Adriana dreamed of giving birth naturally and could not imagine even in her worst nightmares that she would be pressured to take painkillers and induce labor. Bat Ami was recovering after giving birth to a baby girl when the nurse made her get up from the bed only to check out her back tattoo. Ariel was in agony when her obstetrician firmly pressed on her stomach – without prior warning – to get the baby out, using a maneuver considered outdated and highly controversial. Tal was told that unless she agreed to a C-section, she "was killing her baby."
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Israel Hayom has spoken to dozens of women in recent weeks who had given birth and felt that their rights, especially those of bodily integrity and autonomy, were violated by the medical staff.
A milestone as important as giving birth, which was supposed to have been intimate, profound, and exciting, turned horrific when doctors and nurses reportedly violated the patients' privacy, performing procedures without consulting them or asking their permission.
"It felt like they took responsibility for your body, and you no longer had control over it," Bat Ami, who has gone through three difficult births in recent years, said.
For Reut, who gave birth two years ago, the trauma is still present.
Labor is when "I am in my most intimate state, and they take away my strength, control, and faith. They kept saying, 'The most important thing is that the baby comes out healthy,' which makes you think it's okay that they performed a procedure on you without asking first, and that maybe it's okay that the obstetrician pushed hard on your stomach to get the baby out, a procedure that is now not allowed to be performed in any hospital."
Reut was referring to the Kristeller maneuver, named after German gynecologist Samuel Kristeller, which was developed in the late 19th century and involves applying pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth. A highly debated technique, it is considered dangerous due to the risk of broken bones, organ damage, and other painful health problems.
"But it is terrible, terrible," Reut continued. "And that is why I have decided to share what I went through. So that no other woman has to go through what I went through."
"Why did you have to give birth tonight?"
The women often said they felt "helpless" during labor, and that their original plan – to give birth at the hospital naturally – went awry when against their will, they either had to have induced labor or even surgery.
Reut, for instance, planned to give birth naturally and chose a hospital near Tel Aviv, because she was told the staff actually listened to the mother-to-be.
"In reality, it turned out to be the exact opposite," she lamented. It took me some time to arrive at the hospital, "and the moment I walked in, they scolded me for not having arrived earlier. They took me to the delivery room, and the midwives were really sweet. In the evening, I began to have strong contractions, and for hours I was with an open uterus, which signals readiness for giving birth [naturally,] but the doctor began to pressure me to induce labor.
"He would enter the delivery room every few minutes, saying that the monitor showed that the fetal heart rate was dropping, which signaled possible danger. But the midwife had told me that everything was fine and that the fetus was not in danger and that the heart rate had dropped only because of the contractions.
"Then all of a sudden, during a contraction, while the nurse was supporting me, he told her to stop and told me, 'Listen to me now, you are endangering the fetus, and you need to give birth now – vacuum or surgery.' I told him I didn't want to, that I felt that I could give birth naturally.
"The midwife told him that she could already see the baby's head, that I could give birth naturally, but he approached me, pressed on my ribs in an effort to expedite the process [through the Kristeller maneuver]. I screamed in agony and told him he was hurting me. In hindsight, I don't understand how I allowed him to do this to me, but he did. When I screamed in pain, he took a step back and said to stop everything. He decided to perform a vacuum extraction. 'It's your decision, but my responsibility and you are about to kill your baby,'" he said.
"I didn't want to oppose the doctor, because he surely knew what was best. But I feel that everything could have gone differently. The doctor might be walking around thinking he saved my life and the life of my baby, but for me, it was a very difficult experience."
Adriana chose to give birth to her son at a hospital far from home because she too was told that the medical team listened to the patient, and even encouraged natural birth.
But when she arrived, already in active birth, with contractions and an open cervix, she felt she was giving birth under pressure to follow medical protocols, which included taking painkillers, contrary to earlier promises, and the doctors and nurses being inattentive to her needs and requests.
"My pregnancy went well and I dreamed of giving birth naturally without any intervention. When I first visited the hospital, it sounded to me like the staff would be really attentive to my needs. But when I got there, at 41 weeks and 3 days, I realized that I had been deceived."
According to Adriana, from the moment she arrived, she was pressured to take epidural or laughing gas to help with the pain. "
"When I told the obstetrician I didn't want to, she shouted at me, 'You will do as we say.' I was shocked. I got up, while having contractions, and asked her why she was talking to me like that. In response, she sat me back down. I realized there was nothing I could do, and it was a very difficult feeling. I arrived at the hospital feeling well, and I thought I would have the birth of my dreams, but got to a point where I felt helpless. I was pressured to get epidural or painkillers, and no matter how much I explained that I wanted a natural birth, the staff kept pressuring me.
"At some point, the birth stalled, and when the senior doctor walked in and saw that there was no progress, he said, 'Why did you have to give birth tonight?' I will never forget that sentence. He didn't say 'Hello,' nothing. 'Why did you have to give birth tonight?'
"I felt they wanted to hurry the process along. Some women spend 20 hours in labor, and I was actually further along, but then the monitor showed a slowing heartbeat. I was having contractions, in pain, begging to be allowed to focus on the process, but after countless doctors came and went trying to pressure me into agreeing, I gave in.
"The staff pressured me to have a C-section and even told my husband that if I didn't, I would be 'killing the baby.'"
Adriana was put on full anesthesia, but it did not fully take, and she continued to experience the birth and even heard her baby cry upon exit.
"What happened next amazed me. I was still unconscious, and they [the staff] approached my husband, telling him that the baby was not breathing and that a ventilator was needed – as if they were trying to make up an excuse to legitimize the surgery.
"My husband was very angry with me at the time, but later, when I requested the birth procedure documents like any mother is eligible to do, I saw written in black and white that the baby did indeed cry when he was born.
"They also kept my baby away for a long time and vaccinated him without my permission. When he was in my arms, finally, they again rushed to take him away for tests. I ended up signing for an early release."
Adriana is now suing the hospital for alleged emotional distress.
"I want to bring about a change so that no other woman has to go through this. Women who are giving birth must stand up for their rights," she said. "I felt helpless during the process, and after a lot of pressure, agreed to everything. They didn't let me focus on the birth, and half my energy went to dealing with the staff. It was a very difficult experience."
(phot here)
In March, the Birth Freedom Israel organization published a report on the treatment of women in delivery rooms, alleging humiliating behavior and rights violations.
The NGO analyzed the calls of 609 women to its helpline, which did not reflect how widespread the phenomena could be, but did point to cases of mistreatment.
According to figures, 70% of the women said they were verbally abused, and 64% said their right to informed consent was violated. Over half (55%) said the medical staff communicated with them poorly, and almost a third (32%) said they were abused.
In addition, 29% said they felt they were neglected and the doctors did not give them the necessary attention, and 16% felt their privacy was violated.
On average, every woman who called the hotline reported 4.4 abuses.
Moreover, in March 2022, Birth Freedom Israel conducted an online survey, in which 1,700 women who had given birth participated, that showed that over half (58%) felt that someone else made the decisions pertaining to their birth. Some 68% said their privacy was not respected, 32% said they were verbally abused by the staff, 26% said they were abused by the staff, and 13% said procedures were performed without their consent.
"The solution is to raise awareness among the women and the medical teams of the rights of the mother, and to create a fundamental change in the public and personal discourse regarding childbirth," Director of Birth Freedom Israel Hayuta Goren said, which is why the organization holds training workshops across Israeli hospitals on the subject.
As some of the trauma sustained during labor is not of physical nature, some new mothers are left with a sense of violation that is unlikely to hold up in court.
"Oftentimes there's no point in filing a complaint or a lawsuit like that," attorney Dganit Sommerfeld explained. "Contary to medical negligence lawsuits, where you might prove that damage was caused, with mistreatment during labor it is difficult to prove that a tangible injury was caused.
"When the mother returns to work [after a three-month maternity leave] and leads a more or less normal lifestyle, despite the trauma, she cannot request financial compensation and prove that as a result of the birth she suffered future wage losses. The legal premise in such cases is that the mother gave informed consent, and if and when the doctor performs an operation on her without informing her – there was probably a medical justification for it."
To remedy the situation, MKs Michal Shir (Yesh Atid) and Keti Shitrit (Likud) submitted a bill that would ensure a fair economic mechanism for both those that give birth in hospitals as well as at home and in private institutions.
"As of now, women who give birth in private centers or at home, do not get a maternity grant, and the financial aspect might affect someone's decision in terms of location," Sommerfeld said.
In response to an inquiry by Israel Hayom on the matter, the Health Ministry said that it "expected all medical teams to treat patients with professionalism and sensitivity.
As such, the Health Ministry's Health's National Council for Women's Health adopted a gynecological examination convention – recommendations that are also relevant to mothers, as published by the Israel Society of Obstetrics and Gynecology last year. The convention established rules of respectful, sensitive, and considerate behavior toward the women being examined and improving the communication with them, it said.
The convention also stated that the patient must be given a preliminary explanation of her rights and procedures, receive her consent, provide warning and reassurance before painful operations, explain test results, and more.
In addition, it includes a variety of ways to implement the improvement of communication between patients and medical teams in many settings, including medical faculties and different stages of specialization. This is through training, dedicated studies, control, and more. Every complaint that is received in the office is handled upon receiving, the statement said.
The Tel Aviv Sourasky Medical Center said, "We make every effort to involve each patient in the decision-making, transparently and sensitively, while providing an explanation throughout all stages of the birth. We will make it clear that in Ariel's case, no Kristeller maneuver was used during the birth, and all operations were performed as usual. However, we regret her personal experience, And we took these things to heart."
The Shamir Medical Center said, "According to the records in our possession, this is a patient who received detailed explanations throughout the birth procedure, which was accompanied by her overwhelming opposition to any medical activity necessary to save the fetus and care for its well-being. Only towards the end of the birth did the patient agree to the intervention … when there was no other choice left. We regret that this is her personal feeling, but from our inspection, the conduct of the staff was flawless and enabled a successful birth. We wish health to the mother and her daughter. We emphasize that the medical center strongly condemns violence of any kind toward the patients and/or the staff."
The Soroka Medical Center said, "We are sorry for the feelings described by the woman, take them seriously and check every request that is received. At every moment and in every situation, the safety of the mother and the safety of the fetus is at the forefront of the team's attention, which will respond to her requests if they do not endanger her safety. The team does everything in its power to provide personalized treatment to each mother, to explain and update at every stage, and provides professional medical care according to her medical condition, to enable a meaningful and positive birth experience."
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The Hadassah Medical Center said, "The case described in the article, which happened a decade ago, is not in line with the spirit of service and care in Hadassah, which sanctifies the dignity of the human being in all forms. Therefore, we are very sorry for the feelings described by the mother. The team of the women's medicine system at Hadassah, like the teams of the other departments, recognizes the right of women to make an independent and personal decision regarding any procedure, including during childbirth, and even encourages it while maintaining a high sensitivity and consideration of the medical staff.
"Furthermore, the midwives in Hadassah have a variety of choices regarding the course of the birth, pain relief, processing the birth experience, and even early and long preparation for those who are dealing with stress or anxiety. As part of that same sensitivity, Hadassah also operates a dedicated clinic for women who are about to give birth, and who have experienced difficulties throughout their lives, such as sexual abuse or difficult emotional distress, where you can receive significant emotional support in preparation for childbirth."
The Sheba Medical Center, said, "We see great importance in providing an empowering and safe birth experience to the mother and the newborn. At Sheba, there are delivery rooms equipped with innovative technologies, to enable a unique and pleasant birth experience through the use of multimedia, mindfulness, and more. We make every effort to allow the mother to give birth in the way she chooses, with as few interventions as possible and depending on the medical condition, when maintaining the safety of the mother and the newborn is before our eyes first and foremost. This was also the case in this case."
