Psychologist explains obstetric violence causes and how to protect

In early January, the whole country was shocked by a horrific tragedy in Novokuznetsk: nine infants died there in a local maternity hospital over the New Year holidays. As it turned out, patients of this medical facility had long complained about staff rudeness and systemic problems before the tragedy.

But this story is relevant for all of Russia — stories of obstetric violence emerge in literally every region almost every year. This topic has not bypassed Voronezh: we collected stories from mothers in our city about what they had to go through in local maternity hospitals in a separate article. And about where obstetric violence comes from, how to deal with it, and why it should not be a reason to refuse to have another child, clinical, perinatal, and reproductive psychologist Lidiya Kvasova told Voronezh1.ru.

Where does rudeness and cruelty in maternity hospitals come from in principle? Why can female obstetricians treat women in labor rudely — after all, they are women themselves?

— The main reasons can be divided into two categories:

• related to maternity hospital staff;

• directly related to the woman in labor.

To the first category belong, on one hand, personal characteristics of the people themselves, which are hard to restrain at work. If a person is harsh, rude, and unempathetic in life, it will manifest in all areas. The other question is, what are they doing in medicine with such traits?

On the other hand, a maternity hospital employee might be a wonderful person with well-developed professionally important qualities. But years of working in medicine take their toll, and no one is immune from emotional burnout. This is the specificity of our medicine: working within the system, it«s hard to balance between humanity and the need to strictly follow all orders and constantly remember that medical documentation is written »for the prosecutor«.

To the second category of reasons for rough treatment of women in labor belongs, as strange as it may sound, the behavior of the women in labor themselves. Unfortunately, not all women prepare for childbirth — they don«t study information, don»t attend courses. This leads to them not understanding how to behave, what to do. And sometimes they can harm both themselves and the child. And who is responsible for the life and health of both? Correct — the maternity ward team!

Another extreme is also encountered — women who are overloaded with information, and not the most accurate. They don«t allow medical personnel near them, refuse all manipulations, are rude themselves and create a conflict situation. And then the harshness of obstetricians becomes a strange, but the only possible attempt to help.

How can psychological violence during childbirth affect a woman? Can she somehow protect herself from it — at least morally?

— In a global sense, physical harm cannot be done with words. Yes, of course, a sharp release of the stress hormone adrenaline can slow down labor. But not stop it completely!

As for methods of protection, there are several.

• Partner childbirth. This option is now available in almost all maternity hospitals. The most opportunities for partner childbirth are in the first building of the Perinatal Center, as all delivery rooms are individual. The presence of a husband at childbirth gives both a feeling of safety and support to the woman in labor, and serves as a living reminder to staff not to be rude to this woman unnecessarily.

• Contract childbirth. This option is also available in all maternity hospitals in our city. The ability to choose a doctor and midwife who accompany the woman during childbirth and attend only her is almost a 100% guarantee of adequate treatment and correct communication. Moreover, she gets to know them in advance and stays in touch during the last weeks of pregnancy.

• Preparation for childbirth. Attending courses that include the topic of interaction with medical personnel will be very helpful. And the woman in labor having accurate information about childbirth promotes increased self-confidence, developing an understanding of what is happening and how to act.

How can a woman recover after childbirth if obstetricians used violence? Can it leave psychological trauma?

— Yes, psychological trauma can occur. How to understand that it is exactly that? If more than six weeks have passed since childbirth, but this topic still doesn«t let the woman go. If signs of post-traumatic stress disorder appear. If the woman constantly returns to the events of childbirth and replays them in her head. If these thoughts take up more time than thoughts about the child. All of this is a reason to see a psychologist to sort out the situation. Ideally, the psychologist should have a specialization in perinatal psychology. And if they also have experience working in a maternity hospital — that»s perfect.

How to decide on a second childbirth if there was violence from obstetricians during the first?

— It«s important to remember that the only criterion for good childbirth is a healthy mother and a healthy child. If the result of the first childbirth was exactly that, then things aren»t so bad. Moreover, no one is forcing you to give birth with the same doctors and in the same maternity hospital. We always have the right to choose.

If these arguments are not enough, it«s a reason to see a psychologist. Preferably at the stage of planning a pregnancy. And if the pregnancy occurred unexpectedly, it»s better not to delay this issue until late stages.

And most importantly: childbirth is just a short stage that is transitional between pregnancy and motherhood. And when we think about how to decide on a second childbirth after inappropriate behavior of medical personnel during the first, I suggest focusing primarily on the fact that the result of all this will be the appearance of a new person and a whole life with them. And that is the main goal of our decision.