Traumatized w/o knowing? Is it possible? - Page 2 - Mothering Forums

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Old 05-19-2009, 02:02 PM
 
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But then we have an interesting question - if a woman for some reason is NOT traumatised by having a intervention inflicted upon her is the intervention then ok?
That would be an interesting question, except that it's somewhat meaningless, imo, because of this:

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For example if a woman knows very little about labour and birth outwith the highly medicalised model and has a huge episiotomy and later says that despite it taking 3 months to heal enough that she could stand or sit comfortably she is grateful the doctor was there to cut her vagina so the baby could come out (i.e. is unaware this isn't actually necessary in many cases)
Doctors who cut routine episiotomies aren't only going to cut them in women who end up being grateful for it. They just aren't. The performance of unnecessary episiotomies (ie. most of them) is abusive, and the fact that some women don't realize that doesn't make it any less so. Is it okay when a husband calls his wife nasty names, and she accepts it, because she doesn't know that it's verbally abusive, and doesn't realize that most women aren't expected to put up with that?

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should one let her know that episiotomy isn't necessary in many cases or not?
I'd say that depends on a lot of factors.

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I know several women who had inductions for being post dates at EDD+2 or 3, which ended with near-catastrophic situations (for example one had a uterine rupture because the ob dialled the pitocin up so high when she'd had her epidural that her contractions were lasting 4minutes or longer) who are terribly grateful that the Ob "saved" their baby.
And, one of the factors comes into play here. Are these women going to have any more babies? If not, I might be inclined to leave things alone, because there may be no reason to bring it up. However, if they're planning to conceive again, they're not unlikely to end up in the same place, and go through the same things...and I'd rather say something than see a woman rupture and maybe lose her baby because I was afraid of upsetting her. You know the one woman who had the pit dialed up too high...what if one who didn't goes ahead with another induction, because her body "doesn't go into labour on its own"...and hers ends up with a rupture? At least in the case of women having more babies, they need to know.

Then, of course, it also depends on the woman. If I ever found out that a friend or family member knew something had been done to me that wasn't necessary and that hurt me (such as episiotomy or pit overdose resulting in uterine rupture), and didn't tell me, I'd be pissed. I'd be so angry and so hurt that they thought I was too weak and feeble to know the truth about my own past. I'd probably have trouble ever talking to them civilly again. These things have real life ramifications.

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If we talk in the real world about labour and birth we are going to be telling some previously untraumatised women things which traumatise them. Retrospective hurt is sometimes even worse than that felt initially because into the mix you get to feel guilty and stupid for not realising at the time what was going on.
I think that's probably true, and it sucks. But, I'm also not prepared to set a woman up to take 3 months of healing to have a pain-free vagina (if that's even the case - it could be even worse a second time), because I didn't want to hurt her feelings, yk? She could also find out in some other way, when it's too late.

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It was a shock! It would be so easy for me to take on that trauma, the secondary trauma laid on me by society's expectation.
I'm not sure what you mean here, to be honest. For me, at least, trauma has jack all to do with "society's expectation". In the "real world", most people I know don't even understand why I'm not grateful to have avoided "having" to push a baby out. Society's expectation is that I've had it easy (except for losing my baby - I'm allowed to be upset about that), and should be appreciative.

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But with birth it's a tough question - is it worth letting women know that many interventions are unnecessary, counter-productive and dangerous? Is it worth telling women HOW birth can be when it might not have been and cannot be changed in retrospect? Is ignorance bliss?
Is ignorance bliss? Yeah - I think maybe it is. There are lots of times when I wish I just didn't care about c-sections - that I could just accept them as the "easy" way and the "safest" way and all that. OTOH...maybe, just maybe (I'm not optimistic), if people keep talking, my dd won't ever be treated the way I have been during her own births. It's too late for birth to not traumatize me...but it's not too late for dd or my potential future DILs. I'm sorry if it sounds cold, but if other women realizing that was done to them wasn't okay, wasn't safe, wasn't evidence-based, etc. is the cost of preventing those things from happening to other women at all...I think the cost needs to be paid. Otherwise, I feel as though I'm sanctioning the routine abuse of women, including my own daughter, in L&D.

Mind you, that's all from the perspective of somebody who has never felt that my doctors were anything but abusive. I honestly can't even imagine coming out of the hospital appreciating an OB, or feeling gratitude towards them or the hospital...just can't wrap my brain around what that would feel like...

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Old 05-19-2009, 02:03 PM - Thread Starter
 
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But then we have an interesting question - if a woman for some reason is NOT traumatised by having a intervention inflicted upon her is the intervention then ok? For example if a woman knows very little about labour and birth outwith the highly medicalised model and has a huge episiotomy and later says that despite it taking 3 months to heal enough that she could stand or sit comfortably she is grateful the doctor was there to cut her vagina so the baby could come out (i.e. is unaware this isn't actually necessary in many cases) should one let her know that episiotomy isn't necessary in many cases or not?

I know several women who had inductions for being post dates at EDD+2 or 3, which ended with near-catastrophic situations (for example one had a uterine rupture because the ob dialled the pitocin up so high when she'd had her epidural that her contractions were lasting 4minutes or longer) who are terribly grateful that the Ob "saved" their baby.

If we talk in the real world about labour and birth we are going to be telling some previously untraumatised women things which traumatise them. Retrospective hurt is sometimes even worse than that felt initially because into the mix you get to feel guilty and stupid for not realising at the time what was going on.

This is interesting to me because on another thread i've been discussing my experiences as an abused child. I was abused from age 5 to age 12. But i didn't know that what had happened to me was "wrong" or illegal or considered to be the worst thing, short of death, that can happen to someone, until i was 13. It was a shock! It would be so easy for me to take on that trauma, the secondary trauma laid on me by society's expectation.

But with birth it's a tough question - is it worth letting women know that many interventions are unnecessary, counter-productive and dangerous? Is it worth telling women HOW birth can be when it might not have been and cannot be changed in retrospect? Is ignorance bliss?
I would argue no. Abuse is abuse, whether the person interprets it as trauma or not.

Buuut the tricky part here is determining what obstetrical practices constitute abuse and/or when.

It's easy to say, hmm what's an example...it's easy to say that if a husband hits his wife, that is abuse pure and simple even if the wife says she wasn't traumatized or otherwise denies it.

With some medical practices savings lives this analogy doesn't really apply. Which is what I've been pondering lately. Are some obstetrical practices *inherently* abusive?

It's a back and forth in my mind.

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Old 05-19-2009, 02:17 PM
 
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With some medical practices savings lives this analogy doesn't really apply. Which is what I've been pondering lately. Are some obstetrical practices *inherently* abusive?
I can't think of any one practice that's inherently abusive. I've ever heard there's a very, very small number of births in which an episiotomy can save the baby's life, although my placenta brain isn't finding the applicable situation in storage. I think making any practice routine is at least potentially abusive (ie. there's a big difference between performing an induction for pre-e, with a high Bishop's score, and performing an induction, because the mom is a day or two - or even a week - over her "due" date). When interventions are being performed because they're policy, that's very worrying...

In addition, I think a lack of true informed consent is rampant, and that is abusive. For example, I truly believe that any woman who is induced, for any reason, without first being warned that many (most? all? everyone I've talked to, anyway) find induced contractions more painful than naturally occurring ones, has been abused by the doctor. If a woman is counselled, during labour or otherwise, to have a section, without at least some information about the potential effects on subsequent pregnancies, that's abusive. (I do realize there are true emergencies where there isn't time for that.)

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Old 05-22-2009, 10:26 PM
 
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OP, to be 100% honest, when I read your birth story saga, I fully expected you to be traumatized by the way that birth went. But, by all accounts, you weren't - you seemed very happy and unbothered by it.

Trauma is very much in the eye of the beholder; in the heart and mind of the person having the experience. All I feel about your birth is glad for you that you were and are pleased with it. I feel the same about your friend. I don't know whether she needed an episiotomy or vaccuum (perhaps she did). Sounds like she wanted an epidural and was happy with that choice, and is happy with the birth.

If she isn't bothered, you shouldn't be either. If you have told her about your birth, you never know - it may have inspired her to get an epidural! At the very least, it's quite possible she thought your birth experience sounded awful and scary. We all have our own preferences, needs and perceptions. I don't think there's any reason to think she's traumatized but "doesn't know it." While I think that's possible in extreme cases, in this case I think the idea is a bit condescending; I would think that she either was traumatized but didn't want to talk to you about it or truly wasn't traumatized. I would give her the benefit of the doubt on knowing her own heart and mind well enough to be aware of being traumatized.
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