If you have given birth to a child you can attest to the fact that it is one of the most vulnerable times you will ever experience in your life. The double-sided coin is that to possess complete control during the process a woman must give up complete control. She must trust and work with her body, baby and the process. The end result is the same for all women as it has been since the beginning of time, a baby will be born. However, the difference in how that mother receives that baby can range depending on the circumstances. If not handled correctly instead of feeling empowered and confident as a woman, new mothers are often left having to relive traumatic experiences and feeling victimized all over again.
With the above stats it is more likely than not that I will come across more and more clients who have experienced some sort of sexual abuse trauma. I am fully aware of my scope of practice and that I am not a therapist or counselor, but it doesn’t release me from the responsibility of being aware of how a mother is reacting to pregnancy, labor, delivery, post-partum and motherhood. During prenatal visits I try to build a relationship with all my clients by educating them as well as spending time learning about their experiences and expectations. Sometimes the subject may come up during our visits; other times intuition and experience will be my guide. During labor and delivery I am to adapt my response to these mothers so that I may not cause further harm. I need to be mindful of words used that can encourage your average mom but can make a survivor mom completely withdraw or become defensive. A touch that can sooth and comfort most women may send a survivor mom into a cocoon or worst have her completely shut down prolonging her labor.
With all of the literature, education, training for professionals and counseling for survivors have become available as awareness for this subject continues to bring healing to women and mothers. I admit that I am still resolving to learn more so that I may better assist and be a better and comfort and support to survivors of abuse.
2.Besharov, D. J. (1994). Responding to child sexual abuse: The need for a balanced approach. In R.E. Behrman (Ed.), The future of children, 3 & 4, 135-155. Los Altos, CA: The Center for the Future of Children, The David and Lucile Packard Foundation.
Bottoms, B., & Epstein, M. (1998). Memories of childhood sexual abuse: A survey of young adults. Child Abuse & Neglect, 22(12), 1217-1238.
U.S. Department of Health and Human Services, Administration on Children, Youth, and Families. (2007). Child maltreatment 2005. Washington, DC: U.S. Government Printing Office.
3.National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, D.C.: National Academy Press; Tjaden, P., and N. Thoennes. 2000. Full Report of the Prevalence, Incidence, and Consequences of Violence against Women: Findings from the National Violence against Women Survey. National Institute of Justice: NCJ 183781. (www.ncjrs.gov/pdffiles1/nij/183781.pdf)
I had the great opportunity to spend the evening with a group of women last night at the Childbirth Collective . "The mission of the Childbirth Collective is to enhance the childbearing year for parents by promoting quality doula support, advocating evidence-based care, and providing accessible education based on the wellness model of maternity care."
The theme of the evening was birth stories. There we all sat, women of all ages, races, first timers, some having their fifth and sixth child, grandmothers (to-be), and a variety of childbirth experts. Their stories reiterated that there is no ideal birth scenario and much like weddings "the best laid plans..." and so the phrase goes.
I am reminded that a successful outcome is in the eye of the mother; whether she felt like she had control of her birth experience, whether she felt supported, if the birth was faster or longer than she expected and so on.
I also was proud to learn that every woman there had a doula for support (one lady had two). The common thread with doulas were that they were invaluable to their birth experience and that their husbands/partners could see the benefit even if at first they were skeptical. A common misconception is that the father to be is fully capable of supporting a woman throughout her entire labor and delivery experience. I believe this is an unfair burden to put on anyone, especially men who may be squeamish over bodily fluids, or surprised by unexpected sounds to seeing the one they love be in "pain" and not being able to take it away.
This reminds me of a couple I was with a few weeks ago. They were a team. It was obvious they practiced their breathing, comfort techniques, words, and he encouraged her like I had never seen done before. It was beautiful and I feel blessed to have witnessed a couple so in sync bringing their child into the world. They were home for most of her labor and when they arrived at the hospital it took a little over an hour for her to deliver. I told mom, "that's very smart that you did most of your laboring at home." The father to be said, "I wasn't that much help, I slept most of the time". This surprised me because he appeared so confident (and I am sure he was) in his ability to help his wife, but in reality, when I came on the scene he felt like the weight of the world was off of his shoulders (his words). He was exhausted and at a loss for ways to comfort her especially during the transition period.
I only regret that they didn't call sooner, as most of the women and their husbands at this meeting collectively experienced and expressed. Hearing that it was common to wait until they couldn't handle the labor alone saddened me because an experienced doula is trained to not only encourage and support mom, but dad as well. This also taught me to make during my prenatal visits to encourage my clients to call me as soon as they think they are in real labor, that it's not a bother but what they hired me to do.
A doulas job is not to replace the father to-be role. He is a very important part of her birth experience. He can love her in only the way that he can, he knows her more than a doula or any labor support person can. It is great to see a father settle into that loving role.
If you have any questions about what and how a doula supports a family before, during and after pregnancy feel free to contact me, I'd be happy to help.
In my last post I spoke of the possible influences that affect the way women and society view childbirth. In this post I would like to help from a different angle. We’ve heard that knowledge is power. I wonder if we’ve really grasped the meaning of this, or is it just another inspiring quote. One way to combat fear head on is to know your enemy or the perceived enemy in most cases.
I am going to use a job interview as an example of having fear and anxiety about the unknown and methods to overcome them that can be applied to childbirth. When you are interviewing for a job it is not uncommon to begin to have some anxiety about the interview itself and the outcome. Sometimes we begin to play in our mind all the negative possibilities that can take place only paralyzing us all the more. There are several books and websites dedicated to preparing potential job hunters for their interviews. One in particular allbusiness.com has helped me compile this list which I will apply towards childbirth.
1) Do your homework. Although childbirth is a natural process which a woman’s body is designed to achieve most people do not understand the physiological, psychological and emotional components that go along with it. Childbirth classes help expectant parents learn about and prepare for labor and birth. There are several kinds to choose from.In childbirth classes you will learn about the labor and delivery process, how your body is working with you (not against you), ways to manage pain and other information that will help you feel more comfortable about the process and knowing what to expect. Research them as much as you can to become familiar with each technique until you find an course that seems right for you.
2) Know where you’re going. Are you having a home birth, birth center, or giving birth at a hospital? Will your health care provider be an obstetrician, a midwife or your family practitioner? Each option has their strengths and weaknesses and it is best to know beforehand who you’d like to be involved with the delivery of your child.
3) Look the part. Well, your body is already taking care of this one. I would add that it is not only important to take care of yourself physically during this time but your overall well being is important as well. If you exercised before baby keep at it (with doctors guidance). In fact, if you abruptly stop your routines it may cause some stress and anxiety. If you did not exercise regular before baby, I don't believe doctors recommend starting up a program, but Pilate's, walking, stretching, etc. not only benefit you but baby as well. There are (thank God) a lot of great maternity clothing now. Have fun, enjoy this time, get a massage, a facial, be pampered. This is your time, in a few months it wont be so much.
4) Rehearse beforehand. Is there a breathing technique or hypno birthing method you would like to use? Most people make the mistake of skimping on the practicing; they figure they can wing it. The problem is with most methods and techniques they benefit you the most with when you put in the work before labor starts. Many times someone will try something and say it didn’t work, in reality they really didn’t commit to learning it completely. What are some ways you relax, distress? This is the time to practice some comfort measures to see what helps and what would irritate the daylights out of you.
5) Secure your references. Build your support system. Women who labor and deliver alone tend to have less than ideal birth experience. When I say alone, keep in mind that most obstetricians are either taking care of several patients at one time, and most only want to be called to come in when delivery is very near. Most labor and delivery nurses chose that profession because of their sincere desire to serve and comfort women during their most vulnerable time. Unfortunately they also juggle several patients and have to follow procedures and monitors which keep them from the one on one experience with expectant mothers. Midwives can vary depending on if it’s a hospital, home or birth center delivery. They can be more attentive to the laboring mother but as delivery become closer their role rightfully changes from solely nurturing the mother to making sure that a safe delivery is the end result. Whether it’s your best friend, your partner, mother or doula, you will want to consider who you will want with you as each person brings along their experience, fears, and expectations which can positively or negatively influence your birth experience.
6) Arrive early. Or maybe not. Most women (and the fathers-to-be) have anxiety about her water possibly breaking at the movies or trying to determine if she’s having real contractions, Braxton hicks or gas. You will want to discuss with your caregiver at what point you should contact them and head to the hospital, birth center, or should expect them to come over if you are having a home birth. Often women have reported being in labor and rushing to the hospital only to have labor slow down or stop, and this may be due the change in environment, paper work, unfamiliar faces, etc. Whatever the plan is make sure you have it and contact numbers close by and that your support person(s) have access to it a well. Also, taking a tour of the hospital before, finding out their procedures for admitting, labor, delivery and recovery is a good idea.
7) Bring necessary documentation. Make a checklist of everything you will need to bring to the hospital. Toiletries, music, comfort and focus items to name a few. Consider getting a new robe, a new night gown as a gift for yourself, any medications you take, journal, camera, whatever you can think of. This is helping you to be proactive. Being unprepared can caused unnecessary stress to an already potentially stressful situation.
8) Sell yourself. You have to advocate for yourself. This is your birth experience. Work with your doctor, midwife or doula about the benefits of a birth plan. The great thing about creating a birth plan is it causes you to learn about the pros and cons of interventions, how you would like to handle situations as they arise, etc. The process of creating a birth plan empowers you to take responsibility for your birth experience and may ease some fears of the unknown by leading you to search for more knowledge to make informed decisions. Don’t forget to present a copy to your doctor and discuss it with him and also the nursing staff when you are admitted. Be advised that like weddings, things do not always go as planned. Your birth experience may not go exactly as planned but you will have the information to discuss any changes so that you can make an informed decision that you can live with.
9 Don’t neglect to ask questions. It doesn’t matter if it’s your first baby or fifth, there are no dumb questions. If your doctor or midwife responds impatiently or negatively to your questions, it may be time to look for a new one. If you are hiring a doula she can be a wealth of information and resourceful as well. Connect with mothers who have succeeded with the birth plan you desire. Another warning: stay away from people who only want to tell you horror stories. You’d be surprised (especially as an expectant mom) how things stick to you. Before you know it, you’re staring at the ceiling at 3 am wondering if you will have a 46 hour labor that will end up in a c-section because you were so exhausted and you had a small pelvis and the baby’s shoulder got stuck and they ran out of cranberry juice!
10) Follow up. After your delivery it can be helpful to find out from those involved what they experienced. As you mentally are revisiting your birth experience (journaling is great too) their feedback can help fill in the gaps of things that were missing from your story. It’s not uncommon to hear about things that happened that you didn’t notice because you were so focused and tuned in to your body.
Please keep this in mind: Every birth will be a different experience. Your level of enjoyment with each experience will be determined on how prepared you are for the journey. Knowledge is power. You will have the power to allow your fears to influence your birth experience or to face them head on and use them to push you to the birth you’ve always wanted.
My heart is to empower women to take more active roles in making decisions about their health care and lifestyle habits.
I am a mother, wife, daughter and best friend who is passionate about women having a safe and memorable birth experience that they desire. As long as I can remember I have been at awe of what we are able to do as woman and hope to help other women tap into their inner strength.
The blog posts on this website will be a combination of my opinion and research. I value your opinion and only ask that any comments be respectful and courteous.