“I Was Given an Episiotomy Without My Permission”
With this article we’re launching a new series on the Nurx blog where we’ll share first-person accounts of people’s experiences living in, loving with, and caring for their own bodies. The aim of the “Our Bodies, Our Stories” series is to raise authentic voices around sensitive issues and bring even more real talk to our corner of the internet. In doing so we hope to dispel some of the stigma and uncertainty that people too often feel when it comes to their own sexual and reproductive health.
“Can you feel this?”
The female doctor was asking from in between my legs, a place I could no longer see because it was blocked by my rounded belly. On my back, feet in stirrups, I really didn’t know who was down there; it could have been a party for all I knew. I was at a teaching hospital and a good ten unfamiliar floating heads were peering down at me over the drape covering my legs, so there were likely a few more underneath the covers.
“No.”
My answer was short and disinterested. I’d been laboring for nearly twenty-four hours and I was tired. Just twenty years old, and with no family in the room save for my also too-young husband, I wanted this to be over.
Moments later my daughter came forth, slipping out of my body like a wet, flopping fish after the intense stretch of crowning. She cried, I breathed, and the nurses whisked her away. I asked for her, but they kept her, checking this and that, because her arrival was preceded by a long, medication-induced labor after an emergency diagnosis of preeclampsia.
After what seemed like hours — but may have been seconds, I can’t be sure — the doctors passed my now burrito-blanketed baby to my husband, and I asked for her again.
“You can see her in just a minute, we have to stitch you up first,” the doctor said.
Wait.
What?
“Stitch what up?” I asked.
“We just made a small cut called an episiotomy.” She replied nonchalantly.
I knew what an episiotomy was. And I didn’t want one. I said that I didn’t want one, and I included it in my now-useless printed birth plan that I provided to the nursing staff when I was checked in.
(An episiotomy is a medical procedure and birth intervention that involves making a small cut to the perineum, the skin between the bottom of the vaginal opening and the anus. It is typically done to widen the vaginal opening and assist the doctor with birth.)
I lay there, feeling nothing as some of the most intimate parts of my body were sewed shut by someone who couldn’t be bothered to ask me if it was okay to cut them or to even notify me of the procedure before it was performed. Perhaps even worse was that this most basic violation of my human rights came at the hands of another woman.
A Year Too Late
The rate of episiotomies in the United States has been steadily declining since the late 1970’s. In 1979, 60.9% of women who gave birth in America were given an episiotomy, but by 2004 that percentage had dwindled to 24.5% according to a 2017 study published in The Journal of the Turkish-German Gynecological Association.
In 2006, The American College of Obstetricians and Gynecology published a practice bulletin stating that although episiotomies had been a common practice during U.S. births, “prophylactic use of the procedure does not result in maternal or fetal benefit and should be restricted.”
My daughter was born in August of 2005.
Maternal Mistreatment During Birth (It’s Not Just Me)
Women are at their most vulnerable when they are giving birth, both vaginally and surgically. It stands to reason that nurses, physicians, and other medical professionals involved in the care of women during birth would be sensitive, responsive, and caring towards their patients. After all, primum non nocere — first, do no harm.
The World Health Organization (WHO) cites a BMC Reproductive Health study where the authors address the issue of women being mistreated during childbirth. They suggest, “Midwives and doctors may use abusive techniques to get women to cooperate, and paradoxically some women accept such mistreatment if they believe it will benefit their health or their baby’s health.”
The WHO’s official statement on the poor treatment of women during childbirth puts into very clear words just what makes this issue such a critical one for women worldwide:
“Mistreatment of women during childbirth occurs in countries across the world and puts the lives and well-being of women at risk. It also constitutes a violation of the right to the highest attainable standard of health, which includes the right to dignified, respectful healthcare throughout pregnancy and childbirth, as well as the right to be free from violence and discrimination.”
Undoubtedly, the clear, unapologetic stances that powerful health organizations like the ACOG and WHO have assumed on this subject has impacted how birthing is approached by medical professionals — my son’s birth in 2011 was dramatically different. With limited people in the room and few medical interventions, I left that experience feeling more of what a woman should feel after childbirth — cared for, validated, acknowledged, and respected.
But have they done enough?
Women continue to experience mistreatment during birth, especially in smaller hospitals in rural areas. Disabled women, unemployed women, women of color, and women in other minority groups are at a much higher risk of mistreatment than white women. CNN reports that between 700 to 1,200 American women die from pregnancy and childbirth complications every year, and black women are three to four times more likely to die during pregnancy and childbirth than white women.
Where Do We Go from Here?
I’m not sure exactly where we, as women, go from here. I don’t know what it will take to get maternal healthcare from where it is are now to where it needs to be — a field of medicine that holds, nurtures, respects, and cares for women during the many different aspects of pregnancy and childbirth. I don’t know how to make busy obstetricians care more about their patients than they do their convenience.
But I can say this:
We, as women, can support each other. We, as women, can advocate for our friends, our sisters, and our daughters. We can hear them, validate them, and we can make their voices louder by using our own. We can say no, and we can help other women say no.
I was given an episiotomy without my permission, and that’s not okay.
About the Author
Kaylen Jackson is a 14-year writing veteran. Kaylen lives life with the philosophy that there are few problems that can’t be solved with a hug, a snack, and a nap.
This blog provides information about telemedicine, health and related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.
