Birth Abuse

I've been reading on the blogs lately some entries about 'birth rape.' http://www.birthactivist.com/node/226 and http://www.thefword.org.uk/features/2008/03/not_a_happy_bir
Birth rape seems to define an emotionally and or physically traumatic birth that leaves the mother feeling violated and traumatized. As someone who worked briefly as a sexual assault nurse, I hestitate to use the word rape out of deference to what happened to the women I saw, and prefer abuse instead. At the same time I'm not trying to belittle what birth-abused women have experienced. I've experienced it myself. But even worse- I have been an abuser. That is much harder to live with. That is one reason I feel so strongly about not returning to hospital nursing. It is to be perpetually torn. On one hand it is beat into your head that you must be the patient's advocate in the healthcare system. On the other hand, you are to be allies with your healthcare colleagues and there is an unspoken 'code' that you do not betray them- you protect them, and they will protect you, presumably from the patient. This was a line I could not walk. I abused patients at the doctor's will. I abused doctors in every conceivable underhanded sneaky way I could to make myself feel better about being coerced into abusing patients. After some time, I came to despise both camps because I could not do right by either. I cannot have a healthy relationship with birthing women or my physician colleagues in a hospital setting. The power is too unbalanced and I must pick a side. Sweetly coerce the patient into things she doesn't want done, or face down the ire of the doctor- and I did face down the ire. I was yelled at, cursed at, had things thrown at me, written up, complained about, asked to be replaced by another nurse. I also tried to empower women to fight for themselves. Once when a mother of six came in to deliver, she was stunned to find out she would be getting a cesarean because she had one with her second birth and her physician group had just banned vbacs. Now HER physician had promised her a vbac, but of course HER physician was no where to be found when she came in to deliver. When I was alone with her, I took a major risk by telling her she did not have to have the cesarean, she could ask for a different doctor. But later when the doctor reentered the room to get her decision, she simply resigned herself to it- even though she had initially been very angry about it. This story exemplifies birth abuse in all its glory- and yes I helped to cut her open without a medical provocation- just on account of a fear-based policy (litigation fear at that). I remember being angry with everyone that night, the patient, the doctor who promised something she couldn't deliver, the doctor who cut her, and myself. I cannot divorce hospital birth from birth abuse. It happens every day in a million mundane ways- here where I used to practice it is nearly ubiquitous.