midwives: what would you say to a client in this situaion? - Mothering Forums

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#1 of 12 Old 07-23-2002, 04:30 PM - Thread Starter
 
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the following is a compilation of some posts I have
made on a health and healing board here @ mdc. I just do not want to keep
re-writing.
===========================================
"... it does not matter if it's a male or a female. i
am not undressing and letting anybody touch my body in
the most private places (unless it is my dh, of
course)! i like to wear tight sexy clothes, but when
it comes to me being really naked, it's a whole
different story. It all depends on the skills of a
doctor, i think. my family doc (a male) was giving me
a pap once. and only once. it was so painful, i
screamed! then, i went to a male gyn (recommended by
my family doc) when i needed birth control pills, and
let me tell you - it was the most painless pelvic exam
i have ever had! he seemed to have a nice bedside
manner when i first came to his office. i was
petrified and he said that i did not have to have the
pelvic done that day. i may come back later if it will
make me feel better. then, when i needed to renew my
pill prescription, he was very insistent on me getting
both breast and pelvic exams done. it was a "my way or
no way" situation. if i don't get both exams, i don't
get the refill. at that time, i really wanted to stay
on the pill (stupid me, i am smarter now *lol*), and i
can never express in words how i felt laying on that
exam table. no matter that i had the gown on (not a
paper gown, but a real cloth one), and he was only
exposing one breast at a time for the exam, no matter
that he was trying to "talk about the weather" during
a pelvic.... he does have great skills in making the
exams painless (if you can relax, of course), but it
does not help the emotional state the whole thing puts
me into. i came out of there shaking. and never went
back. not just to him, but to any gyn. it's been
almost 2 years. i stopped taking the pill (the reasons
were other then not having to have the pelvic in order
to get the refill, but i guess it's an added benefit),
and feel fine, so i just do not go. i know it is bad
the be thinking this way, but i truly can hardly help
it. for me, it is not just a feeling of being slightly
embarrassed (which i am sure most ladies would feel no
matter who the practitioner is). i am not even sure
what to call it! i am not afraid of the exam being
painful, 'cause i know that with the right kind of
practitioner it can be painless and be done very
quickly. it is the whole being naked and letting a
stranger look and touch at all my most private places
that gets me so much i tremble. it makes my heart race
and i start trembling and/or crying just thinking
about it ...."
===========================================
"... with that male doc i was writing about in my
post, i was happy with him at first. really. on my
first visit he told me i coudl come back for an exam
at another day when i'd feel more comfortable. and i
swear - i don't know what/how he does it, but you
cannot feel the seculum at all! as i had said,
practically painless. but when i was back (not for the
first time) and it was the "my way (i.e. pelvic &
breast exam), or no way" i felt SOOOOO violated. it
was just horrible! that's why i never went back. my dh
does not understand, though why i would feel so
violated. it's just a doctor, after all. *uh* ......
the thing is, unlike you guys, i had never been raped,
had a surgery or anything, so i do not understand
where it is all coming from in me. on the surface,
there is no reason for me to feel this way. i have
tried some soul searching, but still cannot find a
reason."
===========================================
"... it's time to bump this thread to the top again.
guys, i am really at a loss. feeling so frustrated and
scared. i have posted here before telling about the
problems i am having getting my periods back after
going off the pills and i have tried some herbs that
were working while i was taking them, but once i
stopped, the effect did no last. so i decided to go
the acupuncture route. i had my first appointment on
saturday. she acupuncturist was nice, but she was
still saying how i should go see the midwife and stuff
(about another problem i thought she, the
accupuncturist, might be able to help me with). she
knows a nurse in a midwifery practice and also said
she uses one of those midwives, so she gave me their
phone number. she said that once i make an appointment
i can let her know of the date and she will talk to
her friend nurse and the midwife to pay extra
attention to me and then she can collaborate with the
midwife on my care. i have briefly mentioned to her
that i had pretty bad experiences in the past, but she
told me that midwives are not like doctors and this
midwife will listen and not dismiss my concerns and
what not. so what was i to say??? i said ok. but i am
not being myself since then. I've spend the whole last
night crying to my dh that i really cannot subject
myself to that again and i really do not know what to
do! i even told him that we won't have kids 'cause i
am not subjecting myself to other people staring at me
(and not just staring). yes, the feelings are that
strong. (my dh is saying, though, that i want kids bad
enough to actually do it) of course, an acupuncturist
cannot make me go or anything, but what about my life
overall? i cannot be living like this. what if the
acupuncturist is right and this midwife would be able
to help me (even though tons of docs before her were
no help). i am not even sure why i am posting it all
here. i really feel like i cannot live my life like
this, but don't know what to do about it. my entire
night was totally wasted yesterday because of my fear.
the only thing i can think of is to try and go to the
midwife to just talk amd ask her what she woudl say to
somebody who feels this way. perhaps she had already
had a patient with feelings this strong. but i am not
sure she can tell me something my dh or other docs
have not told me before (it does NOT help that she is
a woman). i just do not know who else can help me deal
with it. when thos efeelings come, i feel like I am an
abnormal freak, 'cause in a way it is a part of being
a woman, so why can everybody else do it, but I cant?
how do you all do it???"
===========================================
So if a woman came to your office and told you all the
things I have written here, what would you say to her??? what would do???

Valeria
dd 05.17.2005
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#2 of 12 Old 07-23-2002, 04:47 PM
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I would tell her she is not alone. There are plenty of women AND men who feel the same way.

It sounds as if this concerns a vaginal exam/pelvic exam. If that is the case, then I would do my best to educate her on her own body and how to do the exams herself, or her DH. They would know her body a lot better than any stranger would. Even tho a DR. or midwife has examined hundreds or thousands of vagina's and pelvis's, none are the same. We do not need to see the podiatrist every year to ascertain there are no strange lumps/bumps on our feet, right? A foot massage can be sexual/sensual, or you can touch/feel your foot without being sexual/sensual. The same is true about female genatalia. Males grab themselves in nonsexual ways, and they are never required to be examined. It is common sense that a male would notice a lump/bump on their genatalia. Why not females? With a little education and openness, females can and will be able to do the same. It is their body and they have a right to know it.
Same goes with breast exams. She will know better than any 'expert' whether there is something to be worried about.
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#3 of 12 Old 07-23-2002, 05:24 PM - Thread Starter
 
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Quote:
Originally posted by MamaInTheBoonies
I would tell her she is not alone. There are plenty of women AND men who feel the same way.
i have come to realise that, but the question is, how do all those other people deal with it?
Quote:
Originally posted by MamaInTheBoonies
It sounds as if this concerns a vaginal exam/pelvic exam.
Umm, not exactly. part of a thread was about pelvics being painful, and I was trying to tell the other person that they don't nessesarily are painful and that's why i was bringing the example of my last gyn.
for me it is the issue of letting another person look and touch my private parts wether it is my breasts or my vagina.
of course i have sex with dh and no, i don't make him turn the lights off *wink*, but he's the only one allowed anywhere near my intimate parts.
when i think of having to expose it all for somebody other then him, i tremble. he is trying to reason with me, keeps repeating that it is non sexual and that's why i should not be feeling this way and stuff, but to me it does not matter if it s sexual or not. the bottom line is that it is gonna be a stranger staring at it, touching it etc. and that is where my problems come in.

Valeria
dd 05.17.2005
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#4 of 12 Old 07-23-2002, 05:42 PM
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Hello valeria_vi!
I'm sorry I misunderstood. I hope what I posted is still a little helpful for you or others.
As far as 'dealing' with it, I believe it is sad that anyone would have to 'deal' with something like that. You are right to feel the way you feel. It is your body and your decision as to who sees, touches, or feels it.
With all my pg's I never allowed the Dr.'s nor OB's to touch/examine me. I know my body better than anyone else on earth. If nothing is wrong, then they have no business going there.
If you are planning on giving birth to a baby, then I would suggest your DH learns how to catch the baby and/or how to check your cervix. Then you do not have to worry about anyone else.
Good luck, I hope everything works out for you.
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#5 of 12 Old 07-23-2002, 05:57 PM - Thread Starter
 
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Quote:
Originally posted by MamaInTheBoonies
If you are planning on giving birth to a baby, then I would suggest your DH learns how to catch the baby and/or how to check your cervix. Then you do not have to worry about anyone else.
unfortunately, he will NEVER do that. he did agree to having a home birth, but there's no way i will ever convince him to go unassisted. i know him well enough to say that. i really wished it would be a possibility for me, though.
i've got an idea for myself here. i'm gonna email some of the local midwives (there are just a couple) and see what they write back to me. if there will be a response that will truly touch my heart, i might go in to talk with that mw.
what do you think?

Valeria
dd 05.17.2005
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#6 of 12 Old 07-23-2002, 09:56 PM
 
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Hi Valeria,
I am not a midwife but used midwives with both our daughters' births. I am usually a little nervous before exams but go the "just get it over with and you're set for another year" route. Sounds like that is not possible for you. I wholeheartedly agree with your idea of contacting some midwives. I would suggest calling a midwife in a freestanding birth center (not a nurse midwife who works out of a hospital). At a freestanding birth center, I found that I was given much more time, more respect, they believed what I told them about my own body, etc. After my own house, the birth center where our second daughter was born is the most comfortable, safe, happy place for me to be. Having children is the best gift we get so please continue to look for ways to get through/past this problem. Sounds like your husband will support you so find a local midwife. She will listen to you and go slowly so you are comfortable. I wish you lived in Washington state - my midwives are so incredible that I know you would love them and feel the trust I felt. Do you know any friends in Chicago who had natural birth who could suggest someone to you? Or call your local Bradley childbirth instructor and ask for a referral to a midwife in a freestanding birth center.
Please keep us updated on how things are going for you.
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#7 of 12 Old 07-24-2002, 02:15 AM - Thread Starter
 
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thanks a lot for your warm responses.
Kirsten,
i wished i lived in a statethat had freestanding birth centers, but there aren't any in illinois. well, there is one i can think of, but it is run by 2 MDs (a male and a female), but if i ever get teh courage to go, it will be to a mw. so i have sent emails to 4 mws today. all of them are CNMs (cpms are being haunted by ldpr here, and all of them were banned from practicing). 3 of them are hb midwives, one works in a birthing center that is attached to the hospital. that mw is teh one my acupuncturist recommended, so i decided to send her an email as well.
i've received 1 response so far. will give it a couple of days to receive them all and see what comes out of it.
peace,

Valeria

Valeria
dd 05.17.2005
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#8 of 12 Old 07-24-2002, 03:30 AM
 
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I would encourage you to contact the hb midwives. When I was pg, my midwife never did pelvic exams routinely. In fact, the first time she did, I was in labor and she was checking my dilation. For me, I had spent 9 months building a relationship with my mw and this did not feel like a "stranger" examining me. Obviously you situation is a little different as you are not pg, but , if you could establish a relationship with a midwife, who could teach you to do routine exams. I know that with a speculum and a mirror and a little practice, there is no reason you can't do this yourself. Perhaps in time and with a relationship established you may begin to feel comfortable allowing a mw to provide gynecological care.

Christine, mom to ds Myles(3/02),dd Zoie(1/05), ds Sojourn(1/07) and dsd Saige(10/94).  Professional hand analyst, WAHM.
Discover your child's biggest challenge and truly Parent on Purpose
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#9 of 12 Old 07-26-2002, 10:53 PM
 
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I would also like to point out that you do not need to go unassisted to be able to have your dh catch the baby or check your dilation. I wouldn't say that it happens frequently, but it does occasionally occur in our practice where either dh or mom checks herself, and (with quite a bit more frequency) dh/partner/mom/sibling catches the baby. Our practice is a free standing birth center, but it can (with the right mw) occur in hospitals, and most definately at home.

I think your plan to email the midwives and await their response is a great one.
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#10 of 12 Old 07-29-2002, 01:54 AM
 
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I'm sorry to hear about your experience with doctors pushing their norms on you. It doesn't matter what your history is- it matters how you feel, and any CAREgiver should recognize this and respect your boundaries.
I recently read that (somewhere in Europe), care providers realized that there were many women who were not using prescription birth control b/c they didn't wish to go through all of the exams required, so they changed the policy! What is more important- that they see that a woman's breasts are normal, or that she have access to reliable birth control of her own choosing??
Anyway, I just wanted to add myself to your list of supporters, and add to the comments about midwifery care and homebirth. My midwife never does prenatal pelvic exams. (She did measure my belly occasionally) She did very few during my labor, and only at my request. I know there are some experienced midwives who would be happy to attend a birth without ever doing internal exams- with practice, some mw's feel that they can 'read' a laboring woman's sounds and behavior well enough to feel comfortable advising pushing (or not.)
You could certainly labor in low light, or even underwater in the dark, with a midwife close at hand. Your husband should be able to catch the baby, or you yourself, if you both would rather... It seems that you should be able to find a midwife willing to provide care on your terms, granted that you are willing to work with her to inform yourself about as much of the process as possible. The more you know, the better.
Good luck!
Your body belongs to you.
You need never apologize for stating your boundaries and insisting they be respected.

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#11 of 12 Old 10-15-2002, 12:21 PM - Thread Starter
 
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I cannot count how many times I have gone here to read and re-read this thread as well as the one I posted on midwifery today forum (in hopes to get more input frm MWs). Everybody had great things to say. I felt encouraged by your kind posts. Thank you all very much for your input, encouragement and sharing. It means a world to me.
But talking about it is really difficult, so I could not bring myself to reply.
Here is what happened since I had posted the thread. I took my initial post here and emailed it to 4 local midwives. (3 of which do homebirths). One never replied, but 3 others did. One answer was short and sweet. Other 2 were more in depth and generally touched my heart more. I am thinking I should post them here. I hope it will be benefitial to somebody like me:
===============================
I would go slow if a woman felt so strongly about exams; coming back another time is fine, or even in two more times. But I would really recommend more soul searching or therapy or whatever it takes to get to the bottom of these feelings, because sometime it could be important to get the information from a physical exam. Our bodies are really wonderful, you know, so taking care of them might include getting exams that are really difficult.
Building a trusting relationship with your provider, where you know she will do only what is absolutely necessary, will be important. Is it possible there could be some repressed abuse issues, or something causing shame around body image?
Good luck!
===============================
Dear Valeria,

You are very brave. I admire the fact that you are addressing your fears and responses to the gyne exam. Yes, I have had a number of patients who feel vulnerable, fearful, embarrassed, and violated as you do about the exam. Some have a history of rape or child abuse as you mentioned in the posts, some do not. Sometimes knowing why an individual is fearful is helpful to them and to me as a practioner, sometimes we never know.

So, what would I say to a patient that presented with the fears you describe? I would explore what is OK and what is not OK...for instance, do you feel the same way around friends or sisters when you are nude? Your husband? That is just "exposure" Then there is touching...touch on the thigh OK, but not the labia? So, first, it is just getting to know where the fears are. Most women do not like a pelvic exam no matter what, so sensitivity is always a must. Were you sitting up or lying flat during the exam last time? Women should never lie flat and look at the ceiling, they should be sitting up and viewing the practitioner, and the practitioner making eye contact and talking through the exam (ie, you will feel me touch your thigh, now some downward pressure of the speculum...etc)

We have a certified hypnotherapist in our office who works with clients who have fears about childbirth and pelvic exams. We have seen great success with hypnosis.

We have had some women who have used psychologists/therapists for exploring their fears, or using hypnosis for past life regressions (to discover what happened in a previous life that is making them fearful in this life)

We have used "desensitization" techniques for some women. That is exercises a woman does in private at her home in front of a mirror to practice the experience.

There are a lot of options to help a woman ease/confront/overcome her fears so that she can move through their life, have children, take care of their health needs.

Most important is to identify when you are ready to take the first step is just making an appointment. Then you guide the visit with the practitioner: talk, make a plan, exam or no exam, schedule another visit.

Good luck to you.
===============================
Dear Valeria,

Wow, this is taking up a lot of your thought and energy & causing you a lot of grief. No one likes pelvic exams, and yes I have several clients who are afraid, hate or resent them for one reason or another.

In reading your posts, however, I have to wonder where this upset is coming from. In reading about abuse of women, I was surprised to find an act of actual physical abuse does not have to occur. Nothing has to actually happen for a women to "feel"as if she has been sexually abused. A suggestion, joke or inappropriate emotional attention or conversation can have a similar effect. Your posts also express a strong need to be in control, especially with the painless OB/GYNE. That is often an indication of a person who has had a real or perceived episode of violation or coercion.

My suggestion, Valeria, would be to see someone with experience in counseling women with abuse experiences that you feel you can trust. I am not sure seeking more gyne care will solve the problem. If you are wanting children at some point in your life, these feeling may cause you a lot of trouble. Not only are some exams necessary, but in labor a women really needs to surrender control to the forces of nature. You are way ahead of the game, Valeria, in looking at this before you are pregnant and by defining it so well. Often that is the hardest part of figuring out anything.

I hope this was useful.
===============================
So I had made an appointment with the mw who wrote the second email. Just to talk. It was assumed nothing will be done as far as exams go. Everything was fine until we actually had to drive there. Once we got into the car, I was in hysteric that these words will be put to a face right now. My face. I felt embarrassed. I wanted to escape. But my dh had finally talked me into going in. This mw’s office is very far from our home, we were stuck in rush hour traffic and were late for the appointment. As she had told us later, she saw my name on the appointments list, so she had told the nurses not to bother us much with questions etc, and they did not. They just took us to an exam room and asked to wait. Once in there, a nurse did ask what the purpose of my visit was, but I just said that I’m gonna talk about it with the mw herself and she did not ask anything else. Said OK and left. Because we were late, we had to wait for a long time. The room was tiny with the exam table right into our faces. I just sat there and cried. First, I started to re-live my last gyne experience, whch was pretty bad, then, it was about the email being put to my face again. But the mw made me feel more at ease. She did not look at me like I had 5 heads or like I was a freak (afterwords, I tried imagining myself going to her again for the exam, but I cannot see myself do it).The conversation was somewhat productive, but it was agreed upon that a counselor might be best for me. She gave me a phone number of one, but it took me 2 weeks to make an appointment. It has been 2 years since I last was at the gyne office, and all these thoughts and feelings were tucked into the back of my conciosness. Now they all came back to me and it was overwhelming. I started going to that woman (counselor). It was not easy to open up at first, but I had learned to be more comfortable and really tell her all my thoughts and feelings. So far we had not really made any progress, though. After more soul searching of my own, I had come to the conclusion that I have more issues that are not actualy sexual, but they still influence my body image in a very negative way. I am only 23, but this is already my second immigration (isn’t life tough???) and it is not coming easy to me. My life is not what I think it should be and I started to hate myself a lot. So we are trying to get that out of the way right now. In adition to feeling better about my life in general, I hope I will become more confident about myself as a result and hopefully that will help me deal with my gyne issues. As I had said, we had really made no progress so far, but remain hopeful.
In parallel, I had also phoned the mw that wrote the third email. She seemed to be sort of “nousy” over the phone, if I can describe it as such. I wanted to just call and ask about her office hours. Just as I was abut to say thank you and hang up she started asking me what I need – am I pregnant, do I need a pap? So then I just said that am I the author of the email she had replied to today and she knew. She pretty much said the same things she wrote in the email and said that I can come in and talk to her, if I want, but she would not be able to help me. She promiced to look for a counselor in my area. She had found one and gave me the phone number. Since I am not seeing much success with the counselor I am currently goin to, I decided to see if this one would be better. I have a first appointment with her on Wednesday.
To make things more comlicated … I got a vaginal infection! It does not look like yeast, but I am very red, irritated, and it is hurting around my vaginal opening when I wipe myself in the bathroom (not too much discharge, though). I have it for about 2 weeks already. I am definitely suffering from it as well as my hubby (no sex!), but I still cannot go see anybody! I can do a swab for infection on my own, can’t I??? I should call one of the miwwives and ask if I can come in and do it in the bathroom by myself.

I read a lot about pregnancy and birth and I know that I can go through my entire pregnancy with no exams and possibly even labor. EVEN if I will decide I would like no support fo rmy perineum while pushing (which is unlikely because I believe that a skilled midwife can help in reducing the amount of damage to that area), what I do tear? Somebody will have to check for that and do stiches. Being as self concious as I am is also likely to affect my labor as I might not be able to relax comletely and just let it happen. I will most definitely be planning a home birth when I get pg, but still…
And in general, I feel like I cannot ignore this problem forever. What if I will have a health problem tomorrow that will absolutely require me to expose my breasts and/or vagina??? It might be much worse if my issues will not be dealt with.
So to sum it up, I feel that it is really important for me to deal with it all, but I had not really achieved any progress so far. It is a pretty tough road I am walking, but I hope it is a way to a better me.
Thanks for listening.

Valeria

Valeria
dd 05.17.2005
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#12 of 12 Old 10-27-2002, 01:29 PM
 
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Hi Valeria, oh there is so much to respond to my head is reeling and I am afraid I won't be able to do the subject justice at all. Here are a few thoughts anyway:

I agree that you have some issues that you need to deal with not because you are a "freak" but because doing so will help you in the event, like you say, that your health depends on you exposing your body in some way.

I think your reaction is a very normal defense mechanism for a woman who feels a deep connection to her body, has strong physical boundaries, and is sensitive to the energy of others, and that your bad experiences have made that defense mechanism go into over-drive. It is not wrong to feel uncomfortable with having your body handled by others in a clinical way. The problem here is any underlying issues that may be hurting you by not being resolved and that your feelings limit your health-care choices.

I suggest that you look specifically for a trauma counselor, one involved with birth because she will be more likely to understand body issues. I also suggest you keep looking for midwives. Interview every single one that you can find that seems to be sympathetic to your dilemma and who is willing to offer prenatal care without doing exams or touching you at all, if that is your wish. Those midwives do exist. And then choose the one who you feel comfortable with on an emotional level.

You won't respond the same to every strange touch, either. Some people really do have a healing, compassionate energy, and some have a violent, selfish energy. As just an example (there are others,) I once agreed to allow a student midwife palpate my stomach -- she did not hurt me but touched me in a way that repelled me. I called my midwife later that night and was hysterical because, even though I knew intellectually that it was beyond reason, I felt so violated and had this weird feeling that the student had somehow hurt the baby. If she had been my first experience with someone palpating my belly, I'm sure I would have felt weird about others doing it. As it is, I am cautious now. I am very careful about who I allow to touch me.

And I don't think there's anything wrong with that.
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