Coffee shop feminists do not understand rape

The latest Britblog Roundup was hosted by Redemption Blues, a site headed by a picture to die for. (Which mountain is it?) I was gratified that Dr Crippen’s recent post on Rowan Pelling and the White Witch was featured but then concerned to read the following:

For those with the means to foot the bill, an independent midwife can indeed offer something your average, overworked NHS doctor cannot: she has time to build up a rapport with the expectant mother, displays empathy and actually listens rather than bossing around. Without such qualities the lobbying would hardly make an impact. Callousness and overweening arrogance are – alas – not in short supply amongst medical professionals, many of whom have a less considerate bedside manner than Gregory House. Nor would I dismiss the testimonies of women who have suffered appallingly at the hands of obstetricians, as attested to by Amity Reed in her devastating critique Not a happy birthday. Nor is medical rape confined to the maternity suites. (Redemption Blues)

Independent midwives’ case load is such that they have more time to spend with each of their private patients. No getting away from that. I am sure most of them have an excellent rapport with their patients too. It is a shame that that rapport is built on a touchy-feely but fraudulent framework of medical practice that falls so far short of normal safety standards that the independent midwives are uninsurable. And the generalisation about NHS doctors and midwives being callous, arrogant, inconsiderate and lacking in empathy is an unsubstantiated slur. Most doctors and midwives working in the NHS are decent people doing their best in difficult circumstances.

We are led to a "birth story" written by Amity Reed who styles herself as

“a writer and a mother as well as a reproductive activist”.

Read it. It is horrific. Do I believe it in its entirety? No, I do not. But I do believe that Amity's friend had a dreadful experience and that the midwife’s management was disgraceful. I have on numerous occasions seen midwives treat women callously, and my sympathy is thus with the patient. Before you say it, I have also seen doctors behave callously towards women in labour, but not as often as midwives.

Then we hear from Debs, who is a "radfemsister". She describes a “medical rape”

Before having our son, we experienced 5 years of ‘trying’ and failing to conceive. During this time I underwent many tests and procedures which I won’t bore you with now, but the one I’m going to tell you about was called a Hysterosalpingogram (HSG) - a stupidly long name for what is actually a very simple procedure.

How do the medical specialists describe a hysterosalpingogram:

Investigations of Infertility
The hysterosalpingogram procedure is performed in the X-ray department and usually takes about 15-20 minutes. How is the HSG procedure carried out? The patient lays on a table under the X-ray imager. The doctor inserts a speculum (an instrument inserted into the vagina to visualize the cervix), cleans the cervix from any discharge, then a fine tube is inserted through the cervix and a special contrast medium is injected. The flow of the dye from the uterus to the tubes is observed through an X-ray image intensifier (which looks like a TV screen). Films of the HSG are usually taken for the record. (IVF & hysterosalpingograms)

There is nothing stupid about the name. It conveys in one word all the information that Debs can only convey in a paragraph. It’s not a simple test. It is a sophisticated investigation requiring a high level of skill. Debs does not understand it:

When done properly, this procedure should be roughly the same discomfort level as a smear test, and last about 5 minutes. (Debs)

Simply not true. A smear usually requires a vaginal speculum to be in place for less than a minute. This test takes much longer.

Unfortunately for me my regular (very experienced) consultant was on leave the day I was due to have the procedure, and I was ’seen to’ by a much younger and evidently far less experienced doctor. I have a tilted uterus, which in itself is not really a problem, just one of those quirks of anatomy like being left-handed or something. A tilted uterus should not have been an issue in the carrying out of an HSG, but, apparently, for this inexperienced doctor, it was. It transpired during the procedure that the doctor was not even a gynaecologist, but a radiologist!

I except entirely that the “young” doctor may have been less experienced. Or it may be that Deb’s anatomy made the test more difficult perform. Debs does not understand female anatomy. All uteruses are tilted. Usually forward (anteverted), occasionally backwards (retroverted). There are a number of variants (I illustrate only two) not in themselves abnormal, but some of them can make hysterosalpingograms more difficult:



Hysteroslapingograms are often done by radiologists as they are imaging tests, and the radiologists have more experience of such investigations.

I must have asked him at least twice during the procedure to please stop, and I would wait for an appointment with my usual doctor (who had done previous procedures on me and always been fine), but he was adamant he would keep trying, despite my asking him not to. There were other members of staff in the room who just stood around looking rather awkward. When he finally did stop, and removed the speculum, I was so relieved I think I laughed, and said it was okay when he apologised. It was not okay though, and I was sore and bled for 3 days afterwards.

Leaving aside Debs poor understanding of the test, and her exaggerated presentation of the facts, we must accept that, for whatever reason, it did not go as well as expected, and was unpleasant. Things like that can happen in the hands of the most skilled operators and we all sympathise with Deb for the unpleasant experience. But then Debs loses all sense of reality. She starts to compare the experience to being raped:

And, if it was rape, how many thousands of other women have experienced unreported, unrecognised rape like this? I have never been raped, in the sense of that word as most people use it, so I can’t say, “It felt like rape”. But it certainly felt how I would imagine rape feels. And all the ingredients are there: man penetrating woman’s body, woman telling him to stop, man carrying on regardless….

No, Debs, you have not ever been raped. If you had, you would not be talking like this.

As with a lot of atrocities involving the medical profession, there is a fog of silence around this issue. Women understandably don’t want to talk about it, and the doctors definitely don’t want to hear about. It seems that often when coming across the medical profession during your life, especially if you are a woman, it is too much to expect that you will be treated with respect, and your voice will be heard in amongst all the medical jargon and other people speaking for you. It is time to speak out about this, because the medical profession provides a microcosm for the wider world. The attitudes of men in general are crystallised in the attitudes of doctors - that is, that a woman’s body is just a piece of meat, and her words are of no consequence and should be ignored.

Rape? Atrocities?? "The attitudes of men in general are crystallised in the attitudes of doctors - that is, that a woman’s body is just a piece of meat, and her words are of no consequence and should be ignored."???

At this stage, one worries about Deb’s psychological status. She really does have an obsession, doesn’t she? One wonders how she ever managed to allow herself to be impregnated in the first place. Let us go back to the first story from Amity. She said:

The idea of being raped while giving birth is difficult to imagine. In most people’s minds, rape means forced sexual intercourse where a penis is inserted, forcefully and without consent, into another person’s body. Some broaden that definition to include objects as well as body parts. But still, we often picture rape as an act of demented sexual anger and misogyny, perpetuated by sick individuals. In fact, rape is more frequently a display of power and control, a way to subjugate another human being. And it doesn’t just happen in dark alleyways, bedrooms tinged with the smell of alcohol and ‘mixed signals’, or in war zones. It can (and does) happen in some of the most respected and revered institutions in the land - hospitals.

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.

We now realise that Debs and Amity are not real feminists. They are part-time coffee-shop feminists, doing a bit of “right on” pseudo-feminist blogging between shopping expeditions and the school run. Debs and Amity are a disgrace to real feminism. They both describe admittedly unpleasant experiences in terms that any woman who has really been raped would find offensive. This sort of hysterical nonsense is frequently brought up by the pseudo-feminists as a prelude to justifying home deliveries, if possible managed by independent midwives. I have written about this on many occasions:

“Over the years, I have seen far too many women who have been raped. There will be others, patients of mine, who have not sought help from me and possibly, indeed, not sought help from anyone. I have also seen some women who have had bad obstetric experiences. Sometimes not anyone’s fault. Sometimes, sadly, there have been problems with unsympathetic doctors or midwives. I have seen patients who, as a result of their bad experiences, have developed post-natal depression. I have never had a patient compare their experience to rape. A bad obstetric experience is not rape, nor is it anything like it.

I make no excuse for some of the appalling things that have been done to women in the name of good obstetric care, but this is not rape. The worst obstetrician, or the cruellest and most unsympathetic midwife, may mistreat their patients, but this is not rape. There are far too many Caesarean Sections, but they are not rape. Hospital deliveries may not be as enjoyable experience as home deliveries, but they are not rape."

Read these two comments:

“I was a victim of rape at 14years old, a virgin. I had a hospital delivery and specifically said no epidural for baby no.1. I had an epidural (against my wishes) during transition. When being on my back and numb from the waist down it gave me flashbacks to the rape.They call it body memory. It was horrendous, so bad that my partner left me a month after my son was born. He couldn’t handle my PTSD. I had no anger towards the doctor, only myself. Of course I was angry towards the perpetrator who raped me as a teenager but I just didn’t expect it to come flooding back to me when giving birth. I had no control over this. It just happened. Completely out of the blue.

I believe that many survivors of abuse and rape are reminded of it by feeling out of control. This is what labour can do. For me it was being numbed from the waist down and flat on my back (this is how as a child I disassociated myself from the experience, by numbing and removing myself from my body).”

And a second comment from an experienced obstetrician:

"I am repeatedly struck by the high level of self-reported childhood sexual abuse and rape in homebirth advocates. I put in the words "rape survivor homebirth" into Google and found 15 separate instance of phrases like "since I am a survivor of rape, I wanted a homebirth" or "as a survivor of rape I knew that the way my OB treated me what just like rape". There definitely seems to be a notable association of these phenomena: a history of previous sexual assault, a bad childbirth experience, and PTSD. Here's my question:

Why is there such a ferocious insistence that it was the childbirth experience that caused the PTSD and not the previous sexual assault?

There seems to be a large group of women who report being sexually assaulted in some way, and they are adamant in their insistence that the assault did not have serious psychological repercussions. They were fine until they had a baby. The psychological issues became apparent then and, therefore, it must have been the doctor's fault.

What is going on here? No matter what the doctor did, it could not begin to compare to the original assault. I am almost forcibly struck by the level of anger toward the doctors. Yet there is a curious lack of emotion toward the original assailant. The level of anger directed toward the doctor seems startlingly high, and the level of anger toward the assailant seems curiously low.

It feels like there is a psychological need to blame the doctor INSTEAD of the original attacker. Why should that be?" (Dr Amy Tuteur MD - homepage)

Childbirth is a painful and dangerous business. It is more dangerous to a woman’s health than anything she will experience until she reaches old age. It can be traumatic and it can go wrong. We must do everything we can to make sure we minimise the disasters and provide support thereafter. However good our care, things will go wrong. However kind most doctors and midwives are, there is always the occassional rotton apple. So, however hard we try, a few women will have bad, or even awful, experiences.

But rape? No. Bad obstetric care is not rape.

Introducing the concept of rape into a discussion on the merits of home births is an attempt, consciously or not, to hi-jack the argument. It reflects some deep primeval fear of childbirth and fear and resentment of doctors, particular male doctors. Worst of all, pseudo-feminists like Debs and Amity demean and trivialise the experience of women who have been raped.

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Amity tried to put a long reply to this post into the comments, but it got lost in cyberspace. Her more detailed reply is over at "The F Word" and starts:

Amity Reed has written a response to comments on her birth rape feature for The F-Word, made by an NHS doctor blogging under the name ‘Dr Crippen’.

Having just emerged from yet another luxury shopping trip between school runs and coffee shop natters with my other part-time feminist friends (Ha! I am a full-time feminist and an at-home mother struggling to put food on the table many weeks, thank you), I was not at all surprised to read this scathing dismissal of medical and birth rape victims. The author’s characterisation of these women as fantasists, delusional and hysterical females with ridiculous expectations of bodily autonomy, was resignedly expected. Dr. Crippen exhibits the very lack of empathy that Debs and I dissected by dismissing these stories outright. In a move straight from the misogynist medical handbook - make them feel stupid and reinforce knowledge over personal experience - he follows the checklist to a T:

Refusal to acknowledge the patient’s experience? Check. Outright discounting of her interpretation of events? Check. Use of words such as ‘sophisticated’ and ‘high level of skill’ to reinforce authority? Claims of patient ignorance and ‘exaggeration of facts’ when he was not even present for the event? Yep, it’s all there, in all its ugly and hateful glory. This is exactly the kind of arrogant attitude that creates a chasm between those with a skilful and sympathetic bedside manner and those whose emotional detachment can lead to patient violation.... full post here

The F Word welcomes comments, provided they agree with them. They say:

This blog is a safe and friendly space for feminists and feminist allies. Debate and critique are welcome where it is constructive and deepens analysis or understanding. Anti-feminist comments will not be approved. We get to decide what's anti-feminist.

That's a feminist's definition of freedom of speech, I suppose.