By @Matriactivista Writer, feminist activist and birth educator

In these days of heavy politics and confusion over the most basic terminology, when the patriarchy has somehow managed yet again to dismiss, silence and mock us feminists,

I find myself concerned with concepts that challenge not only logic and coherence but also the very core of the topics that have been my work, my life and my activism for the past decade.

I am a birth educator, an activist and an author campaigning for the rights of women around childbirth, and have come to define my work as ‘matriactivism’, a word now used by other feminist activists too.

It was this work that led me unavoidably to feminism in general and more specifically to radical feminism. This refers to going to the root of our oppression, which is based on the division of the sexes on a mostly scientifically binary basis. This has nothing to do with gender, which to me and many others is the social construct that patriarchy promotes to oppress us and is something we want to abolish, not choose or play with.

So now, after seeing some worrying developments that to me are going backward, I feel that it is urgent to say that the only way to fight gynaeco-obstetric violence and reclaim reproductive justice for women is within the frame of feminism, not the neoliberalism that wants to dilute our movement while claiming to be part of it.

The new way of dismissing and silencing centuries of our struggle by suggesting that “pregnant people” is inclusive, while women, who are more than 50% of the population and are the political subject in feminism, have no place to claim our rights, define ourselves or even fight back when our sex is abused, is a conundrum. 

I would not even entertain the idea of demanding any rights movement change their prerogatives and talk about all people. 

The fight for the rights of Lesbian, Gay, Transexual, Bisexual, Black people and many other oppressed groups matter, and their definitions and specifics matter: they are at the root of their discrimination. The women’s rights movement matters too: it has spent centuries seeking dignity, equality and justice for more than half of the population.

Yet worryingly, some researchers and academics affected by new trends and with little depth or factual information are embracing neologisms and have come to talk about things such as obstetric violence, feminism and gender in a way that suppresses and undermines women’s rights and our historical struggle. 

As an activist, feminist and specialist in obstetric violence I feel that this must be addressed.

In the 11 years that I have worked with women (and their partners in my classes) around the world, especially after we founded The Roses Revolution movement against obstetric violence, the two common denominators globally were that all the victims were women and all the violence was misogynistic. Of course, midwives, partners and even grandmothers have reported being affected by witnessing or even perpetrating obstetric violence, but the victims were always women.

We also realised that there was another level of cruelty with a component of racism or xenophobia, for which we coined the term ethno-obstetric violence*.

But even sentences were common to various countries beyond cultures and languages. The misogyny during labour was in the repeated sentence to women with contractions: “Now you complain, but you didn’t when you were making it.” And immediately afterwards, while suturing (often unnecessarily, which is therefore physical aggression) during episiotomies they will say: “I’m going to leave you even better than before, brand new”, or, as a student wrote beside his selfie with a woman in stirrups: “I’m going to leave your pussy at 0 km”. I actually created a petition against the student’s actions and he wrote to me with the arrogance and macho attitude that I know so well as a woman in this patriarchal world. To him I was a woman, inferior, an activist exposing him in anger. I and the 11,000 signatories thought he should be fired but he wasn’t, and instead he emailed me to mansplain how all women liked him and want him there. He loved women, he said…

When a male doctor in the USA cut the vulva of a woman in labour 12 times while she was begging and crying for him not to do so, the doctor used all the power and talk that men have over women in society and tragically, the mother of the labouring woman was telling her to listen to the doctor. The doctor knows best.

And yes the doctor (male), knows more than the midwife (always female back then) and of course more than the woman. He’s known best about our births since the end of the 1700s when the knowledge of women about their bodies, the oldest profession in the world, which contrary to misogynistic belief is not prostitution but midwifery, our science, was appropriated, reinvented and regurgitated back to us, in a way that concluded that we were ignorant of our bodies, our abortions, our miscarriages. We lost our physical autonomy. We were the sufferers of our bodies, the sinners and the ones carrying the responsibility of them for others, for men. And they tell us how to birth – for starters on the back, the most uncomfortable and illogical position.

But while discussing physiological positions, an outraged male obstetrician told me once: “What do you want?! Do you want me to go on my knees and look up to do my work?” He left offended, so I couldn’t reply: “Well yes, that’s what my midwives did in my three labours and they were so lovely”. But of course positions in labour are also a feminist issue because we women are subservient to the comfort of men. That happens from the bus ride to politics.

And the comfort or pleasure of men is what many professionals still joke about while suturing women’s genitals, and was also highlighted during a trial for obstetric violence in 21st-century Spain, as stated in the decision by the Committee of the United Nations:

Furthermore, the Committee observes that the administrative and judicial authorities of the State party applied stereotypical and thus discriminatory notions by assuming that it is for the doctor to decide whether or not to perform an episiotomy, stating without explanation that it was “perfectly understandable” that the father was not allowed to be present during the instrumental delivery and taking the view that the psychological harm suffered by the author was a matter of “mere perception”, but that they did show empathy towards the father when he stated that he had been deprived of sexual relations for two years.

That’s also a feminist issue because our bodies and our sex as women are considered to be something for the enjoyment of others. Our consent is the patriarchal discussion, our pleasure our feminist fight.

Birth, breastfeeding and abortion were actually ours; even when we had no rights, these still belonged to women: now they don’t. I always tell my classes about something I’ve learned from Sheila Kitzinger, how the word gossip in English comes from birth, comes from us women being sisters and networking, and originally being named godsibs (sisters in god). We were there in sisterhood supporting each other and using scientific evidence in its purest form, out of practice and observation. I tell the story to remind us of our collective power, our sisterhood and our culture. The concept of being with women, comadres, and midwives.

Obstetrics was created from a complete lack of knowledge because men had no place in the birth room and a total lack of physical empathy. They had to infiltrate the births, and they did that quite often by dressing up as women, because men weren’t allowed in the labour room, and imposing themselves on women who didn’t trust them or didn’t want them there. So they had to discredit midwives, accusing them of being ignorant and drunk, and ultimately disempowering them.

And midwives are still, in more subtle ways, suffering this disempowerment, some of them enduring trials, some of them, like the Hungarian Ágnes Geréb, experiencing 3 years of house arrest, some of them giving up their independent practice due to unaffordable insurance, and some of them by not being looked after by the institutions. In fact, the best way to understand how women’s rights at birth are considered a luxury, as if giving cake crumbs to a dog, is to witness how easily expendable our rights are during any given crisis. I could see, looking internationally, how the very small conquests in each country won in relation to birth rights were quickly lost during Covid, and how, if anyone dared to complain, the general attitude on social media was (as it has always been with us women) to call us selfish. Having a room of our own, wanting to be paid for our work, reclaiming our rights, are always “selfish” acts because we are not considered free, and this idea is protected and promoted by gender constructs of women as caring, loving individuals who can’t swear or raise their voices… We are trained from the very early shopping trips in the T-shirt section as children to know through slogans that we are the loving ones, the accepting creatures, which is another way of saying that the right to be angry is not ours either.  

We need to name our anger; we need to name our sex… The power to name, as Mary Daly has stated, has also been stolen from us. We need to name midwives as us women… They are exploited because they are women supporting women, and because care is considered a female thing: the role of women to provide care is promoted as inherent, but the right of women to receive care is as disregarded as we ourselves are. No one seems to care much for what will happen to birth after Brexit, given that 10% of midwives come from other countries, mostly Italy and Spain, nor for the impact that this will have on Black women, whose mortality around birth has already been discovered to be higher than for white women. Obstetric violence against Black women and Black midwives is deeply rooted in the history of obstetrics.

Midwives have always been some sort of feminist mirror for women’s bodies and women’s rights. Midwives were first and foremost us: women, the cousin, the sister, the neighbour but us, the ones who knew of our fear, losses and oppression. That can’t be taken from the history of midwifery or the history of women.

The first thing Spanish midwives had to do when regulations were imposed in their profession was to swear not to practice abortions. In Spain, it was under the Catholic dictatorship of Franco that midwives became a profession taking an oath. In the UK, birth has always been regulated by the Church, with different implications. For example, due to the Church’s concern for babies dying without baptism, one of the rare occurrences of women having power within the Church was when power to baptise a child was given to the midwives and “gossips” – power that was soon revoked. 

And this is also why birth is a feminist issue, because our alliance with our sisters, our midwives, has been taken from us.

Mary Wollstonecraft wrote about a community of women in her book Mary. She didn’t finish it because she died after the birth of Mary Shelley**, but what is perhaps less known about her death is how relevant it is to understand why we contend that birth is indeed a feminist issue. Mary was against the new fashion of having a male doctor attend the birth and insisted on a midwife. After the labour, the placenta became retained so, according to the new rules already created by the imposing obstetricians, the midwife was forced to call an obstetrician. The obstetrician (a role that at the time dealt with corpses and disease) put his hands inside Mary to remove the placenta and introduced the fatal sepsis, which produced puerperal fever, something that went on to become the most common new cause of death after the introduction of male obstetricians and hospital births for the next 80 years, until the Hungarian doctor Semmelweis discovered that the lack of hygiene was to blame.

Until then, they blamed us women of course: they even thought that the pus was perhaps the breast milk. And of course they blamed Mary Wollstonecraft for her decisions, for being a “difficult woman”, a feminist, herself.

And yes, dying of sepsis out of ignorance disguised as dogmatic male knowledge was one thing women died from in huge numbers in the past. But even today, women can still die of sepsis, as shown by the recent tragic death in Poland of a woman named Izabela (her surname has not been made public). Her death has reminded many of us activists of Savita Halappanavar in Ireland. Both women were allowed to die of sepsis because of religion and the patriarchy hating women, controlling women and seeing us as mere vessels: sacrificeable, expendable, redundant. And believing that an unviable unborn foetus is more important than a woman. And that’s also why birth is a feminist issue.

The many women I have talked to through the years have also commonly talked about feeling raped in labour. The term birth rape has even been coined.

Of course, there are then discussions, as always happens with rape, that use what we activists call “tone policing”: lengthy debates about how offensive the term obstetric violence is to medical professionals, how inappropriate it is to call it that, and how we should look for another word… Never mind what the experiences must be like for women to talk about them in such a way.

And that is without taking into consideration the fact that 1 out of 3 of us women are survivors of violence (including rape) while suffering gynaeco-obstetric violence.

In fact, perhaps is the other way around, when us women are told with our first menstruation that our bodies are dirty, that we should hide it, and to be careful in that classic euphemistic way of passing the responsibility for avoiding predators as if we were talking about, I don’t know… potholes while driving. Perhaps it is because we learn to hate our bodies, while being harassed the minute we develop breasts, and we observe the oppression of our mothers and other women, while we begin to comprehend through ads, movies and songs that our body is for the enjoyment of others, the judgement of others and the decisions of others. And because we get to finally figure it out, and then we see that we still have to debate our rights, when we are insulted, threatened and misjudged because we can’t even claim that our movement is about the oppression of women, we can’t even define what women are despite us being them… Maybe it’s actually thanks to all of that, that violence can also be perpetuated in the ultimate battle for conquering our bodies in the labour room, and that is not because it is a male or female professional in charge. It is because history, gender ideology, the protocols, the institutions, the instruments, the language, attitudes and the whole approach to our birth experiences came from the same patriarchy that works from the premise of the sex class man being superior thanks to the oppression of the sex class woman.

Patriarchy establishes itself with the control of women’s reproductive powers based on our sex.

As Grace Atkinson wrote in her foundational piece "Radical Feminism" (1969):[12] –

“The first dichotomous division of this mass [mankind] is said to have been on the grounds of sex: male and female ... it was because half the human race bears the burden of the reproductive process and because man, the ‘rational’ animal, had the wit to take advantage of that, that the childbearers, or the 'beasts of burden,' were corralled into a political class: equivocating the biologically contingent burden into a political (or necessary) penalty, thereby modifying these individuals’ definition from the human to the functional, or animal. “

I will go further: my personal take on it is that the promotion of our reproductive power as a burden is also patriarchal propaganda out of ignorance and fear. And it is because we lost the autonomy to decide over our reproductive powers that they became a burden. 

They still are a burden to many women in countries such as Ukraine, where, in the disguise of modernity and progress, we promote the idea that surrogacy is an example of sacrifice and generosity rather than the objectification and exploitation of women and the objectification and selling/“gifting” of humans (babies). That is possible because we are women and that is also a feminist issue.

It took us years to be able to say “obstetric violence” without being accused of being crazy, and it is still refuted. It has recently been refuted by the College of Doctors in my country Spain, a country criticised by the UN because of its obstetric violence.

And because of all of this and much more, I ensure through a global movement that we will talk about obstetric violence on the feminist date of the 25th of November and as part of the many acts of violence towards women. Ten years later, that fight cannot go backwards – at least not without me being silenced by the so-called inclusivity that invisibilises women yet again.  

As I have always said, birth is a feminist issue because we women want to decide, not because of what we decide.

Birth and reproductive justice to me are at the core of our oppression as women.

And there is only one way to fight the oppression of women, and that is feminism.

Matriactivista

*Originally coined by Silvia Agüero, Roma activist

**Mary was known as Mary Shelley after marriage, obviously not at birth. But she was known as her married name. Our surnames: that is another feminist issue for another post.