AIBU to really hate the term "birth rape"

[laumiere]

It's from this story where a woman is allegedly put under a GA under her will and given an emergency C section. All very unpleasant (although it does throw up the question as to how much we really expect to control a process which at a basic level is still capable of killing us and our babies) but commentators are starting to term it 'birth rape'. As a rape survivor and someone who has supported rape victims as part of my job I am so sick of this term being overused and devalued! (This goes double for the moronic "draping" on FaceBook).

Just regarding the DH - it surprises me that people mention him so much. Maybe it's different in the US but in the UK no one - not even a partner - can consent for an adult who has capacity.
If a patient lacks capacity (the ability to retain relevant information, weigh the risks/benefits and make a decision) then the decision has to be made by the consultant in charge of the patient's care.
You can't do an operation on someone because their DH agrees. Nor can a DH prevent an operation if the patient consents.
Family are often included in the consent process - it's good medical practice and formalises communication - but in the end it's down to the patient (as long as they have capacity).

I think people are mentioning it because the lady herself mentioned it and is using that as part of her complaint.

I agree with LeQueen

so if 'birth rape' or perhaps better 'medical assault' is the term for doctors doing C-sections without consent then what is the correct term for being denied a c-section or adequate pain relief to the point that you are just screaming incoherently for hours on end?

I am going to write a letter to the hospital (although not necessarily send it) and I need a good word to express this concept.

One point in her story is the mask. I've had two major operations in the last year, both with a spinal block and then a light GA to knock me out. Both times the GA went in through the canula in my hand, but I had oxygen through the mask. Both times I have little memory of the actual process, it all gets a bit hazy at both ends. I think there was definitely a portion of time when I was concious but I have no memory of. I think it's entirely possible that is the same for this lady, in that it WAS just oxygen in the mask, but she doesn't remember the GA. Its entirely possible they told her what was happening at that stage, and entirely possible that they had minutes to save the life of her DS.

However, if this is the case, someone should have explained this to her afterwards, before she lef the hospital. That is shocking, regardless of what happened in theatre, she does have the right to know.

lequeen I think I love you a little bit

Two sides to every story and I would live to hear the medical professionals version. Bet it's very different to hers.

The thing is that the medical opinion of experts varies so much between experts, and is so guided in many instances by protocols that relate to finances not patient care.

LeQueen - modern medicine does not work on the basis of 'stupid ignorant patient and expert all-powerful doctor'. Look at the GMC's 'Duties of a doctor' guidance. It's all about respect and shared power - the patient brings their knowledge of their individual history, expectations, beliefs to the consultation or procedure, while the doctor or surgeon brings their understanding and expertise. Which is clearly very significant indeed (although in chronic disease, often the patient can be more expert than their GP, or even consultant - for example, in an area like allergies where there are few true allergy specialists, and you get dermatologists doing eczema and lung physicians doing asthma, but the patient has both and perhaps other problems as well. Or in rare conditions, where a doctor may only see one or two cases over their entire career).

Surgery is clearly an area where the surgeon knows a hell of a lot more than the patient about the actual operation. And obviously with emergency surgery decisions need to be made right now, without too much havering. But it's entirely possible that this surgical team moved far too fast, because they disagreed with the patient and did not respect her autonomy. Cutting someone open without consent, unless they are not in a position to give or withhold consent, is rightly defined as illegal in this country. May well be different in the US which still has a much more paternalistic attitude in medicine.

And it may well be that the patient hasn't got the full picture about what went on - which is a failing on the part of the medical team, who should have ensured she understood fully, either at the time, or if there was not enough time, afterwards.

In America the fetus I believe has rights. Wheras in UK it doesn't.

So I don't know if that means if a woman didn't consent to an em lscs they could do it anyway. In the UK they couldn't.

When leQueen puts it like that it's very difficult to argue with her (13.55 post), although I will try. Who would ever want to justify the risk to an unborn baby?

Well sometimes we have to, to ensure women are not devalued into mere incubators. I believe it is accepted legally that the life of the mother is of paramount importance in any situation where she and the child are both at risk, this is absolutely right, ( I know in this case the mother doesn't appear to have been in danger.)

However, we can fall into dangerous territory if we put the needs of the foetus above that of the mother; if we start a culture where the mother's wishes are being routinely ignored, ( yes some people are misguided but sometimes it is just easier for heath professionals to ignore their wishes), then you could start on the slippery slope to eroding all the rights and freedoms regarding our bodies and reproduction.

Regarding the phrase 'birth rape', I'm not happy with the term, although the loss of control, helplessness, pain and vulnerability that goes with non-consensual medical intervention does feel like a violation.

The more I think about it, the more I think that this case (regardless of what really happened) provides the basis for some really interesting ethical Qs.

Since we are pretty much in the realm of 'what if' with this anyway....

• What if you were in a country where abortion was illegal? And you didn't want to be pg? Would it be 'more okay' in that case to refuse EMCS because of the risk to yourself?

• Does a mother actually have a right to refuse EMCS? I mean, here it's not clear that she even tried to refuse the op, but what if a dr said to a labouring woman that EMCS was the only way to save her child - would she have a right to say 'No thanks'?

• To LeQ and others - have you never felt a that a dr was honest to goodness genuinely wrong? If you did feel that would you not try to argue with them? They sometimes are, you know! Maybe not here but in general, don't you think patients can sometimes be in the right?

If I thought the doctors were wrong I would go back for a meeting to discuss my case, the women didn't want to. I wouldn't try to find a lawyer to sue without going and talking to the hcps who were in charge of my care.

Moomin I guess I meant right there, in the moment.

As a random e.g.: DSis3 had a very aggressive form of cancer as an infant. Once, my mum had to race her to the hospital in our family car because the consultant paediatric oncologist (or equivalent thereof) had inserted some tube wrongly. The guy who had done it was really experienced but apparently it was a v tricky operation. After a day or so my mum was convinced it just wasn't right and took her back. Turned out mum was correct and DSis3 could have died.

So, in a case like I mean, would you argue the toss, or would you just listen to a dr saying 'Look this is my speciality and I know what I'm talking about'?

I think it is actually a really interesting question, and a tough one!

Revolting peasant, in this country you have the right to refuse any medical procedure. Even if it means you and dc will die. Unless they can prove you do not have capacity, I.e. Are mentally ill etc.

Ive had an emcs due to cord prolapse, there was no time to argue the toss. I know they were explaining what they were doing to me on the ward.

They also explained in theatre that I needed a ga because the babys heart beat suddenly dropped, but I don't remember any of it.

"But, there must reach a point where the doctors and HCPs must oft feel like screaming 'Just shut the fuck up, you Muppet who even failed to pass GCSE Biology. I have trained and studied for years to do this - and if you don't let me do what I do, there's a chance your baby might die.'"

I sincerely hope not.

The doctors I know well are nowhere close to being that arrogant (or dim).

peasant I definitely don't think that drs are above doubt. I think that is a false representation of those on this thread. Burke its a life or death situation. To much at stake for taking the risk. All the protocols that avoid litigation, avoud litigation because they avoid dead babies.

there are plenty of cases where doctors have been wrong that spring to mind.

my mother for instance, was in hospital in labour. they said 'right, lets' induce you' she said 'no, i'm in labour', they said 'you are risking your babies life' - she said ' No, you're making a mistake, I'm in labour'

fortunately i crowned then, saving further argument. They had the wrong womans notes. but she shouldn't have argued with the experts eh?

in this case i think it entirely possible that she found an OB that would support her VBAC, but he wasn't there on the day. The one that was, just said no, so they made some fuss and carted her off to the OR (specuation, but fits the story). bear in mind that - rather similar to Roe vs Wade - women may have a right to a VBAC, but actually being able to access one is apparently very difficult in areas of the states.

God, this is like a parallel universe. I find it extremely easy to argue with LeQueen, other than where on earth to start.

Let's see, we're saying that an HCP should feel reasonable to think 'shut the fuck up you muppet' in relation to a woman's feelings and opinions in relation to the birth of her child. Where do I even start to explain how ridiculous and offensive a comment this is.

On a separate point, the term rape does not belong to any one person. It relates to a violation, this woman didn't use the term herself but clearly felt violated.

I've heard it used by other women who had forceful examinations and interventions in a birth situation. Personally I absolutely understand the sentiment. If you've been held down and had a hand or instrument forced into your vagina while shouting 'no' I don't see the distinction between a man in an alleyway or an HCP regarding you as a muppet. And I didn't realise, LeQueen, that a GCSE in biology was required to determine the difference.

yes cervix and an inability to listen to the patient is associated with worse outcomes. Not better.

That's why it's nice to see MN being asked to comment on a draft for NICE about ante-natal care.

one of their aims being that care is well explained, justified and consented to.
Plenty of women on that thread reporting poorly explained and unconsented actions by HCPs too.

see leq the professionals think it matters: why don't you?