I looked up the doctor after the birth… almost everyone that went to her for gynecological care gave her 4-5 out of 5 stars. She had a penchant for successfully treating cervical cancer and performing surgeries to remove tumors. This is not surprising considering that, at their core, OBGYNs are surgeons. Pathology is the foundation of their training and schooling. However, when it came to obstetric care she had 1-2 stars from every patient. Their number 1 complaint—they felt she did not listen to their needs, ignored certain requests and very often made suggestions that prompted them change providers or seek second opinions.

My client had recently moved here from another state and did not know enough about anyone in this area to have an informed decision to make about who provided her care.

I also share this story for another reason. I feel compelled to shed light on how important and vital it is for moms not to fear USING THEIR VOICES! My client chose to allow her husband to be the stronger voice in the important decisions surrounding her birth, such as whether or not she would receive a major medical intervention. She chose not to speak up when someone was present in her birth space without her approval. She chose to let her husband dismiss me when she’d wanted me to stay. I do not say this to place blame on her, but to demonstrate what can occur when women are silently subverted for any reason. She is a strong woman and I’m sure there were many reasons within her relationship and her life that caused this dynamic. That’s how she exercised her free will and it is her right to do so. I pray she finds her voice and is not afraid to use it to get her needs met in any other area of her life. I graciously respect, as my trainers taught me, that I cannot “want it” more than the mother does.

Lastly, I share this story to demonstrate the dynamics of doulas and spouses/life partners. Her husband chose to ignore what his wife expressed during our prenatal visits. He could’ve remembered her desires and empowered her, but he decided that he knew better. He decided to dismiss me and evade me doing my job under the guise of protecting his wife from pain. As the protectors, many men struggle with respecting physiological birth and understanding why it is important to allow the pain of labor to exist as normal. In my experience, wonderful as men are, sometimes they find it hard to reconcile the role of provider and protector and the need to allow women to experience birth as only womb’en can. He had an opportunity as her lover, partner and protector to help honor her choices and remind her of her inner strength. Instead, unfortunately, he was short-sighted. He could’ve communicated with me about what transpired with the doctor in their private chat so that I could provide perspective and clarity, but he unintentionally, or perhaps intentionally, insulted my profession and education and chose not to. This is another reason doulas exist.

Partners, we are your allies not your adversaries. We cannot replace you! Give your partners the power and respect that they deserve and allow the doulas to hold space for that to happen. Protect that space. Enter it with reverence for the mothers of your children and respect for the process that is BIRTH.

This experience made me so thankful for having found this path. It humbled me and made me seek a deeper understanding of my clients to better serve them. As if I didn’t already know the importance of supporting partners as well, it made me seek to more thoroughly understand how they process birth as well.

If you feel the support of a doula is right for you and you make a connection and find the right fit, trust is important. Establish it early and allow that to guide your communications. It is one of the most amazing relationships you’ll ever have.

Doulas trust birth… and so should you.