Victim blaming in the birth trauma world is alive and well. Vicarious trauma is often referred to as a “trigger”. Basically it means that we are traumatised (triggered) by either witnessing, or predicting trauma. Empathy and vicarious trauma can unfortunately team up to become angry bed fellows. Many of us have felt frustrated by a friend who’s requested an induction, or an unnecessary caesarean. A friend who claims to like non evidence based practices or claims to find them comforting. Someone who blindly follows the advice of a knife happy obstetrician despite all your best efforts to educate them.
It can awaken vicarious trauma in even the most stalwart birthy bystander. The bottom line is that it isn’t the woman being induced who should be under the spotlight. Not until women can inject syntocinon (pitocin) into their own veins. If you blame the woman, you are victim blaming.
Our society is so hell bent on personal responsibility that victim blaming is common place. Meanwhile the people who are actually responsible for endangering women with their unnecessary interventions, sit tight. They’re laughing all the way to the bank. Their actions neatly sidestep social discourse, because we’re so hell bent on blaming individual vulnerable women.
As Marsden Wagner asserted in his essay Fish Can’t See Water: The Need to Humanize Birth:
Some women might be willing to risk themselves, but given all the facts about these interventions, very few women would be willing to risk their babies.
Unnecessary interventions carry great risks, we know this because science has shown it to be true over and over again. Any woman who is being misled by a care provider is unquestioningly a victim of obstetric culture.
Just to be absolutely clear here, no one is suggesting that medical intervention in pregnancy is not lifesaving. Sometimes it is. No question about it.
The prevalence of intervention in pregnancy and childbirth is the problem. Routine interventions have become so normalised, that often people are surprised by births that proceed without them. Curiously they are seen as optional, but you can only opt in, not out. In other words, you can choose to be induced because your dog and cat are getting married. However if your doctor books an induction and you politely decline, people think you’re reckless.
Then there are those who come at it from the other perspective. Those of us who have been victims of unnecessary interventions and iatrogenic complications. Once you’ve had that experience, you can never quite grasp why a woman would want a scheduled induction. Not unless you can see it differently, without victim blaming. You can surmise that it’s about lack of support, stupidity, convenience, or ignorance. You can even see it as a personal slight against you. In reality it rarely has anything to do with any of that.
We have a false perception when it comes to safety and medical interventions in pregnancy and labour. And here is the crux of the issue: The only reason a woman can access unnecessary intervention is if a doctor ignores their hippocratic oath. ‘FIRST DO NO HARM”. It doesn’t matter whether or not the woman has been offered alternative information. This is because since the moment of her own birth she has been trained to believe doctors. Trained to believe that birth is life threatening to every woman. Going against all of this, is impossible for most women.
What is most insulting is that often they tout themselves as great allies of feminism. Brave surgeons smashing away at the glass ceiling, performing unnecessary procedures on pregnant women and babies. However we can see this for what it is when it comes to seeking providers for different choices in childbirth. VBAC (Vaginal Birth After Caesarean) is perhaps the best example.
“Sure we’ll induce you because your husband has a football game on your due date”(no mention of the risks of induction.: The high caesarean rate, premature birth, or foetal distress) and then two years later “No, you can’t possibly VBAC, that’s far too reckless”.
Those who seek to reduce the harm caused by unnecessary intervention must avoid blaming women. Even women who “choose” unnecessary intervention should not be held accountable. Don’t beat about the bush here, blame the gatekeepers.
Knowing about vicarious trauma can help us enormously in situations where friends are being led up the obstetric garden path.. We need to avoid adding to the pressure women feel when they are at their most vulnerable. It’s possible to be passive in our support of friends who are facing these decisions, without condoning them. This does not mean that you should avoid sharing information. Quite the contrary actually. You should provide as much information as possible. Just know when to back off. It requires great sensitivity which can be difficult when you have suffered birth trauma.
Vicarious trauma can cause caring friends to become quite agitated by decisions they themselves would not make. We must remain mindful of the fact that we are in the extreme minority. Your friend may come to you if things don’t turn out how she hoped, it’s certainly been known to happen. If we’ve been yelling at them to change course and they have refused ….. will we be their first port of call if they find themselves traumatised? That’s unlikely. If on the other hand we empathetically support them, they will know they can come to us.
Conversely, things might turn out just how she hoped, which can be even more triggering. Sometimes, awareness of evidence based practices and obstetric violence is a double edged sword. Knowing that you might end up feeling like this can actually help. It’s hard because you want your friends to be safe, but you also want validation. You want to be able to say “I TOLD YOU SO!” Reach out to a support group if you need to, try to avoid burdening your friend.
Always remember that it is not your responsibility to save everyone. It’s not your friend’s responsibility to know better either. We must avoid victim blaming, at all costs. Until women can waltz into a pharmacy and buy synthetic hormones to induce their own labour. Until they can perform their own caesareans, women can never be held accountable.
The blame for the over use of obstetric intervention falls squarely on the shoulders of the obstetricians. If there is any hope of fighting back against obstetric culture, it’s essential to cease blindly worshipping “the individual”. Whilst it may trigger us when our friends blindly trust dangerous care providers, it is not their fault. Blame must be placed squarely on the shoulders of the obstetricians. Victim blaming needs to stop. Women are unable to access things like induction and caesarean without obstetrics enabling it, so women are not to blame.
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