Introduction

This project was first conceived by Maggie Smith, who, as a student midwife, was working on the delivery suite of a large consultant unit. A woman was admitted and assigned to Maggie’s care. Part of the admission routine included a vaginal examination (VE), but despite giving her consent to the procedure, each time Maggie tried to examine her, she closed her legs tightly and wriggled up the bed, repeating, ‘You’ll go through me … you’ll go through me!’ She was clearly very distressed. Maggie fetched her mentor who also tried to examine her. When she did not succeed, a number of other staff members tried to persuade the woman to comply. Their approaches, says Maggie in her account, ranged from ‘kindly reassurance’ to ‘cajoling’ and ‘reproaching’. ¹ Despite having given her consent, the woman was unable to allow the procedure to take place. Eventually, the midwife in charge of labour ward became impatient and told her that she would have to notify the medical staff. A male doctor duly arrived and made another attempt, but also failed. By this time the client was so distressed that the examination had to be abandoned. Later that day, the scenario was being discussed by a group of midwives in the staff coffee room. Maggie’s suggestion that the woman’s behaviour could have been indicative of a history of childhood sexual abuse (CSA) met with many different reactions. Some gave accounts of women they had cared for whom they suspected might also have such a history, while others appeared unaware that certain behaviours might be symptomatic of previous sexual abuse. One midwife appeared to find the whole idea distasteful and dismissed it by suggesting that the woman was just being awkward, probably because she was an ‘NCT [National Childbirth Trust] type’, and therefore likely to be uncooperative.