Feminist Rationality and Obstetric Violence

Feminist rationality and obstetric violence 

Introduction 

When concluding her reflections on feminist views of rationality, Genevieve Lloyd asks, “how might “rational thought” change if gender differences - whatever their origin - are taken seriously, rather than masked in an idealised sameness of soul?” (2015, p. 169). Doctors’ offices, operating tables or birthing rooms may not be the most obvious place to look in search of feminist philosophical answers to questions about rationality. This blog aims to draw attention to the value of medical humanities, more specifically the philosophy of birth, by showing that such places may be helpful in finding answers. Specifically, in answer to Lloyds question this blog post looks to obstetric violence. Obstetric violence is a concept that has seen global uptake in recent years, various definitions have been offered but in its broadest conception it captures violations experienced during reproductive healthcare. Thinking about obstetric violence provides one examples of how the harm that occurs from masking perceived gender differences to “rational thought” might be reduced if such differences, as Lloyd implores us, “are taken seriously” (2015, p. 169). Using the relationship between the uterus and rationality as a starting point this post then provides a brief overview of rationality, feminist views of rational thought and argues that rational thought that takes seriously historical and constructed gender differences would take account of emotion, recognise the significance of metaphor, and engage with the role of lived experience in knowledge construction. 

Feminist philosophy and rationality 

It should first be noted that there are many types of feminism, and they take differing views on various issues both in theory and in practice. This blog posts seeks to simply highlight some common features across feminist philosophers and their writing. Rationality does not exist in isolation and is often associated with connotations of objectivity, abstraction, detachment (Lloyd, 2015). Similarly, rationality combined with of knowledge, objectivity and truth can constitute additional concepts such as epistemology (Rooney, 2017). “Rationality and objectivity as epistemic (knowledge-related) ideals were regularly assumed to be exhibited only or primarily by men and, often too, only by men of “higher” races and classes” (Rooney, 2017, p. 243). “Women were regularly thought to be less rational than men because rationality is perceived to require the exclusion or control of emotion, passion, or instinct which were metaphorically or symbolically cast as “feminine” (Rooney, 1991). Not surprisingly then, feminist philosophy is intrinsically tied to the debate of reason because, as Lloyd says, “critique of reason has formed a large part of dramatic expansion in the literature of feminist philosophy” (2015, p. 165). This critique gained traction only in the 1980s (Lloyd, 2015). Attempts to sustain critiques of reason have been met with bemusement and frequently hostility (Lloyd, 2015). However, to critique is not to reject. Feminist critique of reason can be seen as enriching and benefiting the concept of reason (Lloyd, 2015). Casanova argues that “women, like men, think with their heads but have no greater powers of reason than those they have been allowed to develop” (Villarmea, 2021, p. 34). As Villarmea explains, “Casanova recognizes that, if women are determined by anything, it is not by the womb but by the education they receive and by their distinct social condition.” (2021, p. 34). Masculine constructions of rationality have real life consequences, for the social condition of women, for example “in the denial of their access to citizenship and the prohibition of their right to vote” (Villarmea, 2021, p. 30). Feminist critique has to be careful not to fall into the same universalising traps it seeks to highlight (Lloyd, 2015). For example, “feminists are sometimes portrayed as uniformly rejecting reason and objectivity as “male” concepts” (Rooney, 2017, p. 246). “Unity of women” or “feminine” is just as much as construction of the philosophical imaginary as is “rationality” of “philosophy” – this unity requires just as much demystification as reason itself (Lloyd, 2015). 

Obstetric violence and rationality 

Obstetric violence can provide an example of how “rational thought” can inflict harm when gendered difference are “masked in an idealised sameness of soul”. Villarmea explains that “when it came to assessing women’s rational capacities, in question was whether female thought had its origins in the uterus, given that there was no “proof” that it came from the brain.” (2021, p. 23). The relationship between the uterus and women’s ability to think can be seen in the “wandering womb” theories of Ancient Greece and explanations of hysteria in the Middle Ages.  As noted earlier, these views of women’s mental capacity led to the denial of women’s rights such as voting. It could be argued that it has also manifested in potentially contributing to enabling instances of obstetric violence. Instances of obstetric violence, “do not reflect isolated incidents nor sporadic episodes experienced by women in the course of their lives, but rather are part of a continuum of the gender-based violence that occurs in the wider context of structural inequality and discrimination” (Villarmea, 2021, p. 24). “A crucial barrier to warranting women’s rights in the labour room are beliefs as to whether a woman in labour is actually in full control of her capacities” (Villarmea, 2021, p. 35). Often if a woman is not viewed as in control of her capacities her request or expression of her desires are not viewed as valid and perhaps not listened to and her autonomy then violated. A rational thought that recognises perceived and constructed gender difference should recognise a woman’s full control of her capacities and serve to overcome this barrier. As legal responses to obstetric violence are being constructed it is important to consider the factors that contribute to the presence of such instances so that they can be effectively addressed.  

Towards a feminist account of rationality 

There are many aspects of rationality that may change if historically constructed gender differences were accounted for rather than masked, this post identifies emotion, metaphor and standpoint as some common features emerging from the literature on feminist philosophy. This post is simply meant to traverse the types of things that may be taken account and not argue robustly for a definitive and finite list, to do so would be a much large project. 

Emotion  

Feminist rational thought would have a more constructive and gender conscious relationship to emotion. Feminists have highlighted the role of emotion in reasoning. For example, emotions can reveal moral attitudes (Spelman 1991; Lloyd, 2015). Feminists have also highlighted the gendered experience of emotions. Particular emotions are not gender specific (Bartky, 1990). Instead, emotions are experienced differently based on their “total psychic situations and general social location” and the “pervasive affective attunement to the social environment” (Lloyd, 2015, p. 186). In contrast to historical views that rationality is devoid of emotion, it is now recognised that “appropriate emotions are indispensable to reliable knowledge” (Jaggar 1996: 182). Similarly, neuroscientists have in fact found that “certain aspects of the process of emotion and feeling are indispensable for rationality” (Damasio 2005 [1994]: xv, xvii). 

Metaphor  

Rational thought sees metaphors and imagery as incidental - this “functions to mask aspects of the philosophy which cannot be readily articulated at the level of abstract concepts, and to organize the values implicitly in the philosophical texts” (Lloyd, 2015 p. 166). In her account of the relationship between the brain and the uterus, Villarmea notes that a challenge to her essay could be that “it is just a metaphor” (2021, p. 34). However, even metaphors are gendered, “doctors do not devote time to searching for metaphors to describe their (lack of) rationality nor its origin” (Villarmea, 2021, p. 34). A version of rationality that recognises gendered difference would recognise that “different kinds of unity between intellect, imagination and emotion are appropriate or inappropriate in different context” (Lloyd, 2015).  

Standpoint Epistemology  

Rationality has been framed as belonging to those “who can “detach” from their subjective interests and preferences in making judgments” (Rooney, 2017). In other words, those who can be objective. Feminists highlight that objectivity has various meanings and purposes (Lloyd 1995; Douglas 2004; Anderson 2015).  Further they highlight that “objectivity requires taking subjectivity into account” (Code 1991: 31). The ability to look “objectively” on something by being removed from it is not necessarily an epistemic advantage and “those who occupy particular standpoints (usually subdominant, oppressed, marginal standpoints) automatically know more, or know better, by virtue of their social, political location” (Wylie 2004: 341). “Epistemically significant standpoints are achieved through critical, conscious reflection on social locations with respect to power structures that play a role in the production of knowledge” (Rooney, 2017, p. 247). “Justice-oriented political sensibilities can often serve to enhance such critical reflection” (Rooney, 2017). Engaging in critical theories such as feminism may then make individuals more primed to engaged in such critical reflection. “Women and men - differently situated in relation to the past exclusions and privilege of their shared intellectual tradition, may well have different perspectives on rationality and different attitudes to what can be hoped for from its transformation” (Lloyd, 2015, p. 172). A rationality that takes account of gendered difference would acknowledge the validity of epistemically significant standpoints and the role that critical theories such as feminism can play in facilitating conscious reflection on social locations and power structure. It may recognise “situated knowledges” or knowledge that is “less partial and distorted” rather than privileging “disembodied scientific objectivity” (Haraway 1988: 576, 581;  Harding 1993).  

Unmasking the relationship between medicine-humanities and philosophy-birth 

It is possible to see how these features of emotion, metaphor and lived experience could be relevant to birthing women and obstetric violence. This post so far has sought to illuminate what may lie beneath the mask of neutrality in the context of “rationality” using obstetric violence as an example. Birth, and potential aspects of the birthing experience such as obstetric violence can benefit from a philosophical analysis, even more so from a feminist philosophical analysis. Similarly, questions held by feminist philosophy and philosophers can benefit from looking in doctors’ offices, operating tables or birthing rooms for potential answers.