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Every patient wants and deserves respectful treatment from healthcare providers, but this doesn't always happen. Some women come away from their labors and births feeling so violated they describe the experience as "birth rape".

"Birth rape" — this shocking term has appeared online within the last decade, and has been discussed by parenting bloggers and journalists in quite a lot of detail but remained controversial. The term "birth rape" is, after all, not used to describe coerced sexual intercourse during labor.

What is birth rape, then? Should the term be used at all? And if it is a valid concern, what can women do to prevent it?

What Is Birth Rape?

To understand what birth rape means, we'd first have to look at the meaning of the word "rape" without the modifier "birth". While rape most often refers to coerced sexual intercourse, rape is a crime that is motivated by the perpetrator's quest to have total control over the victim. It is more about power than about sex, and we'd generally agree that a crime can still be termed "rape" if the perpetrator used a bottle or some other instrument, rather than his penis. 

Birth rape can be defined as coerced genital contact that makes the laboring woman feel violated.

As far as I can see, the term first appeared online in 2005. Since then, it has become a hot-button issue that has been discussed over and over again by journalists, bloggers including medical professionals, and women participating on message boards. The experiences of those who apply the term to an event they personally underwent vary widely, but all were treated disrespectfully by a healthcare provider.

Women who feel the term "birth rape" applies to them may have had their membranes stripped, their water broken, their cervical dilation checked, an episiotomy (vaginal cut) carried out, or have had their placentae recovered from the uterus manually after giving birth, without their consent or despite their refusal. Sometimes, they are physically restrained while this happens and sometimes, they beg their healthcare provider to stop. Is it rape, though?

The idea that rape is more about power than about sex is widely accepted as true, yet rape does have a sexual component. Is that component missing in these situations?

Perhaps what these women went through can be termed "medical malpractice", or even "battery", or perhaps these women are simply exaggerating because their birth didn't quite go the way they wanted it to go. All these views have been expressed. To make the term "birth rape" less abstract, one woman is willing to share her story. 

One Face Of Birth Rape

Dana is a highly educated professional who spent the last months of her pregnancy reading everything she could about birth. By the time she got to hospital, she knew she didn't want to have an episiotomy unless a very specific situation in which it would truly be warranted arose. She told her OBGYN she would prefer to tear naturally, and got a sneering reply — "And you're a doctor, are you?"

As her labor progressed, she started to do what most women in labor do: scream. That's when her nightmare really kicked off.

"Do you think you're the first woman to give birth? You enjoyed it when it went in so shut up now. If you don't, I'll cut you so bad you'll never [censored!] again."

He kept his word. Dana required surgery to fix the scarring afterwards, but before that she went through a year of pain. She could not sit without pain, had no sexual intercourse because trying hurt too much, and suffered from urinary incontinence. Terrible, yes?

Dana happens to live in a developing country where patient rights are not a priority. The doctor still practices. You'll have to agree that what happened to her is a crime, but also that it has a sexual component and that the doctor wanted total control over her. The situation really isn't that different to rape.

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