Manipulation, coercion, and abuse is not isolated to hospital births. Unfortunately, there are Midwives who make birth a business, and end up treating clients as such. They push and manipulate in order to achieve what they want. Then, they justify.
A Midwife sticks her hand in her client's vagina while she's having a contraction. Client says no. Midwife says sorry, and backs off. Next contraction, Midwife does it again. Client says no again, adding a kick to the Midwife's hand.
Guess what? That's sexual assault. Client said no to vaginal penetration, Midwife did it again anyway.
There's no two ways about it. It doesn't matter if the Midwife felt it necessary, the woman said NO. Clearly, without any ifs, ands, or buts. And the Midwife may say, "I need to do this because...". Manipulation. In a situation which intervention is clearly needed, a woman is not likely to say no, because she understands intuitively that intervention is necessary. Thankfully, this only happens rarely. A woman knows when it's not necessary, but this type of assertive, abusive behavior confuses the woman who is feeling her intuition, but having authority contradict intuition.
The description of how an abuser operates:
Covert abusers are the worst and the hardest to confront. They do their abusing and controlling in a hidden, manipulative, secretive way. They say one thing with their mouth and appear to be loving and kind, but their actions are controlling...
Another:
They are in control of their actions, not out-of-control. They do not harm everyone they meet. They are very careful to abuse people they feel confident they can get away with harming.
Another:
They blame others for their behavior. “The abuser shifts responsibility for his actions away from himself and onto others, a shift that allows him to justify his abuse because the other person supposedly "caused" his behavior.”
The justification and shifting responsibility are particularly important in the operation of an abuser. To say it was necessary because you weren't progressing in labor, to say that it was necessary because you said you wanted to avoid a cesarean, to say it was necessary because you didn't want to tear...these all play into the deep emotions that are present at birth. And in heavy labor, rarely is a woman going to argue with these justifications. My "favorite" one that I just heard:
I am not responsible for a woman being unhappy or traumatized with her birth. If she didn't like what was going on, she should have said something.
Yep. Except often either women DO say something, and are ignored or coerced by justification, or they are too ingrained in the belief that a Midwife is the authority figure, and must know what she's doing. This is still abuse and victim blaming.
I have been abused. Emotionally and verbally. By both parents, and doctors. It's not okay, in any situation. But when it happens in your home by a care provider whom you hired because you thought she would help you lovingly through a deeply spiritual and intimate moment in your life...it's nothing less than heinous.
