“Don't push!” experiences of obstetric violence in U.S. hospital settings

Abstract

Obstetric violence is the institutional and interpersonal violation of women's rights during pregnancy, childbirth, and the postpartum period. Amid increasing recognition of the prevalence and consequences of obstetric violence, there has been growing attention to its cultural, organizational, and institutional features. In this article, I demonstrate how obstetric violence is a form of epistemic and structural violence that unfolds through interpersonal interactions, the organization of labor in medicalized birth, and institutional features of the hospital and obstetric environment. I draw on thirty in-depth interviews with women who recently gave birth in the Midwest, United States to understand how the authoritative knowledge of medical staff epistemically marginalizes pregnant and birthing women's embodied knowledge and how organizational and institutional features of the medicalized hospital environment facilitate obstetric violence. These findings contribute to our understanding of how less recognized and normalized forms of violence shape women's pregnancy and birthing experience, even for those with a high degree of intersectional privilege. I argue for increased person-centered childbirth guidelines that center embodied experiences and address features of the medicalized obstetric care environment that are not sufficiently evidence-based nor facilitate better outcomes for birthing people.