This text is part of the special booklet 90th Acfas Congress
While Quebec still has little data concerning this violence, the symposium entitled Interdisciplinary perspectives on obstetrical, gynecological and reproductive violence: from awareness to action! will look into the matter at the next Acfas convention.
The event will bring together students, activists and researchers from around the world. The projects on the agenda will address the themes of reproductive violence committed within unions themselves. The question of violence committed within the health system by healthcare personnel will also be discussed. “It’s really a fairly wide range of behaviors and actions that will be considered during the congress,” explains Sylvie Lévesque, professor in the Department of Sexology at the University of Quebec in Montreal (UQAM).
Non-consensual gestures, lack of listening, grossophobic comments… several negative experiences can be experienced by patients when they receive health care. “For example, a woman who knows she doesn’t want to have children and sees a doctor for irreversible contraception, such as a tubal ligation. We tell her that she is going to change her mind, that she has not yet met the right person to start a family with, ”reports Mme Levesque. Thus, this patient must often turn to another form of contraception which is not infallible. “We judge that she does not know what is best for her”, adds the one who is also co-responsible for the conference.
Some women are patted down without being told what it is. “It’s still intimate gestures. When we go to see a doctor for a gynecological examination, it is not your elbow that you show, ”underlines Mme Levesque.
Such incidents also occur during childbirth. Some patients in particular undergo an episiotomy without their consent. This procedure consists of an incision of the perineum to simplify the expulsion of the baby. “It’s easier to sew up than a tear, except that it’s still an intervention that is not necessary in many cases. In some cases, it may be recommended, in others, it is not”, illustrates the researcher.
Aboriginal women in Quebec have also been the subject of a study by the University of Quebec in Abitibi-Témiscamingue (UQAT). Last November, Suzy Basile, a professor in the school’s School of Indigenous Studies, released the report Free and informed consent and coerced sterilizations of First Nations and Inuit women in Quebec.
After collecting 35 testimonies from Aboriginal patients who have suffered obstetrical violence or forced sterilization, she will present the results of her report at the Acfas congress.
These women have been victims of prejudices that precede them even before being admitted to a hospital center, explains Ms.me Basil. “They are often labeled as problematic patients when they leave. Obviously, they “all consume alcohol and drugs”, so we treat them as such, ironically the professor. And we will also assume the fact that they have too many children and make decisions for them in this sense or strongly encourage them to accept a ligature. Some women also reportedly received threats of having custody of their other children removed if they refused sterilization.
A lack of data in Quebec
The study conducted by M.me Basile concludes that 63% of participants were offered tubal ligation as a method of contraception, regardless of their age or the number of children they had. The majority of women who were sterilized were between the ages of 17 and 33. However, the most favorable period for conceiving a child is between 20 and 35 years old.
However, there are still no comparative studies between the number of Aboriginal, racialized and white women who have suffered such forms of abuse. “In Quebec, we have long denied that it existed, obstetrical violence. Until very recently, women were told: ‘Stop exaggerating, it doesn’t exist’”, emphasizes the researcher.
Sylvie Lévesque agrees with this. “We know too little and, above all, we do not collectivize. It remains anecdotal. We have no observatory on these realities. So we don’t know that much what we’re talking about, ultimately, ”she said.
Compared to other countries in the world that have laws against obstetrical violence, “we are late,” she says. “In Quebec, we don’t even have an inventory yet,” she summarizes. Her team will also launch research on the subject next June to collect the experiences of Quebec women who have received health care in the province.
The professor points out that such studies have already been carried out in several countries in South America and Europe. In France, the High Council for Equality between Women and Men published a report on the issue in 2018. “That does not mean that their care is currently better. But at least they have started a reflection on the subject, ”underlines Mme Levesque.
According to Suzy Basile, there is still “much to do for Indigenous, racialized and Quebec women to find their account and be fully respected in their fundamental rights”.
For First Nations and Inuit women, improving things starts with education about the notions of consent and colonialism, she believes. “People in the different health professions need to understand where these patients are coming from, with a long series of traumas that are transmitted from one generation to the next,” she argues.
Mme Basile cites the example of today’s women who have experienced residential schools, who have been sterilized against their will, or who have seen some of their children disappear in the Quebec health network. She also pleads for stricter rules in terms of ethics and for more severe consequences if there is a breach. “Because, for the moment, there is nothing. »
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