"My midwife says she'll let me eat during labor, but only if things are progressing quickly enough."
"I have to have an episiotomy if I push for longer than 45 minutes."
Every time I hear comments like these, a part of me dies. Since when did pregnancy mean that your body no longer belongs to you? Whatever happened to informed consent? And why are doctors, who should not want to force anything on anyone else's body, embracing this language?
It's time for feminists to recognize that reproductive choice is not limited to abortion, and that bodily autonomy is not limited to rape. Seventy percent of women who experience episiotomies--a largely unnecessary cutting open of the vagina--say they did so against their will. Seventy percent! The fact that we, as a society, are willing to openly embrace female genital mutilation solely because a woman is pregnant and a doctor insists that it's "for the baby" speaks volumes. Women do not cease to be people solely because they are pregnant.
The Angela Carder Case and the Horrors of Reproductive Coercion and Court-Ordered Medical Procedure
If you really want to understand what can go wrong when women lose reproductive autonomy during childbirth, then you need to know about the Angela Carder case.
Angela Carder was a woman who suffered from cancer at 13. The cancer recurred ten years later, but she fought it off. Twenty-five weeks into her pregnancy in 1987, Angela learned that she again had cancer. Because the fetus was so young, its chances of survival, especially as long ago as 1987, were not good. Angela sought radiation and chemotherapy in spite of the risks to the fetus, desperate to save her own life--a life upon which her fetus's life also depended.
Sadly, Angela quickly deteriorated. Her doctors supported her decision to continue aggressively fighting her cancer, but when hospital administrators caught wind of things, everything changed. The hospital's risk management specialist questioned Angela's right to pursue chemotherapy--a decision supported by her parents, husband, the entire obstetrical department, and the hospital's lawyers.
Nevertheless, the hospital sought a judgment to overrule Angela's wishes and sought a court order for an immediate C-section. The family continued to oppose the C-section. Hospital obstetricians were so opposed to the surgery that they refused to participate. A staff obstetrician ultimately agreed to perform the surgery.
Angela's last words about the surgery were "I don't want it done." They might have been her last words ever. The surgery killed Angela and her baby.
Ultimately, a D.C. Court of Appeals ruled that the surgery was illegal and that Angela had the right to make decisions about her own body and her own baby. Of course, it was too late for Angela, but the story remains a cautionary tale for pregnant women, pushy doctors, and the hospitals that push needless and dangerous surgical interventions.
You Have a Choice
Most women don't face a cancer diagnosis or a court order during pregnancy or childbirth. Instead, coercion is more subtle. Doctors often phrase their opinions as legal judgments: "You have to do this," "We need to act immediately," "I'm just going to make a little cut..."
Sometimes they guilt women: "It's for the baby!" "Motherhood means making tough choices!" "Are you really going to let your fear of a scar endanger your baby's life?" The message here is clear: oppose me and you're a bad mother.
To women who are worried about their babies, in pain, or terrified of birth, this subtle pressure can be too much to resist. No matter what your doctor says, though, you have a choice.
That's right. It doesn't matter if your choice endangers your baby or offends your doctor. It doesn't matter if your reasons for the choice are stupid, trivial, or ill-informed. You have a right to control what happens to your body. You are the one who lets your doctor make decisions, not the other way around.
Doctors Don't Always Know Best (and It Doesn't Matter if They Do)
Most of the time, doctors make recommendations because they truly believe those suggestions are in their patients' best interests. Most doctors are good people who are deeply invested in their work. So it makes good sense that they would phrase their judgments as final verdicts. Your doctor really does want the best for you and your baby.
The problem is that sometimes doctors are wrong. Fear of lawsuits, hospital policies that preserve convenience rather than safety, and unsupported medical traditions conspire to bias doctors' judgments. What your doctor tells you to do might not be the right thing. Indeed, the more opposed your doctor is to considering outside opinions or presenting you with evidence, the more likely it is that he or she is wrong. After all, people who are really certain that they are right are not threatened by a little research or a second opinion.
Even if your doctor is right and you are wrong, your right to informed consent does not evaporate. Courts have ruled, for instance, that patients can say no to blood transfusions even when doing so will kill them. You own your body. Not your doctor. Not your spouse. Not the hospital. Not even your baby.
If your doctor does something to you against your will, it's not just an inconvenience. It's an act of medical battery. It's only battery, though, if you stand up for yourself. As long as women continue to believe that doctors "let" them do things, women will continue having little reproductive autonomy during labor and delivery.
You own your body now and forever. Don't let anyone take that away from you.
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