What are the childbirth conditions in Belgium? To objectify situations that are still too often overlooked, the Platform for a Respected Birth launched a major survey in the Wallonia-Brussels Federation which surveyed 4,226 women and the results of which were unveiled on November 19.
“Gynecological and obstetric violence is not a myth“, writes the Platform in its report. Deleterious acts, such as abdominal expression [un acte consistant à appliquer une pression sur le fond de l’utérus afin d’accélérer la sortie du bébé], live acts [pratiqués sans anesthésie ou avec une anesthésie inefficace] and the point of the husband [le fait de recoudre une épisiotomie plus serrée, pour soi-disant augmenter le plaisir du mari lors des rapports sexuels] continue to be practiced“.
And the figures are indeed startling: 1 in 5 women has been the victim of this violence. When they are racialized, the figure rises to 1 in 3 women. If they have a high school education or less, the figure is 1 in 4 women and if they come from the province of Liège, the figure is 1 in 4 women.
“We suspected it even if the caregivers told us that there was no problem in Belgium. And the objective of this investigation is not to make them feel guilty individually, but to show how this violence is systemic.“, explains Florence Guiot, president of the Platform, to Grenades.
“The hospital is increasingly becoming a capitalist enterprise, which puts pressure on the employees and leads to violence. Births are standardized because they have to be cost effective, but not all births are the same! A childbirth, and it is not a trivial event. It is a moment when the identity of parents is also built. Suffering from gynecological and obstetric violence has serious and very broad consequences. Some couples do not survive it, for example. Pediatricians and psychologists also tell us that they are seeing the repercussions of this violence in their practice with children and families. We must take care of women who give birth“, she continues.
If you don’t calm down, I’ll give you a [anesthésie] general and you will not see your baby today
Verbal violence and … slaps
By refining the figures, the survey specifies that one in four women reports having experienced psychological violence during childbirth. 6% of them report having experienced verbal violence and almost 3% … physical violence. “We are talking about slapping or physically pushing women during childbirth by the nursing staff. Everything happens as if there was an escalation in the violence, first it is the doctor who enters the delivery room without saying hello, then who performs acts without explaining what he is doing, then verbal aggression appears if the patient asks questions, etc. There is still a real denial surrounding this violence, women have discovered that they have experienced some violence by answering the questionnaire.“, souligne Florence Guiot.
Several women testify in the report: “When they sewed me up, I reported it was very painful and I was told “take care of your baby, it will change your mind”“, “If you don’t calm down, I’ll give you a [anesthésie] general and you will not see your baby today“, “Force exit from the car by 3 men who pulled me and undressed me by pulling“, “Persistent feeling of a missed appointment, over-medicated, without pleasure, a waste while meeting and welcoming your child should be a tender and harmonious moment.“
In the survey, twenty women explained that they had refused acts, but their choice was not respected. The act performed was not explained in two out of three cases and consent was not requested in half of the acts performed.
According to Florence Guiot, this perpetual violence takes place “at a crossroads of several causes” : “There is the patriarchal culture, but also the way in which caregivers are trained which leads to the reproduction of violence. The skin color of patients also plays a role, and the way they express themselves, if they are going to dare to ask questions. Finally, there seems to be in Liège a hospitable culture conducive to violence. We know that midwives and nurses from Liège come to Brussels to give birth. There are great disparities depending on the hospitals and this is not normal.”
Force exit from the car by 3 men who pulled me and undressed me by pulling
“I still suffer from that moment”
Véronique gave birth almost a year and a half ago, in the middle of the health crisis. She participated in the investigation. “It’s difficult for me to talk about my childbirth, it plunges me back into not very pleasant moments“, she explains directly.”My delivery lasted 27 hours. On the big day, I went to the hospital but was told that my cervix was still closed. Except that an hour later, I was losing water. When I returned to the hospital, I was immediately told that I was in the worst situation: I was losing amniotic fluid but my cervix remained closed. I went home and came back at midnight as requested. I was having contractions.”
But the reception of the nursing staff is freezing, says Véronique. “I don’t blame them, they were overwhelmed. The midwives put us in a room and I couldn’t figure out what was going on. My companion went to get my things and a midwife wanted to check my cervix for the umpteenth time. It’s a vaginal examination but I’m in a simple room, there is no stirrup and I lost my water so I’m soaked, there is no protection on the bed. She is aggressive, brutal and still tries to give me a vaginal examination. I am in great pain and I tell her but she continues. The amniotic fluid is leaking and I don’t feel well. I still suffer a lot from that moment today, I don’t want to be touched any more, not even for sexual intercourse for example. ” Véronique breathes.
“The midwife told me I was not in labor, so I repeated this phrase to myself all night. “I’m not in labor, I’m not in labor, I’m not in labor.” We stayed in this room until 7 am The bed was soaked and I was uncomfortable so I was sat on a chair. I was forced to do an enema myself when I was in pain and I knew very well that it was not compulsory. I wanted to leave this hospital. I did not want to be me anymore. touch at all! I broke down in tears when the midwife from the morning shift arrived. She gave me time to calm down, have a hot shower and breakfast“, she remembers.”I was so exhausted that I accepted the epidural, so I stayed in bed for 2 hours again, they had to tell themselves that I was not in pain so that it was good …“Finally comes the moment of childbirth itself which is also painful for Véronique.
She is aggressive, brutal and still tries to give me a vaginal examination. I am in great pain and I tell her but she continues. Amniotic fluid is leaking and I’m not feeling well
Difficult to give birth with a mask
“I only wanted to get this baby out. But with the mask on, I couldn’t breathe and push. The gynecologist kept telling me to push harder, harder. I saw it very badly, like a failure, of not being able to push enough. My companion offered to change my position, but he was not listened to. The gynecologist told me about her own deliveries and those of other women, as if to compare me, I found that inappropriate! And she threatened to use the suction cup if I couldn’t. “This is finally what happens.”For us, the arrival of our baby is not at all a good time. We compare it to the butcher, when he takes out his sausage necklaces from his machine. This is how we lived it“, deplores Véronique.
The gynecologist sews her up without explaining what she is doing. “On the other hand, she told me that I was going to have to see the midwife who had forced me for the vaginal examination, I had asked not to see her again. She told me that otherwise it would put tension in the team. I didn’t want that, so I agreed for a transfer to my room, but in fact she did more than that and she had to take care of my baby in particular. She had very sudden gestures with my little girl, I was afraid.”
Other midwives advise Véronique to file a complaint. “I never did and I don’t regret it. I think that’s why I took part in this survey, to have an impact on the system. These are people who are not well, who are overworked, I do not want to add a complaint to them“, she explains.”If I still have to give birth, even if I don’t feel capable anymore, I would take a private midwife who will stay with me throughout the pregnancy and delivery.“, she ends.
What solutions to such situations? Florence Guiot, president of the Platform for a Respected Birth, believes that patients’ rights are an important lever. The Belgian law of 22 August 2002 relating to the rights of the patient stipulates that “Each patient receives in view of his needs, the best possible care based on medical knowledge and technology available. Services are provided with respect for dignity human and patient autonomy, without any discrimination based on class social, sexual orientation or philosophical belief.“
Regarding consent: it is clear in the law that any medical act must obtain the consent of the patient. This means: informing about the medical situation, the dangers it represents, explaining the proposed solutions (advantages and disadvantages), leaving the choice, considering possible alternatives … The patient has the right to withdraw her consent at all moment, further specifies the Platform. “Women must be told that they have rights as a patient, and that they are far from being respected“, observe Florence Guiot.
“There is also the question of birthing centers, giving birth outside the hospital. These are difficult choices to make because it is much less supported, less well reimbursed. In the entire province of Luxembourg, for example, there is no birth center or home midwife. We therefore push women to make certain choices. However, hospitals could learn from the practices of birthing centers. There is a way to do it differently, we are convinced of it. Demand is increasing on the side of women, we must listen to them and respect their decisions“, analyzes Florence Guiot before concluding:”I would like to thank every woman who took part in the survey. They are forces for change, as patients. And for us: the fight continues, through the door or the window!“
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