But what haunted Marissa to this day – even more than the physical pain she experienced – were the memories of being invalidated and dismissed by her providers. “I was told constantly to relax,” she explained. “I just always felt like I was overreacting to everything.” By failing to take Marissa’s needs seriously, her providers placed her in harm’s way and she was left with long-lasting physical and emotional consequences.

Marissa was just one of forty-six mothers with whom we spoke during our research on traumatic childbirth.

Traumatic childbirth is inexcusably common in the US; between a fourth a third of mothers report their experience as traumatic. Moreover, these births occur within the dire context of America’s maternal health crisis: the US has the highest maternal mortality rate among industrialized countries and glaring racial/ethnic disparities in maternal health outcomes.

In our study, we found that core to most mothers’ experiences of traumatic childbirth was feeling ignored and invalidated by providers, as well as being cast as crazy or irrational. Mothers’ accounts pointed to the prevalence of what we term obstetric gaslighting.

In new research published in Social Science and Medicine, we argue that obstetric gaslighting occurs when medical providers deny – and thereby destabilize – mothers’ and birthing people’s realities. Within the context of childbirth and obstetric care, these denials can manifest in 4 ways, when providers deny: 1) mothers' humanity, 2) mothers' knowledge as valid, 3) mothers' judgements as rational and 4) mothers' feelings as legitimate.

All four denials are harmful because they disorient mothers and cast them as the “crazy” ones. They play into stereotypes of women as dramatic and irrational, in contrast to physicians as “rational” “experts.” In doing so, these denials diminish mothers’ sense of agency and security, making it hard for mothers to advocate for themselves.

Institutional courage is essential to combat obstetric gaslighting, especially within a context of crumbling reproductive rights across the country and increasing numbers of forced pregnancies and births. This courage can take many forms, but it must include facilitating greater awareness and transparent discussions of gaslighting within the obstetric community to prevent providers from falling back on gaslighting tactics. It should include connecting and insuring mothers with supportive services such as doulas, midwives, and maternity care models that offer greater support and continuity around childbirth. And it must involve soliciting feedback from mothers about their birth experiences, including standard screenings of mothers for gaslighting that draw lessons from tools like intimate partner violence (IPV) screening.

Ultimately, medical institutions and leaders will need to step up to combat obstetric gaslighting and work across contexts to recognize women’s and birthing people’s right to information, autonomy, and dignity.

[1] All names are psuedonyms.