As at so many modern births, the camera was rolling as 27-year-old Kimberly Turbin gave birth to her son at California’s Providence Tarzana Medical Center in 2013. The video, which went viral this year, also recorded Turbin’s episiotomy, the medical term for a surgical cut of the perineum—from the vagina to the anus—used to facilitate or hurry a difficult delivery. But Turbin claims the procedure was done without her consent, and the horrifying video is now being used by the new mother in an assault-and-battery lawsuit against the provider who performed it, Dr. Alex Abbassi.
In the very NSFW video Turbin, a self-described two-time sexual-assault survivor, lies on her back, naked from the waist down, her legs in stirrups. Turbin, who has apparently had an epidural, attempts to push. One her third try, the on-call physician, Abbassi, silently readies a pair of scissors and a cloth.
“I’m going to do the episiotomy now,” he says.
“Why? We haven’t even tried,” Turbin says.
Abbassi explains that she is pushing, but the baby isn’t coming out and warns that if she continues to try, “it’s going to rip the butthole down clean.”
Turbin continues to protest. “No, don’t cut me!” “No! Why? Why can’t I try?”
“What do you mean, ‘Why’? I am the expert here, OK?” Abbassi says. “You can go home and do it! You go to Kentucky!”
Then, Abbassi cuts Turbin 12 times, and her baby is born.
Abbassi noted in Turbin’s medical record that the “patient refused any surgical intervention,” and the record shows no emergency necessitated the procedure, according to the complaint.
Though episiotomies were once common in the U.S.—in 1979 they were performed in 61 percent of vaginal deliveries compared to 14 percent today—the American College of Obstetricians and Gynecologists (ACOG) released a statement in 2006 discouraging their routine or preventive use, finding that it benefited neither mother nor baby. ACOG also noted there were consequences to the procedure, including severe tears, infections, anal sphincter dysfunction, as well as painful sex.
As a result of her forced episiotomy, Turbin allegedly suffers from both physical and emotional injuries, and trauma related to her prior sexual assaults, according to the complaint.
Abassi, 78, is an obstetrician gynecologist with 36 years of experience who came to the United States from Iran 41 years ago. A search of the California state medical board found no history of disciplinary actions or lawsuits against him. In a local news segment covering his 12,000th delivery, Abbassi said, “Each time when you bring a new life in the world, it’s just an accomplishment, it’s an achievement, and also some deep happiness when you can make another person happy.”
Abbassi could not be reached for comment, but calls were returned by a woman named Khatereh. She wouldn’t give her last name, but a 1991 Los Angeles Times story quotes a Khatereh Abbassi, identifying her as “Dr. Abbassi’s wife and office assistant.”
“These are confidential matters,” Khatereh said, before refusing to comment. “Don’t ever call here again. And if we find out [a story] is being done, you’ll be No. 1 to be sued.”
Patricia Aide, a spokeswoman for Providence Tarzana Medical Center, where Turbin delivered her baby, said she couldn’t comment on a patient’s case, but noted that while Abbassi delivers at the hospital, he is not an employee (California bans direct hospital employment of physicians.)
While the legal merits of the case have yet to be decided, the video is undeniably disturbing. What’s more, say Turbin’s advocates, is that her alleged trauma is far from isolated and points to a larger problem of general obstetric violence—a term they use to define the dehumanization and medicalized abuse of pregnant women.
“The obstetric model has always been ‘You do what I say,’ and too often women are talked down to or mistreated,” Dawn Thompson, founder of Improving Birth, the national organization that helped Turbin in her year-and-a-half-long search for legal representation, told The Daily Beast.
“Women need to trust their care providers, and their care providers need to be trustworthy,” Thompson said.
With most patients, the idea of informed consent is straightforward: Competent patients must be educated on the risks and benefits of procedures and agree before they are performed. But in obstetrics, research and anecdotal evidence collected by advocates suggests a number of procedures are often performed on laboring women without such education or consent.
In a 2013 survey by Childbirth Connection (PDF), only 41 percent of new mothers who experienced an episiotomy reported having been given any choice beforehand.
And in a recent survey of more than 2,000 doulas, childbirth educators, and labor and delivery nurses across the U.S. and Canada, Louise Marie Roth, an associate professor of sociology at the University of Arizona, found that 63 percent of maternity support workers either “occasionally” or “often” witness a provider “engage in procedures without giving the woman a choice or time to consider,” and 17 percent report that providers go through with procedures even when they are explicitly against the wishes of a laboring woman.
“When you’re in the moment and things are urgent, it can be difficult to have the kind of comprehensive conversation that needs to happen to get really good, informed consent,” Roth told The Daily Beast.
Still, Roth stressed that a pregnancy doesn’t negate a woman’s civil rights. “There is no informed consent without informed refusal. If you can’t say ‘no’, then you don’t have conformed consent.”
In a statement to accompany her lawsuit, Turbin said, “Every time I hear one of these stories about women being ignored when they complained about how they were treated in the hospital, it reminds me of why I’m doing this. It took a lot of people to get this far, but this is the proof that you can do something. This is a big step for women who have been silenced.”
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