What is medical gaslighting, and how does it show up in maternity care?

The term gaslight comes from the 1944 film of the same title, whereby the main character seeks to have his wife committed to an asylum.

He tampers with the gaslight, making it flicker and then denies that he sees this, making his wife question first her senses and then her sanity. This is just one way in which he seeks to manipulate her in the hope of institutionalising her and steeling her property. 

The term really caught on because it is a sadly common form of exerting power, deceit and control over another. 

Gaslighting is a term that is often reserved for manipulative relationships, however it is equally well recognised now within medical settings too. 

Medical gaslighting always involves:

• Manipulation or distortion of the facts.
• A covert exertion of power and control.
• A desire to make the other person wrong (with the implication that the HCP is right).
• It feels like a self doubt, impotence, dismissal, invalidation and insignificance.

Some common examples of gaslighting within a maternity context are: 

• Disputing parent’s account of what occurred during their birth.
• Dismissing a woman’s experience of labour (‘but you’re only  xcm dilated you can’t be ready to push’ or ‘you can’t be in pain you only xcm’ ).
• Using fear as a means of coercion (‘you’re measuring very big for your size/week, we’d better induce you soon.’). 

A rather large scale example of gaslighting was the recent AGGP report that failed to mention some of the most common causes of birth trauma (induction for non medical reasons, medicalised, industrial scale birth units, lack of choice in birth place).

As a perinatal therapist who has listened to 1000s of births stories  and as a birth doula who has attended dozens of births the report certainly made me question all of what I have heard and seen over the years.

Really, gaslighting will always exist in any relationship (personal, business, or in public service) where one party has the desire to exert power or control over another party.

The only way to eradicate gaslighting from healthcare settings (or any other public service setting such as law or education) is to return to the point of serving the individual and their unique needs.

This is challenging in a modern medicalised maternity system which hasn't the numbers of trained workforce required to provide individualised care AND  has a tendency towards processing parents through a set of pre ordained, preset measures.

If you are ready to become part of the solution to:

• Traumatising maternity careWhat is medical gaslighting, and how can call it out and how can we prevent it?Lack of support for parents struggling with mental health

Then you might be a good fit for the TBR Certificate in Perinatal Health & Wellbeing starting in September.