A challenging climate: authoritative speech and saying no to routine vaginal examination in labour

Abstract

People in labour have a right in law and policy to say no to vaginal examinations. This should be uncontroversial: in almost no other space is it acceptable to penetrate another’s body without their say-so. Yet reports abound of women in labour having fingers inside their vaginas even after saying ‘no’. Some describe their experiences as being akin to rape. This article argues that the framing of vaginal examination as routine may be seen as a form of authoritative speech that severely limits the ability of women and birthing people to say no to unwanted examination. Routine vaginal examination creates and determines the routine of labour care, delivers finding of fact in relation to progress of labour and creates normative and practical expectations of birthing people and clinicians. This constrains birthing people’s ability to prohibit vaginal examination on their body. This framing also presents a limited and inadequate conception of what a vaginal examination is, which further limits people’s ability to successfully say ‘no’.