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question for birth pros: helping mom when birth doesnt go as she'd wanted?  

post #1 of 19
Thread Starter 
hello birthing professionals!

i have a question i am hoping someone here can help me with. i'm involved with a couple threads on mdc talking about dissapointing and traumatizing birthing experiences, and it is starting to seem to me that there isnt much "out there" about dealing with this stuff....

some of us have seen "traumatic birth" therapists, some have found help in the form of ican/vbac, etc... and some have PTSD or PPD, and get help because of those things....

but there are many more women than i'd ever imagined who simply are dissapointed or upset or otherwise not happy with their birthings... and it seems like there is not much they are being guided to do... there's not much in the way of help, at least readily available....

i know my midwives knew what to do, and so i know there is *some* info/sources/etc out there.... but i am wondering...

how many of you receive/d training on this?

any info would be most appreciated.

thanks!
post #2 of 19
I'm a student doula and we talk with our clients about making a postpartum plan. We also discuss with clients about ppd before they ever give birth. So when we do those postpartum check ups, it's easier to evaluate and talk with the mother about these issues. And yes, the midwives and doulas who are training me have also discussed things on how to handle a mother who hasn't had the best birth experience. Give time to let them grieve and be their witness when something didn't go right. But at the same time, look at the positives. Even a disappointing birth can be empowering. I think if a woman didn't have an empowering birth, then something terriable went wrong. She should still have a choice and a voice about her birth. We remind a mother that she made the best decisions she could have under the circumstances.

Me and a few other local moms are putting together a group. In addition to it being an advocy group, we hope to be able to offer mothers a safe place to share their births. Perhaps we'll be able to fulfill the need this way.
post #3 of 19
I am an RN in a hospital birth center. I remember in nursing school talking a lot about "just being there" for your patient(s) and the power of presence. Last year I had a Mom who just delivered her 6th baby, 1st via c/s; and she was so shocked and disappointed about the c/s. I spent time just listening to her so she could get these emotions out and feel validated.
I think listening to others experiences and letting them talk about the highs and lows can be helpful.
post #4 of 19
As a midwife I am very interested in this subject. One thing I have come to realize is that not every woman/couple will be happy with their birth outcome, even if both she and baby are healthy. Sometimes justifiably and other times not.

I think that birth is often traumatic for one reason or another - and that our culture does not fully address the subject. Often, as birth professionals we don't do a great job at preparing clients. This is difficult, because you can't predict the outcome - if you try to tell a client how difficult it might be, they can get scared or even criticize you for not supporting natural birth.
If you don't tell them and they have a hard birth - they can criticize you for not adequately preparing them. I have had it happen both ways. I don't have a hard time accepting the criticism if it is directed at me personally, but I always wish they could have had a better experience.

I admit that sometimes I feel at a loss as to how best help a mother who is grieving or feels betrayed by their body because of their birth experience. All the attention in the world can't take away their pain. I have clients who still have issues with how their birth unfolded - many years later. We process and still there is no closure.

I have sometimes referred women to Gayle Peterson (Therapist and author of Pregnancy as Healing). But that type of care is only accessible to a small percentage of women. A close circle of friends is important...they can provide a forum for women to process and offer support.

I would like to hear what other midwives have to say....

Carla
post #5 of 19
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post #6 of 19
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post #7 of 19
Thread Starter 
thank you for your replies!

Quote:
Originally Posted by mendomidwife View Post
I think that birth is often traumatic for one reason or another - and that our culture does not fully address the subject.
...
I admit that sometimes I feel at a loss as to how best help a mother who is grieving or feels betrayed by their body because of their birth experience.
...
A close circle of friends is important...they can provide a forum for women to process and offer support.
i agree so much with that first statement. i'm struggeling to find a way i can help with this (my bold).

i did want to say, though, about the friend thing, that as someone who has been thru this, and has heard from many who have as well, friends are often the most hurtful where this topic is concerned. i'm sure there are cases where they have helped, but to be honest, i'm not entirely sure i've ever heard one of the mommas in the threads about this here on mdc say a friend helped. and i know i've heard many say they've hurt. just, ya know, for what that's worth.
post #8 of 19
I have friends who have helped process, but to varying degrees. A lot of how much they understand or can offer support hinges on their own birth experiences though- particularly whether or not they've ever had a disappointing/surprising/traumatic birth.
post #9 of 19
talking with a MW or doula is best, sometimes there is not alot that can be done. I had one very dissapointing birth, it still bothers me today even with my knowledge & one of my best friends is a MW, we talk it gets better, but it is still there. Also making sure she has LOTS of help in the following 6 weeks, since lack of help & dissapointing birth can lead to ppd. you can't change the birth but you can change the following 6 weeks by being there & organizing help.
post #10 of 19
Quote:
Originally Posted by moosemommy View Post
hello birthing professionals!

i have a question i am hoping someone here can help me with. i'm involved with a couple threads on mdc talking about dissapointing and traumatizing birthing experiences, and it is starting to seem to me that there isnt much "out there" about dealing with this stuff....

some of us have seen "traumatic birth" therapists, some have found help in the form of ican/vbac, etc... and some have PTSD or PPD, and get help because of those things....

but there are many more women than i'd ever imagined who simply are dissapointed or upset or otherwise not happy with their birthings... and it seems like there is not much they are being guided to do... there's not much in the way of help, at least readily available....

i know my midwives knew what to do, and so i know there is *some* info/sources/etc out there.... but i am wondering...

how many of you receive/d training on this?

any info would be most appreciated.

thanks!
I teach childbirth classes and I would suggest you reading Peggy O'Mara's column from "Quiet Places" called "Regrets". It is one of her best, and my favorite, editorial of hers. I strongly believe that every single woman should read it after birth. It not only validates every mother's birth experience, but also any breastfeeding issues, etc. And, it points out that we need to respect every mother and her birth experience. Here is the link to the article on the website. It is genius.

http://www.mothering.com/guest_edito...place/133.html

I very much agree w/ the pp about witnessing and being present. It is a good lesson for life to be able to do that and not have to feel obligated to always "fix" things. Mothers have to process their birth experience themselves. I have found, especially in the case of miscarriage or infant loss, there are many people who don't want to *hear* that hard stuff. And, it is mostly because they don't know what to say in response. However, all they need to say is exactly that, IMO. "I'm so sorry...I don't know what else to say."

Also, you may want to check Sheila Kitzinger's website on this.
http://www.sheilakitzinger.com/Artic...irthHaunts.htm

http://www.sheilakitzinger.com/BirthCrisis.htm

I will definitely be watching to see what others say, as this topic is always present in my teaching. Thank you for this thread.
post #11 of 19
You know, when I had Ds it was very traumatic for me. Whenever I talked to my doula after the birth she acted as if she thought the birth was great and she was so happy to be a part of it. All she said were good things about it. It really confused me at that point in time. I was at a stage were I totally blamed myself for everything that happened, and I was relieved that she wasn't mad at me, but confused as to why she would think that there was anything about the birth that was good. It shut down communication about it between us because inside I felt that I must be absolutely crazy to feel traumatized by this birth that Dh and the doula think was not that bad in Dh's case, or was rosey and wonderful in the doulas case. Now I know why that happened, because doulas are trained to portray the birth as good to their client no matter what, unless the client themselves express disapointment. Doulas are supposed to protect the memory and not in any way influence that memory. Or at least, this is what I have read since the birth. I don't know how I feel about this because in one way I can see the point of doulas doing that, but in another way I know how I reacted to that, and it was to just tell myself that I must be crazy, to not trust my feelings that something bad did indeed happen to me, and to just stop discussing the birth with someone who seemed to be remembering it in a very different way than I was. I felt very alone with my thoughts and I would have loved someone to talk it over with back then. I am sure my doula would have done that with me, but due to the way that I believe she was trained to handle a bad birth, that just didn't happen.

I just wonder if trying to create a good memory can be inapropriate under certain circumstances. I can understand that if something goes different than planned and then trying to look on the bright side of the situation, but, if you don't get the birth that you had planned at all and instead you get raped by hospital staff, then I don't think there is any good memory you can create out of that and I also think the intense feelings that stem from that need to be dealt with.

I wonder if more experienced doulas have a found a way to balance this out a little better or handle this situation in a way that will encourage further communication and processing of the birth. However, I do think that doulas who are certified are not trained to do that, and I don't really agree with that aspect of being a doula. I mean, it kind of even angers me when I read things like "our job is to just be a witness" because it implies to me that several things that I would really want out of a doula are out of her scope, which they are, and that is a whole other topic, but in my opinion a doula's job should be more about support and comfort than witnessing traumatic events and then painting rosey pictures about them.
post #12 of 19
Quote:
Originally Posted by jennica View Post
You know, when I had Ds it was very traumatic for me. Whenever I talked to my doula after the birth she acted as if she thought the birth was great and she was so happy to be a part of it. All she said were good things about it. It really confused me at that point in time. I was at a stage were I totally blamed myself for everything that happened, and I was relieved that she wasn't mad at me, but confused as to why she would think that there was anything about the birth that was good. It shut down communication about it between us because inside I felt that I must be absolutely crazy to feel traumatized by this birth that Dh and the doula think was not that bad in Dh's case, or was rosey and wonderful in the doulas case. Now I know why that happened, because doulas are trained to portray the birth as good to their client no matter what, unless the client themselves express disapointment. Doulas are supposed to protect the memory and not in any way influence that memory. Or at least, this is what I have read since the birth. I don't know how I feel about this because in one way I can see the point of doulas doing that, but in another way I know how I reacted to that, and it was to just tell myself that I must be crazy, to not trust my feelings that something bad did indeed happen to me, and to just stop discussing the birth with someone who seemed to be remembering it in a very different way than I was. I felt very alone with my thoughts and I would have loved someone to talk it over with back then. I am sure my doula would have done that with me, but due to the way that I believe she was trained to handle a bad birth, that just didn't happen.

I just wonder if trying to create a good memory can be inapropriate under certain circumstances. I can understand that if something goes different than planned and then trying to look on the bright side of the situation, but, if you don't get the birth that you had planned at all and instead you get raped by hospital staff, then I don't think there is any good memory you can create out of that and I also think the intense feelings that stem from that need to be dealt with.

I wonder if more experienced doulas have a found a way to balance this out a little better or handle this situation in a way that will encourage further communication and processing of the birth. However, I do think that doulas who are certified are not trained to do that, and I don't really agree with that aspect of being a doula. I mean, it kind of even angers me when I read things like "our job is to just be a witness" because it implies to me that several things that I would really want out of a doula are out of her scope, which they are, and that is a whole other topic, but in my opinion a doula's job should be more about support and comfort than witnessing traumatic events and then painting rosey pictures about them.
I am so sorry that this happened to you. I do believe that a doula's role is, above all else, to mother the mother. That means, to me, to do what the mother needs. The doulas I know would not do what you described.

It is so important to *listen* to the mama, after the birth, too. Every woman needs to process their birth experience, no matter how it went. Every woman should have their feelings and thoughts HONORED, otherwise the pain and suffering cannot go anywhere but fester. Even if your doula or DH doesn't agree with you, they should not degrade your experience. After all, they aren't the one who gave birth, are they?

So much goes into how a woman's birth proceeds, and each one is different.

For me, I had a hospital birth with my 1st DS and a *midwife* (I found out later she went more by the medical model of birth, unfortunately.) While both my baby and I were healthy and okay after the birth, I was definitely not happy with the experience and had a waterbirth with my 2nd DS at a freestanding birth center and had *ALL* the support I would ever need. It was completely different....and empowering and wonderful.

As for being a witness, let me clarify. A good doula empowers mothers and fathers to make the most informed decisions possible before, during and after birth. But, ultimately, they are the parents'/mothers' decisions. And, sometimes, things don't go as planned during the birth process (or postpartum) and that has to be dealt with afterwards. Despite their personal feelings, a doula should be supportive and *listen*. Perhaps if you ask her opinion, she might give it to you, but she should not negate yours. This is what I mean by witness. Just as you hold your baby who is crying and you can't "fix" it 100% of the time, sometimes there are events/emotions that cannot be "fixed" and all you can do is hold someone's hand, or say simple things like, "I'm here." Just holding your crying baby makes all the difference in the world. You are being present for your baby and "witnessing" his/her pain, even though you can't fix it.

I think this is a human factor, unfortunately. And it is good we are discussing this...obviously it needs further discernment.

My best to you and hope you find some peace,
Heather
post #13 of 19
Thread Starter 
I hope I am misunderstanding you here:

Quote:
Originally Posted by linaee View Post
Mothers have to process their birth experience themselves.
I dont think you are saying that you think that the mother should do this alone... but just to be sure-- are you?

Quote:
Originally Posted by linaee View Post
Peggy O'Mara's column from "Quiet Places" called "Regrets". It not only validates every mother's birth experience, but also any breastfeeding issues, etc.
That is an interesting article. it does touch on the issues i am seeing, but IMO, it barely scratches the surface. i'd be interested to know if she has written more about this. I wouldnt go so far as to say it validates all experiences, but i do like that she admits this:

Quote:
It is a challenge to keep this perspective at Mothering because, as one of the few media voices for normal birth, we feel compelled to tell birth success stories to inspire others to the possibility. In doing so, however, we risk giving the impression that birth is always within our control. This message can give the erroneous impression that birth will turn out well if we only try hard enough.
I wish wish wish that there was something i could do to help make this better. surely, i keep thinking, there is a way to balance this? so that women who do not manage the ideal mdc birth can still feel like mdc goddesses. oh, that is my biggest wish.

The traumatic birth site is interesting, thank you for sharing that. It is good to know that it exists.

Quote:
Originally Posted by linaee View Post
And it is good we are discussing this...obviously it needs further discernment.
YES, and thank you for participating. Can you tell me, are there/have there been other threads about this in this forum? Is it something that is talked much about?

Thank you for all your replies, this is helping me to understand what is "out there". :
post #14 of 19
[
Quote:
QUOTE=moosemommy;8909915]I hope I am misunderstanding you here:

I dont think you are saying that you think that the mother should do this alone... but just to be sure-- are you?
You are right. That is *not* what I meant at all. I just meant that the woman needs to move through processing her experience, but a key part of that is being able to grieve, being validated, being honored, and having a very, very good listener to really *hear* you. I think this is the same as any other loss or expectations that are not fulfilled. In the end, you should not have to do it alone, but in a way, you do have to do some heavy-duty emotional/psychological work to move past it, or at least live with it. But, having the right support in place is the best way to do this, IMO.

Quote:
That is an interesting article. it does touch on the issues i am seeing, but IMO, it barely scratches the surface. i'd be interested to know if she has written more about this. I wouldnt go so far as to say it validates all experiences,
but i do like that she admits this:

I guess from reading her other writing, I inferred some things. I think very highly of her and her publication (obviously!). I have not found much that addresses this issue, so perhaps I got a little slap-happy/overzealous when I discovered it.

Quote:
I wish wish wish that there was something i could do to help make this better. surely, i keep thinking, there is a way to balance this? so that women who do not manage the ideal mdc birth can still feel like mdc goddesses. oh, that is my biggest wish.


First, you have already done something by asking the question. Some people don't even stop to think about that aspect.

I would also suggest organizing a Red Tent/BOLD event night. You could even just have a night where women gather and tell their birth stories. We are having one in September (Be Bold on Labor Day) in our area and all women will have the opportunity to share their birth story if they wish. For more about this type of event, see:

http://www.birthonlaborday.com/announce.html

The idea of the Red Tent is that every woman is welcome there...no judgements, no criticism...only support...and every walk/path of life is honored. It is something that our culture has lost, yet we crave it so much. (IMO)

Quote:
YES, and thank you for participating. Can you tell me, are there/have there been other threads about this in this forum? Is it something that is talked much about?
I am not sure about other threads. As you can see by my # of posts, I don't post a lot, so I am not sure. Maybe someone else can chime in on that. I also tried to multi-quote this, but I am not sure I was successful. Sorry if I made it too confusing...still learning.
QUOTE]


post #15 of 19
I believe that 6 weeks post partum is too short of a time to end care. I think that contact at 6 months would be better, in a purely non-medical way (to address scope of practice issues). Just to see the baby and talk and hear from her after the after-birth oxytocin goes away.
post #16 of 19
Thread Starter 
Quote:
Originally Posted by linaee View Post
You are right. That is *not* what I meant at all. I just meant that the woman needs to move through processing her experience, but a key part of that is being able to grieve, being validated, being honored, and having a very, very good listener to really *hear* you. I think this is the same as any other loss or expectations that are not fulfilled. In the end, you should not have to do it alone, but in a way, you do have to do some heavy-duty emotional/psychological work to move past it, or at least live with it. But, having the right support in place is the best way to do this, IMO.
ok, good. that's what i figured. thanks!

yes, i do think that it deserves the attention of the mom. i was lucky, i had a ton of time on my own (well, with a nursing and sleeping babe!) to think about it all, procss it, etc... but i'm more than normally equipped to do this kind of thing-- it falls in line with my personality and stregnths, and went with my reaction to all that happened... not everyone is so inclined. i think that's why i am feeling such a need to make sure there is a place here to make this process easier for women who do need a little extra help-- and make the healing even better for those like me who need some gals who "get it." *none* of the people i know IRL come *even close* to "getting it..."

Quote:
Originally Posted by Apricot View Post
I believe that 6 weeks post partum is too short of a time to end care. I think that contact at 6 months would be better, in a purely non-medical way (to address scope of practice issues). Just to see the baby and talk and hear from her after the after-birth oxytocin goes away.
i think that is a wonderful idea. my wfs were fantastic about post care. at first i was like, omg let me get on with it, but i am so glad they kept harassing me. it was so comforting. the post oxytocin visit is a freaking brilliant idea.
post #17 of 19
When I suffered from PTSD after #1, it helped to talk to my midwife off and on for about 2 years. Mostly by email - I would think about something and then bounce it off of her. I think it helped both of us. And now we still keep in touch.
post #18 of 19
[QUOTE=moosemommy;8923938]
Quote:
but i'm more than normally equipped to do this kind of thing-- it falls in line with my personality and stregnths, and went with my reaction to all that happened... not everyone is so inclined.

i think that's why i am feeling such a need to make sure there is a place here to make this process easier for women who do need a little extra help-- and make the healing even better for those like me who need some gals who "get it." *none* of the people i know IRL come *even close* to "getting it..."
I *completely* understand, as I am very much the same. I have a friend who was pregnant with her 2nd and found out he had trisomy 18 at 20 wks. She continued the pregnancy and delivered at 29 weeks. He was stillborn. I was a close friend before that all happened, but then we became closer because most of our friends didn't "get it"...and they didn't want to "witness" it (her falling apart and not being able to cope). Unfortunately, our culture doesn't support looking hard at things and really delving into them in order to move on in a healthy way. What a shame.

Perhaps there can be a Red Tent thread---am I understanding correctly that you are wanting to provide something online, or is it where you are located?

Where I am, some have recently formed a kind of doula support group. We have a different topic each time and often a guest speaker. Perhaps this is another possibility for you?


Quote:
the post oxytocin visit is a freaking brilliant idea
Ditto that! :
post #19 of 19
Thread Starter 
Quote:
Originally Posted by linaee View Post
Unfortunately, our culture doesn't support looking hard at things and really delving into them in order to move on in a healthy way. What a shame.

Perhaps there can be a Red Tent thread---am I understanding correctly that you are wanting to provide something online, or is it where you are located?
When i was young, i had two experiences with birth. when i was 10, i attended the birthing of one of my mom's friend's baby (i'm friends with him to this day, actually!). when i was i think 13, i attended the passing of one of my mom's friends newborns (the baby had a fatal heart defect, and the mom held her as she passed, while we sat with her, filling the room with love). both were beautiful, both were powerful... and both impacted my view on childbirth. but, yes, i think you are correct. it's not the common thing.

it's funny you mention the red tent thing! i was actually just thinking about this the other day, and wrote to someone about doing this.

thanks again for your thoughts, ladies!

(also-- a note to avoid confusion-- i'm changing my username from moosemommy.... not sure when it will change, but hope that doesnt confuse anyone! )
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