Title: Message
As a doula what do I offer my clients in terms of support pre and post c-section?
Well I wrote this before all the discussion happened today.
 
With all my clients we discuss the possibility of a c-section birth and as part of their "birth plan" have a c-section plan. I do this now because so many women seem to ignore the possibility of c-section and say "that won't happen to me" even though they are birthing in places with rates of 1 in 3, or 1 in 2. Once we have done that (unless they are planning a c-section of course) we then put that aside and focus on the birth she wants. I also teach them simple tools that they can use to help them feel in control even when things don't go as planned so if they choose to they can remain the ones making the final decision about what happens to them and their baby.
 
Post birth I am available to debrief whenever they want to and refer them in need to good independent preg and postnatal counselling. Often the debriefing happens casually over time in those first weeks but we also make a special time to sit down and have a thorough debrief when the parents are ready.
 
I am a co-facilitator for a course/support group called Healing Birth for women who have had traumatic birth experiences (many but not all are women who have had c-sections) and already we see trends with the things done and said by the same careproviders over and over again.  Sometimes I think If only the ob's and midwives involved in these women's experiences could hear and see these women tell what happened from their point of view perhaps something might get through and change their practice - many of the women write letters to help them heal but very few are actually posted.
 
I think it is true that almost all women need to debrief their birth no matter how it went and I have seen the positive changes in women after they have had the chance to debrief in a supportive place over a number of weeks. Some even look physically different after the debriefing. Not to mention the more positive empowered experiences they go on to have with any future babies.
The other thing with debriefing is have you noticed that those who don't debrief their births are still telling people the horror stories (up to 60 years later in the case of a family member of mine.) Often pregnant women are bailed up in checkout queues or odd places by a stranger telling them titbits of their birth story that perhaps would really have benefited from a reflective debrief.
 
Honey Acharya CD (CBI)
Studying BMid through UniSa
 
Birth Buddies - Doula
Townsville
 
 
 
 
 
----- Original Message -----
Sent: Friday, February 03, 2006 11:30 PM
Subject: Re: [ozmidwifery] Post cs support

Jo, you're speaking from my heart as well. I was at a meeting last year of women working to support others in birth trauma. All of us had been suicidal at one point, myself included, none of us had had any support from careproviders.
I'm always happy to share my journey but it rarely scores a comment on ozmid. What this means I cannot judge but it makes me fear for other women in my position if we can't talk about it with careproviders. It's not about blame, it's about responsibility for our actions as consumers and a hope that our careproviders will also take responsibility for their actions. We really need everyone to be be truly "with woman" on this one, not with protocol and not with status quo.
J
----- Original Message -----
From: Dean & Jo
Sent: Friday, February 03, 2006 7:43 PM
Subject: RE: [ozmidwifery] Post cs support

I think it is ESSENTIAL for midwives and consumer groups to be working together on this one.  Amazingly enough, many complaints we hear about are from women who feel their midwife let them down.  Interesting issue (as I am a doula also, perception and expectation of support is of great interest). 
 
Most would agree with the fragmented care currently offered there is a huge reliance on trusting someone who has just walked in the door.  anyone caring for a woman tries to do their best; but their best may not correspond with the woman's needs, even the 'nicest' midwife can upset someone unintentionally.  where does the accountability lie?  bit tricky there...probably too hard to define: but it doesn't remove the fact that some woman is feeling like shit.
 
I think it is important for midwives and doctors (if they would ever listen) to listen to the trauma experienced by women.  From experience I can say that MY perception of a particular birth was it was positive: but to the woman is was shit.  Care providers need to base their post birth care on not what defines positive to them, but what defines positive to each individual woman....so easy in this system! NOT.
 
I wish that one particular person who posted on Janet's Accessing Artimise list would give me permission to paste some of her recent post about the grief she felt postnatally.....over a year later.  To exploit her pain would be adding to her grief: but her words are so powerful, it is heart breaking. 
Trauma after birth effects so many and there seems to be little being done to minimize it. Bugger all being done to acknowledge it.  passing the sense of responsibility on to others seems to be the way.
 
The 'head in the sand', 'too hard basket', 'total denial', 'my hands are tied' mentality has to stop soon before birth trauma claims more than a woman's soul. 
 
I am deeply concerned about the lack of information provided by participants of this list (a deep source of supportive woman focused care providers) o the topic of post cs support.  From a consumers perspective: if people like yourselves cant offer up strategies to minimize trauma after cs, then what are we to do?  It doesn't bode well.
 
no disrespect intended.  I value and hold all active members of this list - however as a consumer it is my right and my role to point out weakness.  birth trauma is a huge weakness that needs to be dealt with.  The ideals of one on one midwifery should not be seen as the solution to current trauma.  yes it will hopefully reduce the trauma of future women, but for those who birth today...there is stuff all except isolation....not what they need.
 
I was hoping to hear multitudes of posts sharing the methods of supporting and educating women about cs birth:  information on post cs care: methods of debriefing that does more than shift blame: words of wisdom about how we as a society are caring for our future.
 
*sigh* 
 
love Jo
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, February 03, 2006 2:58 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Post cs support

Speaking as someone who helps pick up the pieces after these scenarios, this is what I offer as a starting point:
As well as a pamphlet on PTSD symptoms, and one for partners on how to support a traumatised woman.
 
The various groups I run offer peer support and accurate birthing information. We encourage women to seek their birth records and go through them with a disinterested party, to look at the reasons why they made choices which put them in more vulnerable positions, and provide resouces with how to make more nurturing choices next time - provided it's not an emergency hysterectomy as that's a whole other kettle of fish. We offer contacts for groups and counselling in each state, where they exist.
: )
J
I'll be interested to see what those closer to the coalface are offering to consumers as well. It would be neat to work in concert!

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