Sexual abuse/other abuse history and childbirth - Mothering Forums

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#1 of 31 Old 03-24-2003, 01:58 PM - Thread Starter
 
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How does an abuse history, either recent or childhood abuse, affect labor, birth, birth outcomes, postpartum?

Have you had, or know someone who has had, a negative experience in childbirth that has felt like a violation, assault or rape?

What do you think?
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#2 of 31 Old 03-24-2003, 04:41 PM
 
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We talked about this a lot in my doula training 2 weeks ago.

Any kind of abuse, especially sexual, can affect birth negatively. Women are so vulnerable during birth, which oftens takes them back to when they were abused.

I can't really answer your other questions, but did want to say that it sounds like your thoughts are on the right track.
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#3 of 31 Old 03-24-2003, 05:04 PM
 
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Wondering if there are resources to help with this? I'm sure I can ask my midwives as well, but I'd just like to know if there are any specifics for dealing with this stuff so it doesn't affect the birth (well as best as you can)...

Lisa, mama to Orion (7) , Fiona Star (born sleeping @ 38wks 12/6/08) , our bitty (m/c 7/27/09) , and Charlotte Athena (11/5/10)
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#4 of 31 Old 03-25-2003, 10:56 PM
 
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My mother had Munchausen's Syndrome by Proxy and it has had a huge effect on my dealings with the medical establishment and, as a result, it had a huge effect on the birth...none positive except that I made it through "like a trooper" as one friend put it.
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#5 of 31 Old 03-27-2003, 02:08 AM
 
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Well, if you're a midwife and are wondering what to do or not do, I have some suggestions:

Be willing to work with the woman, even if it means "policy" will not be adhered to. For example, let her skip the pelvic exams.

Don't tell a woman that her episiotomy will make her as tight as a virgin. Better yet, don't do an episiotomy.

Tell her that her feelings are normal.

Tell her that her body is doing the best job ever.

(For me, childbirth wasn't the problem, it was all the medical stuff around it. All those people whose job is to tell me how my body is failing me so they can fix it, and then them telling me I had to see a counselor "for the health of the baby." Some women find counseling helpful during pregnancy, but only if it's their choice.)

Also, many abused women have issues with weight so as long as they are not anorexic or bulimic, it helps to not lecture them about how they need to gain or lose weight to fit some ideal.
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#6 of 31 Old 03-28-2003, 12:26 AM - Thread Starter
 
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Jerawo, did your trainer mention any books on the subject? Would you mind summarizing the information given, or better yet, if you have notes on your computer (perchance) could you pm them to me? If not, that's okay. Don't worry about it.

Lisa_Lynn, I'm wondering what has been others' experiences as well.

Sohj, so it was the medical est. not birth iteself that was the challenge? Sorry i don't know much about MSP.

Greaseball, thanks for your thoughtful input. I'm not a midwife, but a doula/cbe. I've done a lot of research in this area in the field of psych, besides my own personal story. I'm just basically wanting to know as much as I can, and am curious to know how my own exp. plus my theories of how best to support a survivor in labor compare to what others' experiences are.
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#7 of 31 Old 03-28-2003, 12:46 AM
 
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I'm not sure what notes I have, but I'll look through them and my training manual.

I do know that Penny Simpkin has done a lot of work with abused women, and she would be the expert to consult. Try looking for her website, and maybe there would be some info there.

My don't you PM me, and leave a reminder about looking through the notes. I'm moving in 2 days and my grandmother just died, so it's a little crazy at the moment.
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#8 of 31 Old 03-28-2003, 03:09 PM
 
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Mamajamz: Munchausen's is an extreme form of hypochondria. The victim manages to replicate symptoms so clearly that (sometimes) surgery is performed. diagnosing it is very difficult and usually only possible with hindsight. The victim changes doctors frequently and records aren't continuous. When it is "by proxy", the victim is not the person with Munchausen's by Proxy, but someone in their care, frequently a child. Always someone who is not in a position of sufficient authority to contradict the 'caretaker'. The most extreme forms of this have the 'caretaker' giving non-fatal amounts of toxins to someone to mimic disease. This is done for attention. My mother did not give me poisons, but did report lots of symptoms that various renal specialists found interesting as well as frequently fed me inappropriate food. Also, somehow any regular illness I got required extra special care (no need to go into too much detail here). In my case, this resulted in a huge lack of trust in the medical establishment as they were the only ones who could have connected the dots and they didn't bother. As all the diagnostic stuff that was done to me was fairly invasive and painful, I have additional fears of MDs & hospitals & nurses.

I unfortunately did not end up with a sufficiently sympathetic (to say the least) midwife and she (effectively) saw to it that I ended up in the hospital instead of at home...totally unprepared. My fears (among other things) held the whole thing up and it ended up being incredibly unpleasant. During recovery I had to get catheterized and had a flashback during this. It was especially terrifying.
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#9 of 31 Old 03-28-2003, 03:13 PM
 
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Well, I had an isolated incident with my stepfather (not the stepdad I have now) which I considered molestation. I really hate pelvic exams, but not because of that incident, just because I am a very private person. I think speculums hurt and I hate and dread papsmears because of that. I never even thought of the molestation when I was birthing. I was thinking "Get this thing out of me now!"
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#10 of 31 Old 03-28-2003, 08:26 PM
 
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sohj I just wanted to give you a ! What a tough childhood!

Lisa, mama to Orion (7) , Fiona Star (born sleeping @ 38wks 12/6/08) , our bitty (m/c 7/27/09) , and Charlotte Athena (11/5/10)
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#11 of 31 Old 04-05-2003, 01:51 AM
 
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One thing that would help is if during labor nothing touched the woman's genitals except for loving hands and babies' heads. No metal things, no tubes, no knives. Abused women have had all sorts of horrible things happen there already.

I read that paps can be done without a speculum. The ob/gyn who said this (Women's Bodies, Women's Wisdom) also said that most speculums are too large. I remember docs telling me "We do have a smaller one, but I think we'll just use this one!" and "We could warm it up, but I think it's fine the way it is." What about what I think?!

The same doctor also said that a pap should never hurt and it it does, it's being done wrong.

I think medical professionals could do more to empower abused women - all women, actually. For example, a woman should never be told to "lie down and wait for the doctor" - who wants to meet a doctor lying down? And trust that the woman knows more about her body than anyone else - I remember a nurse trying to give me an IV and I was screaming and she kept telling me that it didn't hurt. If it didn't hurt I wouldn't be screaming. Why would anyone just want to sit there and scream? Also, if I feel pain, it generally means that something hurts, no matter who is trying to make me think it's all in my head.
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#12 of 31 Old 04-05-2003, 04:50 PM
 
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Quote:
Originally posted by Greaseball
Also, many abused women have issues with weight so as long as they are not anorexic or bulimic, it helps to not lecture them about how they need to gain or lose weight to fit some ideal.
Amen.
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#13 of 31 Old 04-06-2003, 12:30 AM - Thread Starter
 
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Jerawo, so sorry to hear about your grandmother. I'm about to go through that as well. Good luck with your move...I'll pm you sometime later about this. Thanks.

SOHJ-- Thanks for sharing so openly. You got guts, Girl.

Bladestar5--It's good to hear another perspective, since it's just as important to not project feelings or experiences onto someone else. I'm also glad for you that it didn't affect you in your birthing. That's great.

Greaseball-- so right about the metal things, tubes, etc. Wow, I didn't know paps could be done w/o the speculum. Hmmm I'm apalled at the treatment doctors give women, and how the medical est. continues to think (with exceptions) that it's okay! Did you see the movie with Emma Thompson called "Wit"? Your doctor reminds me of the doctor she had. Ugh.

Mamaley--I second that "amen"
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#14 of 31 Old 04-06-2003, 07:11 PM
 
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I was looking for the same info. My first birth experience wasn't great and looking back it was because of my trauma history. Of course in the moment I didn't know that. I contacted Penny Simkin for resources for my next (I'm TTC) and found out that she is working on a book about it. I also found a lot of info in back issues of midwife/psychology journals. PM me if you are interested in photocopies or the bibiliography.
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#15 of 31 Old 04-09-2003, 08:13 PM
 
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Ok- so I *finally* found the bibliography! It's amazing how well my 2year old helps me file (ie. giant piles of paper everywhere!)

This is the link to the best list of articles on the subject that I've found. I am making photocopies of some of them for my own reading. I haven't found any of the articles online but if anyone else does I would love to know where.

http://www.gentlebirth.org/archives/abusebib.html

Hope it helps!
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#16 of 31 Old 04-09-2003, 08:18 PM
 
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I also found these articles online with good references at the end. A lot duplicate the previous link.


http://www.gentlebirth.org/midwife/abusepaper.html

http://www.radmid.demon.co.uk/abuse2002.htm
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#17 of 31 Old 04-10-2003, 11:21 AM - Thread Starter
 
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THANK YOU WENDY!!!
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#18 of 31 Old 04-27-2003, 11:52 PM
 
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I had a *very* traumatic first birth, during which I felt violatied more than once, and I think family issues going on at the time (extended family) plus my history of sexual abuse had a lot to do with it. Although not the only reason. I hated those VEs and I had four days of it...that was the worst part and there were a lot of terrible things that happened that I don't want to go into here :-}.

For my second birth, I did a lot of work, on my own, mainly birth art (although I am a really bad "artist"), hypnobirthing, and guided imagery. But still I did not directly confront my abuse history. I only addressed the more recent trauma of my first birth. Miracle of miracles, I had a smooth, easy, drug-free labor. However, I had severe tearing, which I also blame on my abuse history and related issues. I remember my midwife touching me at one point, and I shot forward and away from her yelling "no episiotomy!" although she was only trying to support me and does not do episiotomies at all.

I tore badly because in the heat of labor, in the last moments, I did not trust anyone or anything. I had crazy, frantic thoughts that boiled down to I had to push the baby out before "they" (the hospital staff) did something to me. Before "they" punished me. It came back to my history. I am working through those issues so hopefully they won't crop up in my next birth :-}. It's been 18 months since my daughter's birth and I think next time will go well, since I think I have finally identified and am facing my demons.

As a practical matter though, I think what really helps is...

1. acknowleging that issues might come up. I never told my midwives that I had a history of abuse. If I had maybe we could/would have addressed them.

2. laboring in privacy. As it happened, I was with my husband in the ER of another, larger hospital most of the time I was in labor. I used hypnobirthing techniques and never told anyone there until my membranes ruptured with a rush. Even when things kicked up a notch I felt wonderful and on top of things. No one at that hospital touched me, although staff tried to talk me into staying and even tried to block me when we finally left. It's hard to block a woman that feels ten feet tall, even when she is in hard labor ;-). It was actually very empowering and I did a lot of prenatal work to feel that self-possessed. When I arrived at the second hospital I was complete but for a lip, so I was deep into my own world, no time for the hospital environment to get to me as a patient. (I know it sounds weird to say that I labored "privately" in a public place, but I did. It's hard to explain.)

3. Work on centering. I did a *lot* of prenatal work. One of the things that helped during pregnancy was walking a pattern at a local organic farm. (I think it was a form of mandala) I breathed deeply and deliberately and thought deep thoughts as I walked. I did that several times in the months leading up to birth, and each time it made me feel really connected to the baby and emotionally and spiritually strong. It's another thing that's hard to describe.

5. Having a sense of control. Because of the number and type of complications from my first birth (directly related to the interventions) I couldn't find a midwife to attend a homebirth, but I did find two that would attend me at a tiny community hospital (4 bed maternity unit) in an Amish area. The protocals there were completely flexible and the staff were used to adapting. The midwives themselves were a good match. Experienced, calm, connected without fluff. It was a professional relationship, but something vibed right. We had long dicussions about everything, until I felt safe and that their standards of care met my needs and desires, and that my needs and desires would be respected. FWIW they were true to their word on everything we discussed prenatally. The maternity staff were great as well, the only problems were with the staff pediatrician and the lab tech, but the nurses warned me what to expect ahead of time and coached me on my *real* choices. Very supportive in many unexpected ways.

4. Water. This helped me more than I expected, in ways I didn't expect. I used water in my first labor, but although it helped some with pain relief, the tub was too small. The only position that brought any relief was to lie on one side, and even then I wasn't completely covered by water. In the end it probably did more harm than good, although even that bit was a relief at the time. The tub at my second birth was roomy, and I could get into any position I wanted. Arriving so late in labor I wasn't in it long, but the water surrounded me, protected me, and gave me a measure of privacy. I felt *safe* and supported. The weight of it against my skin was reassuring. I can't recommend water enough. Unfortunately, when push came to shove, my old issues surfaced and because everything went so relatively quickly, I didn't have time to sort it out before getting the "worst tear we have ever seen as midwives". But I am looking forward to my next birth. I have learned a lot and I think it will be beautiful :-).

5. Position. I labored (once things shifted into high gear) and delivered almost exclusively in hands&knees and kneeling positions. I didn't do this conciously, but this is what felt most "right". To turn over just screamed *wrong*. I even refused to turn over for the few VEs, which made things more difficult for my midwife because she wasn't used to doing them that way ;-) but to her credit she gave it a shot and didn't hassle me a bit. I think staying off my back was more important to me than the water. It felt less vulnerable and helped me distance myself from bad baggage and bad memories. The popular image of American birth (ie. woman on her back with doc and lights between her legs) makes me feel physically ill just thinking about it.

6. And lastly, as you might have guessed, my second birth was my first vaginal birth. I was completely unprepared for the sensation of my daughter decending. I was so focused on coping with a long, difficult labor, that I never prepared for the birth. I was totally caught off guard by the flood of crazy thoughts triggered by that sensation. That was the point when I started losing it. It think if I had to do over again, I would include some visualizations and meditations about that. About her decending slowly and safely, and how everything is not about to go horribly wrong at any second.

I guess this is longer than I intended when I started :-).
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#19 of 31 Old 04-28-2003, 12:32 AM
 
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Phyllis H. Klaus, MFT, CSW - wife of Marshall Klaus (they co-authored books on newborns and they co-founded DONA) counsels women suffering from this. She teaches and practices psychotherapy at the MILTON H. ERICKSON INSTITUTE OF SANTA ROSA, California. Maybe you can contact her there if you need more info. She is definitely an expert. I attended my local LLL Area Conference (Southern CA/Nevada) last May and she gave a great series of talks on this topic:

- "Possible Impact of Childhood Sexual Abuse on the Postpartum Period"

- "The Impact of Childhood Sexual Abuse on Pg, Labor & Postpartum: Its Effects and Management"

- "Counseling Strategies and Help Around Breastfeeding for Women with a History of Childhood Sexual Abuse"

If you still need this, perhaps I can make a copy of her hand-outs for you.

Here is the Bibliography:
Arnold RP, Rogers D and Cook DAG. "Medical problems of adutls who were sexually abused in childhood," British Medical Journal. 300:705-707, 17 March 1990.

Secret Survivors: Uncovering Incest and its Aftereffects in Women

Chu JA and Dill DL. "Dissociative symptoms in relation to childhood physical and sexual abuse." American Journal of Psychiatry. 147(7):887-892, July 1990.

Courtois CA and Riley CC. "Pregnancy and childbirth as triggers for abuse memories: implications for care," Birth. 19(4):222-223, December 1992.

The Courage to Heal Workbook : A Guide for Women Survivors of Child Sexual Abuse

Grant LJ. "Effect of childhood sexual abuse: issues for obstetric caregivers," Birth. 19(4):220-221, December 1992.

Trauma and Recovery

Beyond Sexual Abuse: Therapy with Women Who Were Childhood Victims

Kendall-Tackett, K. "Breastfeeding and the Sexual Abuse Survivor," Journal of Human Lactation. 14(2), 1998.

(You could probably find Tackett's papers on this at the LLL website.)

Kitzinger JV. "Counteracting, not reenacting, the violation of women's bodies: the challenge to perinatal caregivers," Birth. 19(4):219-220, December 1992.

Parratt J. "The experience of childbirth for survivors of incest," Midwifery. 10:26-39, 1994.

Rhodes N and Hutchison S. "Labor experiences of childhood sexual abuse survivors," Birth. 21(4):213-220, December 1992.

Rose A. "Effects of Childhood sexual abuse: the role of caregivers and childbirth educators," Birth. 19(4)224-225, December 1992.

10 - boy
5.5 - girl
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#20 of 31 Old 04-30-2003, 12:53 AM - Thread Starter
 
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Thank you thank you thank you......Walosi and Tanibani. YOu gave such helpful info.
Thanks, Walosi for being willing to share your story. I hope your next birth is your best one. I'm sure it will be. BTW, I've heard recently about something called NET (Neuro Emotional Technique). It's non-invasive and can clear past traumas stored as energy in the body in a matter of minutes.
Pretty amazing stuff. Try this website: www.netmindbody.com
I think that's it. Otherwise you could just do a google search on it. Good luck.
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#21 of 31 Old 04-30-2003, 02:18 AM
 
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Just have to second the energy-release work recommendation. I have been doing tons of it in the last six weeks, and for the first time in my life, I believe that anything can be healed. In particular, my abuse history, and the pain surrounding my son's stillbirth five months ago are healing dramatically. I feel like a new person, and I am more grateful than I can ever express. Certain things that used to trigger flashbacks now have no effect on me. It's astounding.

I am certain that my abuse history has directly led to my three c-sections. The first two were a protection, because I had not yet remembered that I had been vaginally raped frequently until age seven. For those memories to have surfaced during a vaginal delivery in a hospital, with a less-than-empathetic OB and staff, would have been a true nightmare for me. With my stillborn son, I did so much emotional work, and we were planning a homebirth. For other reasons, the c-section was still necessary. (I believe one reason is because of old scar tissue--that's a spiritual belief and hasn't been documented medically.)

Thanks so much for this thread and all the excellent information and resources.
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#22 of 31 Old 05-09-2003, 11:28 PM
 
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I have recently begun to believe that my birth actually helped me to heal a rift between myself & my body caused by sexual abuse. Though I didn't do any work emotionally during my pregnancy to achieve this, it seems to have happened. I think that during the birth I was able to give myself over to my body in ways that I had never imagined. I think that this has resulted in my trusting my body as I never had & in a stronger libido. I think that this was a final step to push emotional work that I had done previous to the pregnancy into action & into my real life.

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#23 of 31 Old 05-09-2003, 11:44 PM
 
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Quote:
Originally posted by annakiss
Though I didn't do any work emotionally during my pregnancy to achieve this, it seems to have happened. I think that during the birth I was able to give myself over to my body in ways that I had never imagined. I think that this has resulted in my trusting my body as I never had & in a stronger libido. I think that this was a final step to push emotional work that I had done previous to the pregnancy into action & into my real life.
That is really amazing and wonderful to read. I'm so happy it helped you. I do believe birth can be (was meant to be) a transformative, empowering and POSITIVE experience for women.

If your birth story is online somewhere, I'd love to read it.

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#24 of 31 Old 05-16-2003, 01:39 PM - Thread Starter
 
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Hello! Sorry I've been away for a while.


KatherineinCA: Really cool about the healing work you're doing! I'm just getting into it, and so excited to learn that I don't have to always carry around the *&^% for the rest of my life, ya know? I'm curious to know what other energy release work there is. I'm just familiar with NET. I'm sure that my history has impacted my premature labor in both pregnancies (fear of baby getting to big?). I'm anxious to do some clearing before being pregnant again.

Annakiss: I'd love to read your birth story too. I relate. My second birth was so amazing. A huge door burst open and I began to understand and claim what personal empowerment meant. I had an emotional clearing for a while postpartum, which would have been much easier had I known what was happening, but the results have been phenomenal. I rejoice with you. Planning any more babies?
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#25 of 31 Old 05-19-2003, 01:34 PM
 
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Tanibani & Mamajamz - I'm working on that birth story, I'll PM you a link when I get it up...

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#26 of 31 Old 05-28-2003, 04:07 PM
 
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wow, i was looking for a thread like this!! i didn't even think to look in this forum for it...

i was molested as a child, and raped when i was 19. i never really thought about those experiences could affect my gynecological care or my birth experiences, but they most certainly did. until i went to a birthing center, no ob/gyn asked me if i had ever been abused. it became a huge issue after my ds was born, because i never knew that birth could trigger flashbacks, particularly because i had an episiotomy which i did not consent to. that caused a lot of problems for me, and it really affected my relationship with my dh. i wish that i would have known before i gave birth so that i could have had support in place.

the information in this thread is so vital for practitioners. i never even thought about the weight thing--one of the mw at my birthing center made a couple of remarks about how much weight i had gained : things like that do not help you trust someone!!!

on a positive note, being in a birthing center, having the privacy i needed, knowing my care givers, and knowing that i wouldn't be subjected to unnecessary and unwanted interventions made all the difference in my experience with my second birth. i also think i'm doing a lot better pp than i did with my first.

anyway, i'm so glad to see this thread!!
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#27 of 31 Old 06-08-2003, 05:13 PM
 
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In my experience, the trauma of sexual assault and giving birth are in no way related. I speak only for myself and I don't mean to say that giving birth couldn't bring up these kind of wounds. Birthing can bring up any wound of any kind, I think.
But for me, I didn't think of being raped at all during the pregnancy of delivery. Being raped was something that happened to me by another person. Giving birth is a process of me and from me...no body else is doing anything to me. It feels like two totally different things. I felt like I was in control the whole time of the labor. I did tell the midwives that although I want a natural labor and want them to support me in every way if I ask for medication or to go to the hospital for an epi. that they would simply help get me what I wanted/needed. So I knew not to say I wanted the med's if I didn't mean it. I did not want to be in a position of begging and convincing them I want it becasue that did seem like a power struggle and challenged my sense of personal control.

I think it all depends where a woman is with her past and her experiences. If the wounds are fresh it can be a big deal but if she has worked on the issues and isn't hurting from the past then it may not emerge as an issue at all.
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#28 of 31 Old 06-09-2003, 12:48 AM - Thread Starter
 
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Mary-Beth, I think you hit on something REALLY REALLY important, and thanks for bringing that up. I think it is so wonderful that you had grown to the point that you could make choices that would enable you to hold onto your power. I know with both of my first two births, I somehow didn't "get it" that this was MY body and I had choices. With the second one I was beginning to see the truth of this, but was far from being able to really grasp it in such a way that I could say "yes I want this. NO I don't want that." to the fullest extent that I now do. Too many times, not just in my own experience, but with other birthing moms I see women believing that they must hand over their bodies to their caregivers, not so much out of trust but out of a belief (that is taught and reinforced) that they have to give away their power. How wonderful that you had such a great experience of personal freedom and power!

It is truly powerful when we can step out of the past and say "I was victimized, but I am not a victim."
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#29 of 31 Old 06-10-2003, 11:28 PM
 
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just to clarify, i didn't have flashbacks during pregnancy or birth; they happened sometime after, particularly when i was starting to be intimate with my dh again.

but i agree that it's really important for women who have been abused to feel in control and not feel like birth is happening to them.

Quote:
Originally posted by Mary-Beth
But for me, I didn't think of being raped at all during the pregnancy of delivery. Being raped was something that happened to me by another person. Giving birth is a process of me and from me...no body else is doing anything to me. It feels like two totally different things.
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#30 of 31 Old 06-13-2003, 12:03 PM
 
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Couple more resources. Hope it helps...Joyce in the mts.

About sensitivity for caregivers:
http://www.cwhn.ca/resources/csa/links.html

From Radical Midwives:
http://www.radmid.demon.co.uk/abuse2002.htm

CD Labor/Postpartum (MSTM), Doula trainer (BAI), Midwifery Student/Apprentice, CPS Tech
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