Hidden wounds: obstetric violence and its impact on maternity professionals
Maternity care is a sacred space where compassion, support and empowerment should reign. But often lurking beneath the surface is an undercurrent of systemic toxicity, eroding the emotional and physical wellbeing of those dedicated to this noble profession, as Laura Spence reflects.
Starting the conversation
As a midwife who recently left the profession, I feel compelled to shed light on the dark side of maternity services, which can have a profound impact on both the woman and the professionals who are trying to fight against it.
This blog explores the meaning of obstetric violence, its consequences for patients and caregivers, and the ethical dilemma faced by midwives in such situations.
Understanding obstetric violence
Obstetric violence refers to acts of mistreatment or abuse inflicted upon women during pregnancy, childbirth and the postpartum period. It encompasses a range of violations, including physical, verbal, emotional and psychological abuse by healthcare providers.
Impact on the woman
For the woman who is directly affected, the consequences of obstetric violence can be far-reaching. She may experience intense fear, helplessness and a loss of trust in the healthcare system.The trauma inflicted upon her can have lasting effects on her mental wellbeing, self esteem and future reproductive experiences, potentially leading to post-traumatic stress disorder (PTSD) and a profound sense of disempowerment.
Impact on maternity professionals
Obstetric violence can also take a toll on the healthcare professionals who witness or are involved in such events. As midwives, we are driven by a deep commitment to compassionate care. However, encountering obstetric violence challenges our professional identity and core values.
Vicarious trauma, stemming from witnessing the abuse inflicted upon the woman, can cause a range of emotional responses, including guilt, anger, powerlessness and a sense of betrayal. It erodes our confidence and can lead to burnout, ultimately driving professionals away from the field they once loved.
Ethical dilemma and duty of candour
Midwives can find themselves in an ethical dilemma. While our duty of care requires us to advocate for the wellbeing of our patients, we also face the reality that obstetric violence may be carried out during what may be a life-saving delivery. This delicate balance necessitates tact and strategic decision-making, as we must prioritise the immediate safety of the woman and her baby, while seeking to address and rectify the abusive behaviour.
Challenging these situations in the presence of a patient risks further traumatising her, making it essential to handle the situation deftly and protect her from further harm.
Escalation and duty to support
Rightfully, when any act of obstetric violence is witnessed, it should be escalated to management. Very often though, following escalation there is a lack of action and subsequent disregard for the recognition of the act, perpetuating a culture of silence and neglect. This leaves the professionals feeling unsupported and abandoned.
It is essential for healthcare organisations to prioritise the wellbeing of both their patients and staff by implementing policies that address and prevent obstetric violence, providing avenues for reporting and support, and fostering a culture of transparency and accountability.
Conclusion: demanding change
Obstetric violence inflicts deep wounds, both seen and unseen, on women and the professionals who care for them. It is a violation of human rights, a betrayal of trust and a stain on the integrity of maternity care. There is an urgent need for change within the system, demanding action from management, and a commitment to the principles of compassion, respect and accountability.
The shared objective of maternity services is to ensure each woman's childbirth experience is met with dignity, empowerment and unwavering support from dedicated healthcare professionals.
Midwives deserve a leadership and management framework that showcases professional respect and promptly addresses their escalations and concerns, thereby enabling secure and compassionate birthing experiences.
Read more about obstetric violence in our blog post Obstetric violence: what is it? or What does ‘violence’ mean in obstetric violence?
If you’re a birth professional looking for support, we recommend our Support for Professionals pages here.