"A woman who is raped while giving birth does not experience the assault in a way that fits neatly within the typical definitions we hold true in civilised society. A penis is usually nowhere to be found in the story and the perpetrator may not even possess one. But fingers, hands, suction cups, forceps, needles and scissors… these are the tools of birth rape and they are wielded with as much force and as little consent as if a stranger grabbed a passer-by off the street and tied her up before having his way with her. Women are slapped, told to shut up, stop making noise and a nuisance of themselves, that they deserve this, that they shouldn’t have opened their legs nine months ago if they didn’t want to open them now. They are threatened, intimidated and bullied into submitting to procedures they do not need and interventions they do not want. Some are physically restrained from moving, their legs held open or their stomachs pushed on."I'm somewhat ambivalent as to where my sympathies lie in this argument. I've seen some callous behaviour in the delivery room (more often from midwives than doctors I have to say). Of course any medical procedure carried out without consent is assault, and a patient can withdraw that consent at any time. On the other hand, when carrying out examinations and procedures which are uncomfortable it is always sensible, when a patient wants you to stop because of discomfort, to engage in at least some discussion with them - this is because people are often just temporarily unhappy about the discomfort and will continue with a little encouragement, avoiding terminating the procedure and requiring the whole experience to be repeated. This applies as much to inserting a cannula as to intimate examinations. I don't think there is any easy answer as to where the line lies, which is why doctors are always walking something of a tightrope between best interest and violation of autonomy.
Friday, 16 May 2008
Interesting, if bad tempered, exchange going on between Dr Crippen and the F Word (and others) over this post there on 'birth rape' and 'medical rape':