Women repeatedly experience disrespect and even violence during childbirth. The day of the “Roses Revolution” commemorates this annually on November 25th.
It was taboo for a long time: It wasn’t until 2015 that she did it World Health Organization drew attention to “contempt and abuse at birth”. The global movement “Roses Revolution” has also initiated a debate. Every year more and more mothers report that they have experienced violence and disrespect during childbirth.
Movement “Roses Revolution” breaks a taboo
Around the day of action on November 25th, which is also the international day against violence against women, the Rose Mothers concerned divide up Facebook and using the hashtag #rosrev to publicly share her distressing birth experiences.
They symbolically place roses and letters in the delivery room. You can read about too many interventions and not enough care.
Mothers experience psychological, physical and structural violence
Types of childbirth violence reported by women:
- Interventions without consent such as intra-uterine drip, episiotomy, cesarean section
- Being given medication without education or consent
- painful vaginal examinations, caesarean section without sufficient anesthesia, (incorrectly performed) Kristeller maneuver (pushing the child out by pressing the abdomen during a contraction)
- Neglect: being left alone, not being allowed to eat or drink
- psychological pressure from shouting, threats, humiliation
- violation of privacy
Katharina Desery of the parent organization Mother Hood knows many stories of difficult births. Women often have the feeling that decisions are being made over their heads: “I was just a piece of meat as to what the child should somehow be born to,” Desery repeatedly hears from mothers.
Many women also felt massive psychological pressure in the delivery room with words like “You don’t want anything to happen to your child,” reports Katharina Desery from Mother Hood.
The association campaigns nationwide in public and politics for better obstetrics and sends an expert as an expert to the Bundestag or to “round tables” on the subject of birth in several state ministries.
Council of Europe denounces violence in midwifery
The Council of Europe has also dealt with violence in maternity facilities. In a resolution in October 2019 it says:
Frequency of violence is unclear, but these are not isolated cases
Julia Leinweber is a professor of midwifery at the Charité Berlin and co-founder of the Working group “Respectful Obstetrics” of the German Society for Midwifery Studies. In July 2020 she published a position paper together with others to raise awareness of “trauma-sensitive” obstetrics.
It is unclear how many women in Germany experience violence during childbirth. So far, there have been no representative studies that clearly show how often mothers are affected by assaults in the delivery room or in birth centers. Scientists like Julia Leinweber assume that these are not isolated cases.
Overall, Leinweber sees a large research gap in the field of birth experience. Science would have focused too much on physical outcomes such as blood loss at birth or the health of the child. So far, there have been no meaningful surveys on the subjective experience of childbirth in women.
Lack of midwives and insensitive communication as causes
Why are borders crossed at all? One problem is the shortage of midwives: The fact that a midwife runs back and forth between several delivery rooms and is therefore unable to provide adequate care for the woman giving birth seems symptomatic of German obstetrics. The German Association of Midwives therefore primarily sees structural reasons as the cause of violence. Many midwives no longer wanted to work in the delivery room due to the poor working conditions, says Christel Scheichenbauer from the Baden-Württemberg Association of Midwives.
According to the association, more staff and more money are needed in obstetrics. A birth that sometimes lasts three hours, sometimes 30 hours, cannot be squeezed into a flat fee.
Frank Louwen, Vice President of the German Society for Gynecology and Obstetrics until October 2022, does not see the clinic structures as the main cause of violence in obstetrics.
For Louwen, violence begins when someone walks into the delivery room and doesn’t present themselves. The doctor who heads the obstetrics department at the University Hospital in Frankfurt am Main sees the management level as having a duty here. The management must establish a constructive way of dealing with mistakes – and set an example of respectful communication.
Preventing violence through empathy and one-to-one care
Empathy is another key to preventing violence, emphasizes midwifery scientist Julia Leinweber. Studies show that empathy can be trained well.
Leinweber also sees one-to-one care as a key element in preventing violence. Research has long indicated that births go better when one midwife looks after a woman: There are fewer interventions, Caesarean sections are rarer, the mothers are happier.
Since January 2021, a new medical guideline has recommended one-to-one care and a woman-centered birth for the first time. From the point of view of the NGO Mother Hood, this is an important step to prevent violence. The corona pandemic would have worsened the situation in obstetrics in many places, but awareness of violent acts in the delivery room is increasing.
Violence against childbearing is a problem of violence against women
Tina Jung, Marianne Schminder Guest Professor for Gender Studies at the University of Magdeburg, regards violence against women in childbirth as part of a fundamental problem of violence against women. The problem is not only due to structural causes, the lack of midwives, economic constraints or insensitive communication.
For her research project, Tina Jung interviewed around 30 affected mothers and obstetricians in detail. The scientist draws similar conclusions from the experience reports as can be found in the resolution of the Council of Europe: If you want to solve the problem of violence in midwifery, you have to raise awareness of gender stereotypes in society as a whole.
Many midwives have clichéd expectations of women, according to which the woman giving birth should, for example, be “well educated, slim and communicative”, but should also be docile and ideally not contradict measures.
One thing is clear: bad births have long-term consequences, mother and child suffer mentally, and aftercare costs more than prevention in economic terms, as a study from England shows.
Mother Hood’s Katharina Desery summarizes that violence in midwifery has to do with the way society views childbirth. In the end, it is also about the question of what society values a good start in life.
manuscript for the broadcast