Epidural for Mom, Manners for the Nurse

Advocates say it’s time for the Health Ministry to end verbal abuse against women during childbirth; the government denies a widespread problem

One woman’s childbirth experience was so awful that her daughter felt the need to share the story on Facebook: “When the doctor arrived to attend to my mother,” she wrote, “he shouted at her to turn around so that he could view the birth in the mirror. It took her some time and he yelled, ‘Damn it, do you want me to get rid of this baby?’ Afterwards she was left on the delivery table for a half an hour before someone came to take care of her.”

While that happened in a U.S. hospital, there are plenty of upsetting childbirth stories in Israel as well. In April, a story made the rounds on Facebook about a woman delivering a child at the Sheba Medical Center in Tel Hashomer. The anesthesiologist called her “fatty,” and later, only in light of publicity, was forced to apologize.

Israeli professional organizations that support women during the childbirth process recently decided to campaign against the phenomenon of verbal abuse experienced by women in the delivery room. “An anesthesiologist may not tell a woman in childbirth that she is overweight or criticize her for the way she copes with pain,” says Ruti Karni Horowitz, the head of the Israeli branch of the Childbirth and Postpartum Professional Association, “and a midwife may not tell her that there is no chance for a natural birth ‘because I’ve already seen a thousand like you.’ Beyond their humiliating effect, these statements are potentially highly destructive of the childbirth process.”

Last month Orit Helfgot of the umbrella organization and the local women’s group for free choice in childbirth, Nashim Korot Laledet, called on the director general of the Health Ministry, Dr. Ronni Gamzu, to institute a system of care for women who have been verbally abused by medical staff during labor. Helfgot distributed a petition on social websites protesting the phenomenon, which has already garnered more than 1,000 signatures.

‘Some women shouldn’t be mothers’

The petition offers examples of remarks made to women during delivery such as, “Some women shouldn’t be mothers,” “Next time, lose weight and I’ll give you an epidural the right way,” and “In my delivery room, there’s no crying. Got it?”

Helfgot, a doula and an alternative medicine practitioner, asked ministry officials to act to eradicate the problem. “These remarks have a negative effect on the birth process, the mother’s level of satisfaction and the health of families, including communication between the mother and newborn and the mother’s self-image,” she says.

More than a quarter of 89 women who took part in a study published in the Israeli Medical Association Journal in June exhibited post-trauma symptoms after having given birth. “It is hard to believe that negative remarks are not one of the reasons for this trauma,” Helfgot says.

Beyond the petition, Nashim Korot Laledet has begun distributing a form, via its website, that allows women to lodge complaints about verbal abuse during delivery. The organization plans to refer some of these cases to a lawyer specializing in the rights of women during childbirth.

The Israeli organizations are joining a battle against delivery room abuse that already exists elsewhere. Susan Hodges, president of Citizens for Midwifery in the United States, protested the phenomenon in an article in the Journal of Perinatal Education in 2009. Hodges argues that “Physicians frequently are able to get laboring women to ‘agree’ to interventions due to the power imbalance between the physician and the woman. [Isn’t a Caesarean section performed] to reduce vulnerability to a lawsuit even more violent than a black eye?” In her article, Hodges encourages women who have been verbally abused to lodge official complaints with hospitals.

According to Karni Horowitz, Israeli standards of interpersonal communication “are very low. A doctor who told an American woman in labor that she was spoiled or fat would be permanently suspended from his job. In Israel, anything goes.”

In a response to the petitioners, the Health Ministry insists the problem is not nearly as prevalent as they claim. “The midwifery profession is important and its practice demands a high level of training and the taking of responsibility,” the ministry said. “Most women want to give birth in a professional framework, protected by Israeli midwives whose professional freedom, reputation and training are among the best in the world.

“The Health Ministry treats each reported incident of abuse, and every complaint is treated immediately with utmost gravity. To the best of our knowledge, not only is there no abuse in our delivery rooms, but a high level of satisfaction is expressed by delivering mothers about the staff in general and the midwives in particular.”