Ashley Collins pushed for three hours when she gave birth to her first baby in 2013, but the pushing wasn’t the hardest part.
The hardest part was trying to block out the nurse — who had her hands inside Collins’ vagina — who kept scolding her.
“She was telling me ‘You aren’t pushing right,’” recalled Collins, now a 34-year-old mother of two. “And then would say to the other staff, ‘She’s not pushing right!’ as if I wasn’t there—in an annoyed tone.”
Collins’ baby required a forceps delivery and he spent five days in the NICU, an experience that was challenging, physically and emotionally. The nurse’s behavior toward Collins only added to her load. “I found her to be incredibly rude,” she said.
Like Collins, nearly one in six women in the United States believe they have been mistreated in childbirth, according to a new survey recently published in the journal Reproductive Health.
Of more than 2,000 women who responded, roughly 17 percent said they’d been yelled at, believed they’d been scolded, or threatened; ignored or denied some kind of help; or they’d experienced a mix of those things. And women of color were far more likely than white women to say they’d experienced mistreatment, as were low-income women.
“I was surprised to find that the top two forms of mistreatment during childbirth were shouting and scolding,” Monica McLemore, an assistant professor of family health care nursing at the University of California, San Francisco, and an author on the study, told HuffPost. “I find that to be unacceptable.”
Notably, the survey received funding from the Transforming Birth Fund, which provides grants to projects that support its aim of lowering medical intervention during birth.
Jessica Illuzzi, an OB-GYN and section chief of Yale School of Medicine’s Obstetric and Midwifery section and who sits on the board of the American Association of Birth Centers, told HuffPost she has some concerns about the study’s inability to fully tease out the relative contributions of women’s race and where they delivered to mistreatment.
“I worry there are many consumers who grab onto studies like this and use them to say, ‘See? See! We shouldn’t give birth in hospitals,’” said Illuzzi. “We need to put this in context. Not all hospital birth leads to mistreatment. Not all hospital birth leads to the use of over-intervention.”
But the findings nonetheless draw attention to the fact that many women believe they are being unnecessarily scolded, yelled at, and more during labor.
“I was told I was hurting my children and being selfish because I wanted to have a vaginal delivery,” said one study respondent who said she was “forced” into a C-section by her OB-GYN. “I hated being shouted at and lied to by the midwife,” said another.
HuffPost Parenting posted a callout on our Facebook page looking for stories of women who’d been mistreated during labor, and we were inundated with hundreds of emails and comments detailing experiences that ran the gamut from perceived snide comments to physical abuse.
“My experience was traumatic, and my husband and I are expecting again,” Meghan Antosh, a mother of three, told HuffPost. She says she was bullied when she opted not to get an epidural, and then ignored after delivery, which led her to hemorrhage. “I am very scared to give birth again because this taught me that I cannot trust the nurses and I must be my own advocate.”
The challenge in addressing this problem is that there are many contributing factors, and at least some of this is subjective.
Childbirth can be a pressure-filled experience — the stakes are always high, as it is — and doctors, midwives and nurses might speak to women in ways that come across as unintentionally rough, even demeaning. Illuzzi said sometimes when she is working with medical students who are relatively new to labor and delivery, they’ll express surprise at hearing an OB-GYN speak in a way they feel is stern. “You do have these difficult situations, where a provider might say ‘You have to roll over now because of your baby’s heart rate,’” she said. “And a patient might think, ‘I’ve been yelled at.’” Illuzzi offered that example not to let providers off the hook, but to show how miscommunication and misperception frequently coexist.
But there is also ample evidence that maternity care in the United States is in crisis. Women have higher rates of death and serious complications than women in other developed countries — and major health groups like the Centers for Disease Control and Prevention say the majority of those deaths are preventable. And while mistreatment may not always be a contributing factor, it — at a minimum — points to a system that could be doing better for women.
“You know, I’m a nurse by training and hearing a lot of these stories was hard for me to manage,” McLemore said. “It’s hard to know that people are doing and saying these things.”
For now, McLemore says women can take steps to protect themselves against potential mistreatment in the delivery room by making sure they have a support system with them.
“Your job is to give birth,” she said, suggesting women consider hiring a doula who can advocate for them as needed.
Illuzzi also believes women can be well-served by giving births in hospitals that embrace what she calls a “collaborative model of care,” which often means midwives and doctors work closely together, and where the nurses are on board with helping women give birth how they would like, to the extent that is possible.
“All women need to be able to give birth with dignity, to be able to make informed decisions, and to have access to high-quality, evidence-based care, no matter their race, age, or socioeconomic status,” said Illuzzi. “I believe that is what the authors of this study are saying, that is what women are saying, and I believe all OBs and nurses would agree. We all agree. So we have to come together to make it happen.”