Women's experiences are frequently overlooked in research on childbirth and breastfeeding, highlighting the need for a more holistic approach to medical decision-making.
In the realm of reproductive medicine, there is considerable emphasis placed on factors such as breast milk quality, neonatal health indicators, and risk profiles. However, according to a recent study conducted in the province of Quebec, 20% of women report experiencing coercive pressure, non-consensual acts, or pain ignored during childbirth and breastfeeding. These experiences are often downplayed or attributed to "a lack of effort," underscoring the need for medical practices that prioritize patients' autonomy and mental health.
Medical decisions in reproductive health rely on various forms of scientific knowledge, with much focus centered around fetal development, reproductive capacity, and managing pregnancy-related risks. This extensive research has led to robust recommendations from international bodies. However, less attention is given to the psychological and social consequences of policies that promote breastfeeding, as documented by a 2024 study in Quebec involving 944 women.
The survey revealed that regardless of their choice to breastfeed or their attitudes towards it, nearly one-fifth of respondents reported receiving judgmental, coercive, or intrusive messages. Some participants described feeling completely disregarded for their mental health needs: "Messages never consider my physical and psychological state." Others recounted instances of non-consensual actions during breastfeeding sessions, such as being forced to continue despite pain or a lack of information about alternative feeding methods.
The study also highlights the broader context in which women experience difficulties with childbirth. Seventy-eight percent of participants reported encountering at least one unpleasant incident during their labor and delivery, often linked to how care was provided or imposed. These practices are rarely described as violence but rather as part of a culture that prioritizes obstetric safety.
These findings underscore the importance of recognizing the value of women's lived experiences in medical decision-making. When insights derived from these experiences conflict with biomedical priorities centered on reproductive functions, such as carrying and giving birth, biomedical knowledge tends to dominate. This hierarchy can lead to marginalized voices and undervalued perspectives within clinical settings.
Research into obstetric violence—abuse or mistreatment during labor and delivery—provides another avenue for observing the tensions between different forms of knowledge. In a study involving 271 women who had given birth in the past two years, participants described experiencing unsupportive interactions with healthcare professionals, lack of consent for certain procedures, and organizational failures.
These practices are often justified as part of standardized protocols aimed at ensuring obstetric safety. However, from the women's perspective, these interventions can feel intrusive, humiliating, and dehumanizing. Participants reported a sense of powerlessness during their childbirth experiences, with pain being downplayed or procedures carried out without consent.
Both bodies of research—centered on reproductive functions and focused on maternal mental health and decision-making autonomy—coexist within the same scientific fields but are often treated unequally in clinical practice. When biomedical imperatives clash with patients' lived experiences, the latter frequently take a backseat.
Recognizing this imbalance is crucial for expanding the framework used to make medical decisions. It requires considering not only the biomedical outcomes of practices like breastfeeding and childbirth but also their effects on patients' mental health and ability to make informed choices. By valuing women's perspectives more fully, healthcare providers can better support mothers during these critical periods.
Ultimately, a more holistic approach that integrates both scientific evidence and patient experiences is essential for improving maternal care and ensuring that medical practices are truly centered around the well-being of those they serve.
