In ‘Making Loud Bodies “Feminine”’, I focused on how women live with and experience obstetric violence and why it is frequently described not only in terms of violence in general but specifically in terms of gender violence: as violence directed at women because they are women.1 For this purpose, I used feminist phenomenology to explain and account for the feelings that many victims of this violence experience and report, including those of embodied oppression, of the diminishment of self, and of physical and emotional infantilisation.
In this chapter, I examine such feelings of diminishment of self and infantilisation through the epistemic aspects of the phenomenon of obstetric violence, mainly by observing it from the perspective of recent theories on epistemic injustice and specifically through the concept of ‘gaslighting’. I argue that a central part of obstetric violence involves labouring women being disbelieved, distrusted, and (unjustifiably) questioned about their violent labouring experiences and, more pressingly, even being made to doubt their own experiences of violence and to feel deprived of epistemic authority altogether. I show that the distrust shown towards labouring women operates both during the experience of labour and afterwards, when they attempt to tell others about their (violent) labouring experiences and to obtain epistemic recognition from them. I emphasise that this experience of deep distrust needs to be understood not simply as a response to the phenomenon of obstetric violence but must be recognised as a core part of the phenomenon itself.
The idea of ‘gaslighting’ has recently been used to account for specific cases of epistemic injustice, where the victim is intentionally or unintentionally made to doubt and distrust her own experience and testimony, since her interlocutor (often her supposedly ally) heavily questions their truth. Thus, in this chapter, I argue that to be a victim of obstetric violence means (also) to be continuously gaslighted: first by the medical staff involved and then by those who listen to the victim’s story.
‘But you cannot know for sure, can you?’
Last year, I went through several miscarriages. During one of them, I started bleeding at six weeks and five days into the pregnancy. I went to the hospital and was welcomed by a gynaecologist, a young woman. She seemed to be truly empathetic and kind. One of the first things she proceeded to do, after briefly conversing with me and my partner, was to examine me via ultrasound. She saw a tiny sac, with an approximately four-week-old embryo, a discovery she communicated to me optimistically. ‘You are four weeks pregnant’, she said, ‘and you are bleeding, like so many women at this stage. Everything seems to be all right, do not worry too much’. ‘But there is no heartbeat’, I countered. ‘Of course there is not’, she replied, immutable: ‘At four weeks we still cannot see any heartbeat’. Then I started impatiently explaining to her, for a second time now, that I was, in fact, not four, but rather almost seven weeks pregnant, and that this was surely an embryo that had stopped developing at four weeks (a situation similar to what had happened to me during several past pregnancies). It was then that a patronising dialogue of distrust began.
‘But you do not really know exactly when you got pregnant, do you?’ ‘The truth is that I know the precise date’, I responded. ‘But you cannot know for sure’, she continued. ‘I do believe I can, though: I feel ovulation very clearly and I also used an ovulation predictor kit’. ‘Well, this is what I see in the ultrasound’, she said, attempting to bring this hierarchical conversation to a happy ending by using the ultimate silencing weapon: Technology.
‘You just do not believe me; you do not believe me at all, right?’ I desperately tried, one last time.
She wielded her final weapon, condescendingly: ‘Well, we cannot base a diagnosis on your intuition, can we?’. And then I just shut up. I knew that this was pointless. I would not be able to convince her. In her view, I was still pregnant. To me, it was clear that I was miscarrying. I had experience, and I had knowledge, but this knowledge was being silenced mercilessly and turned by the ‘epistemic authority’ into ‘pure intuition’, just another suspicious female hunch not to be trusted. This is how I, an adult woman in her 40s, a responsible professional, a professor of philosophy, was sent home and told not to worry, since in eight more months I would most probably become a mother for the third time.
I went home, and I miscarried. Everything was all right and I needed no further intervention. However, that meeting with the kind doctor demanded reflection. After I went home that night, before I miscarried, I had noted that there was something else awakening in me alongside my anger and desperation at being disbelieved. I felt self-distrust, an uneasy feeling of not being sure whether I might be four weeks pregnant after all and not seven. That is, I had a feeling of not being sure whether I knew anything at all. In the end, I thought, it would be nice if she was right, and maybe she was, and how could I really know, after all?2