Being Believed: Obstetric violence in the age of #metoo

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AIMS Journal, 2020, Vol 32, No 1

By Maddie McMahon

The story of the female holiday maker in Ayia Napa, Cyprus, who was raped and then not believed has brought back some strong memories and emotions for me. It's more than 25 years ago now, half a lifetime. And yet, the fear and fury can still be brought to the surface.

This poor woman has been traumatised twice. It's not just the men who raped her who are perpetrators. The police did not listen. They coerced and gaslighted her, imprisoned and prosecuted her. They are perpetrators of violence against her.

I know.

I know how it feels to feel small. And powerless. I know how it feels to be told, in no uncertain terms, that you don't matter, you are unreliable, that you are not worthy of belief, trust and support. I know. It is a deepening of the initial trauma that has ripple effects across your whole life.

He pounced on me in the dark, violently attacked and tried to rape me. It seems madness to use the word lucky, but I was. Adrenaline made me angry and strong. It doesn't always do that. Sometimes it makes you freeze. I was able to grab him where it hurts most and twist with all my might. It gave me a chance to do the other thing that adrenaline is there to fuel - run. When he saw me escaping towards my block of flats and help from neighbours, he grabbed my dropped bag and ran off himself.

Because he stole my bag, the police branded his crime a 'mugging'. I was told by the police and many other people that I had been 'silly', 'stupid', 'idiotic' and 'asking for it' to say goodbye to my boyfriend at the top of the steps and walk the 100 yards across the Roman amphitheatre to my flat, alone. Like the girl in Cyprus, I was a Brit abroad, young and fearless, with a new boyfriend. Like her, I was branded because of my gender and nationality. Like her I was expected to swallow what happened, chalk it up to experience and keep my mouth shut. To my shame, I did.

I've been reflecting this week on what a lifetime of this shit does to a woman. A lifetime of being made to feel small. Of being told that we must not take up space - either physically or in any other way. We are made invisible; vanished and vanquished on a daily basis. What does it do to us to feel so powerless year after year? To be minimised and given such a minuscule amount of agency?

For me, it has folded me up inside and quite literally bends me double. The anger and sense of bitter injustice has sat, in the pit of my stomach, for so long, fermenting. The irritable bowel I’ve suffered for years is the physical manifestation of that emotion. It makes me fear conflict and I find it difficult to know how to safely express my anger. I have been taught since childhood that I must not express strong emotions. The result is that I sometimes struggle to know how to safely and appropriately express and channel my fury. It means that if I am threatened, my reaction may be hard to fathom and unpredictable.

Mostly, my sense of justice is enhanced. I cannot bear injustice and my whole working life and volunteering activities are based around that feeling.

This week I am reflecting on what the layering of injustice, insult and assault does to women. It heaps trauma upon trauma and ironically makes it more likely that we become victims again. I see it in the birth room all too often. A lifetime of being taught to put up and shut up, not make a fuss, not be visible or take up space, results in birthing people who are unable to speak up. It feels easier to submit to the painful, embarrassing examination than to speak the words that twist and turn in their guts, yearning for expression. It's easier to smile and comply.

And when we try to talk about what happened to us in the birthroom, we are all too often treated like the girl in Ayia Napa. Our story is minimised, dismissed and not believed. We hear phrases like

'Well I'm sure the doctors had your best interests at heart', '

‘They wouldn't have done it if they hadn't needed to',

'I think you're exaggerating',

'Maybe if you hadn't acted that way or argued with them...',

'You've got a healthy baby, that's all that matters',

'You're OK, try not to think about it'.

What do these phrases and others like them do to us? Any psychologist will tell you. Denial of trauma deepens it. It opens a wound and digs around in it painfully. It doesn't just try to erase the trauma, it annihilates us. Our very sense of self can vanish. We are effectively rubbed out.

A few weeks after the attack in the amphitheatre, I 'came to' and looked around me. My new boyfriend was still there. Patiently waiting. He believed me. He didn't say it was my fault or imply I carried any responsibility. He didn't make quips about the dress I was wearing. He didn't beat himself up about not walking me home. He understood that the only blame to be attributed was on the perpetrator. Rape and sexual assault ONLY happens because people commit those crimes. Full stop.

Having that firm and steady validation protected my mental health. It stopped me falling down any rabbit holes of self blame. He enabled me to take up space in the world and own my experience. He didn't try to make me small by silencing me because my words made him uncomfortable. For that, I am eternally grateful.

Yesterday, talking to my counsellor about all this, he pointed out that my body language had changed as he validated my emotional experience. From folded in on myself, I stretched out, took a deep breath and took up space.

We have to stop telling women they are mistaken. We have to stop telling them that others have it much worse. We have to tell them they are seen, heard and believed. We have to show them that they can unfold, open up and take up the space they deserve. Being pregnant is about getting bigger, not smaller. Birth is enormous; it is something of value that should not be diminished. Our stories deserve to live on, take flight and grow.

Am I really comparing the birthroom and the amphitheatre, I hear you ask? I know that it is vanishingly rare for malice to be lurking in the birthroom like it lurked on those Roman steps. But people can be hurt by people who are intending to help. People can be hurt by those who are hurting themselves. Fear, exhaustion, ignorance, pressure, haste and thoughtless routine practice can all cause harm. These days, it's unlikely that women will know those caring for them in labour. It makes it so much harder for midwives when they haven't built a relationship with the birthing person. They have no opportunity to peek into the lives of the families they care for. They rarely witness our heart's desires and the demons we battle.

But when a person comes out of a birth emotionally damaged; when they talk about the way they were treated and touched. When they describe being pressurised and coerced by people who seemed cold and distant, it doesn't matter if the abuse was intended. It still happened. The parent who is traumatised feels that way. Whether you believe them or not, is irrelevant.

In fact, if you really don't believe her, can I suggest you keep your mouth shut?

Maddie McMahon is a doula, doula trainer, breastfeeding counsellor and author. She has 2 teenage children and lives with her family and a small, black and white cat, in Cambridge. She blogs on birth, breastfeeding and feminism at thebirthhub.co.uk