Tuesday, July 28, 2009

Women and Western Medicine

Yeah, so this story combines two of my favorite beefs with western medicine. And ironically, these are two areas in which I experience the most skepticism from other people in conversation. Is western medicine really pharmaceutical-driven and patriarchal and concerned first and foremost with their profit at the expense of your health and safety? Is it really true that the mental health industry has been and is often still used as a means for controlling female behavior? It just sounds so conspiracy theory-ish. And then a story and court ruling like this fall into my lap which demonstrate my claims for me, as if it was a gift from the gods.

So here we go. A woman in New Jersey refused an unnecessary cesarean section during labor, and proceeded to deliver a perfectly healthy baby vaginally. So we should all be happy, right? Wrong. You see, this woman committed the cardinal sins of questioning medical professionals, to their faces, no less, and not being a docile, easily-controlled, passive "patient." And nobody can commit these sins without paying for it. No sooner had she delivered her healthy baby than child protective services was called and yanked her child from her, terminating her parental rights due to the abuse she had inflicted on the medical establishment child.

But there's more to this story than just the refusal of a c-section, which is after all major surgery and carries huge risks for mother and child, and which is one of the most overused surgeries in western medicine, contributing to the shameful fact that the U.S. has the second highest infant mortality rate in the developed world. For real, we have a 31.8% c-section rate, while the WHO recommends at most a 15% rate. But if you read the court ruling from the appeals court, you'll find that refusing a c-section was rejected by the appeals court as the reason justifying removal of the child and termination of parental rights. This is significant, because it would result in a legal precedent for routinely taking children from mothers who refused c-sections in the future. And that's something you oughta know (and no doubt the medical industry would love it if this were the precedent, and all parents knew it) when writing up your birth plan. Instead, the court upheld the termination of parental rights on the grounds that the mother had a history of mental illness, behaved in a less-than-calm manner during labor (shocking!), and had the gall to abstain from informing the doctor of her history of mental illness. Get that? She didn't inform the doctor of her history of mental illness.

Now why would somebody do something like that? Hmmm. Perhaps because we have a tendency to take children from women who have a history of mental illness? Perhaps because "a history of mental illness," no matter what the specific issue was, is universally thought to render one a bad mother in our culture? It seems to me that hiding your history of mental illness is a profoundly rational thing to do, if being a mother is important to you.

I have a friend who lost a baby to SIDS. It was tragic and sudden and inexplicable - a complete nightmare. She was heartbroken to the point that she could barely go on. She would drag herself out of bed just long enough to care for her older child and get him off to school, then return to bed until he came home. After several months of this, her friends and family encouraged her to seek treatment. Immediately upon seeing a therapist she was diagnosed with clinical depression and medicated. Like after the first visit. About a year later she stopped taking the medication, and everything seemed to be fine. However, two years later during her divorce, her "history of mental illness" came back and was used as evidence against her in the custody battle. And she could protest that she had merely been heartbroken over the death of her son (which hardly seems pathological to me) until she was blue in the face, but according to the court, she had a history of mental illness, which compromised her ability to mother her child.

So don't tell me that mental health diagnoses and treatments, which are disproportionately applied to women, aren't used as a means of regulating women in our culture and "encouraging" them to walk the line of appropriately gendered behavior. Don't tell me that the patriarchal approach of western medicine doesn't seek to control women in childbirth and render them docile and passive revenue streams by which doctors can maximize their profits (c-sections are lucrative) and minimize their work time (c-sections are quick). Don't roll your eyes at me when I question the claims of the medical industry and refuse to drink the coolaid of their PR and lobbying and social bullying. If this case doesn't shake your faith in "the system" then what will?


  1. I hadn't thought about how the two issues of childbirth and women's mental health treatment combine in this case. Interesting...

  2. I think it's interesting that most of the coverage and blogging about this story focus only on the c-section part, when it's the mental health issues part that became far more relevant in the appeal. But it's still the case that her mental health history wouldn't have become involved if she hadn't refused the c-section. It almost seems like the doctors were mad at her for refusing the c-section, so they dredged up the history of mental illness as a means of revenge. Sad.

  3. Meg'n7/29/2009

    I think sometimes people are also reluctant to reveal their history of mental illness to their medical doctor because they don't know if they'll be believed about their current physical symptoms, or if it will change the way their doctor interacts with them.

  4. But I think you can be critical of the way western medicine handles childbirth without being critical of western medicine in general.

  5. Tori,

    I agree. And in fact I think there's a lot to like about western medicine. But the way it's implemented when it comes to women, and the way profit trumps people's well-being, and the way it's so pharmaceutical driven is deeply problematic. When you get to a point where the pharmaceuticals (and insurance companies) are dictating legislation, and actively blocking research into prevention (because if less people get sick, they make less money) then I think you have a huge problem. But I also think that a lot of the eye-rolling and dismissiveness is based on a false dilemma - that you either have to wholeheartedly embrace conventional medicine or you're a new age hippy type who only believes in alternative quackery and snake oil. I think there's a compromise somewhere in the middle, and I refuse to dimsiss all alternative treatments as quackery, as many of them hold up under research. And it's sexist and racist to dismiss the knowledge of many generations of women and non-white non-western cultures simply because big pharma's not gonna make a buck off it.

  6. I read elsewhere that this hospital has a 49% c-section rate. For real. Clearly they're not accustomed to having anyone refuse a c-section, for any reason.