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This is a fascinating thread
I have a friend whose first birth was in a private
hosp with epidural and forceps = no reason medically for the forceps and the
epidural was not working well at that point. No one allowed her to push,
she was made to wait for the doctor who then pulled the baby out. She was
young and believed that it was all normal, her ob came the next day and
patted her on the knee and said "lucky you - no stitches, you must be very happy
with that" She agreed at the time and went home believing she had had a
good birth because she did not have stitches.
Next pregnancy she experienced total panic and went
to a different (and more empathetic ob, fortunately) and demanded an elective
C/S. He had the insight to discuss the first birth in detail and assure
her that things would be different this time - and they were. She had a very
healing birth experience.
My point is that the trauma she suffered was very
real, but she was unable to identify this at the time of birth and agreed with
all that the first birth had been fine. Ten years later she discusses this
with me, a newly made friend, and the pain is still evident.
I do believe that many OB's do not have the
slightest idea how much they sometimes traumatise women, whether this is due to
women NOT complaining at the time (at least not directly to the traumatiser) and
very few who actually complain later either, or to their (often) blase and
overbearing attitude - believing that the delivery of a live child is the only
important outcome.
I recently had a situation where I personally
was traumatised by the brutality I witnessed, but the OB stated to me
later that the woman was very happy with her care! This made me wonder
about the discussion he had had with her and the slant he must have put on
things, because I cannot imagine any woman being truly happy to have been
subject to the assault that I witnessed.
My CNM at the time told me that I could not state
that the couple had been traumatised, because it was MY perception and theirs
may have been different - true enough I guess but.........:-(
One only has to listen to women of all ages and
backgrounds - we all love talking about our births, good or bad, the joy
or the pain stays with us forever.
On a more positive note - this week I was 2nd
midwife at a delightful birth with a lovely couple. There was a persistent
and prolonged 'anterior lip' and she seemed to take a very long time to get past
that point. As I was just standing quietly awaiting I remembered something
someone posted a while back and thought I would try it so I said to her "What is
your biggest fear right now?" She didn't answer for a couple of
contractions then suddenly burst out " My biggest fear is that I won't be able
to birth the baby" What do you know - lip went and baby started to
appear!
So thanks to whoever it was who posted that one -
it's good to tap into all this wonderful midwifery wisdom.
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"
Edmund Burke
----- Original Message -----
Sent: Saturday, February 04, 2006 5:00
PM
Subject: [ozmidwifery] Post cs
support
Interestingly last year our South Australian Gov held
an inquiry into post natal depression and direct links to birth- cs
specifically. I sat there and listened to a private OB who said "none of
my patients are unhappy with their cs".....
how
would he know? when does he ask? who does he think he
is?
yes
Andrea, the problem is a difficult one to address but I think there are
definatley ways to start. Inclusion of PTSD during antenatal classes and
a handout describing the difference between PND and PTSD; a list of possible
contacts of support from outside the hospital and perhaps maybe one within.
Find out if someone can be appointed a specific consumer relations counselor
with expertise in PTSD and birth at the unit who acts as the consumers
advocate or point of call, actively encourage any birthing woman (but
especially those who have had difficult or emergency births) to contact this
person to at least register their concerns regardless to when it
happened. This person could also be used to document the cases and make
links to particular behaviours or procedures that cause harm and even
individuals who are repeat offenders in offending - then they could be
encouraged or even enforced to get educated or get out.
Units need to actively support the consumer groups in
their area. Advertise the details of consumer groups and LISTEN to the
group's findings and feedback- good, bad and ugly.
Educate women about the realities of birth in our
current system. This is a hard one as it would be easy to tell them that this
is the way it can be but it doesn't need to be or worse, tell them this is the
way it can be so accept it. educating women about birth as a positive
thing is an ongoing challenge but attention to wording, and reiterating the
rights of women to say NO or in the very least be ASKED not TOLD. If a
midwife witnesses an event that has clearly disempowered the woman, if that mw
has not the strength to stand up for the woman, to at least pull her aside
after and tell her that should not have happened and would she like to make a
complaint. I would hope that this scenario would be avoided however by
not letting it happen.
Perhaps a list of standard things that happen during
each visits (breast checks etc) is given to the woman and unless she
ticks the 'yes' box the procedure can not go ahead. Information or
rationale can be given for all procedures so the woman is informed as to the
reasoning for it. INFORMED CONSENT. If she ticks 'no' and it
happens then her rights have been abused and consequences must
occur.
Agreed that going back to where the trauma was
committed is not what most people do...as many have said before, no one goes
back to their rapist and asks why they did it or gives them an opportunity to
defend the attack.
MOST
WOMEN WHO SUFFER TRAUMA UNDERSTAND THAT THEY CAN NOT GO BACK IN TIME AND
CHANGE THINGS- BUT IF THEY CAN DO SOMETHING TO PREVENT IT HAPPENING TO SOMEONE
ELSE THEY WILL. Most women who are hurt emotionally and physically
do not want to sue: they want an APOLOGY an acknowledgement that they have
been wronged. Most have the strength to go back if they knew they were
going to be taken seriously and not dismissed off handedly for not "getting
your fantasy birth" like I was told by the Bendigo Hospital CEO a few years
back (sorry but these days I name names. It is the only right I have
left.)
Do
not fob off people like Janet and myself, we are the type of people who are
angry, hurt and vocal yes-but we are the ones who units can learn from.
the only way to improve things it to ask the ones who are not happy. The
majority of unhappy people don't know what to say or who to say it to.
Use people like Janet and myself as very open in tracks into just how stuffed
this sort of thing can leave women (sorry Janet, but you know what I
mean!:o)). We are the type of people who should be invited to come back
and talk to the staff. we are classified as extreme minority...only by
those who chose to see us as that. If you ask us, we will tell you that
we are NOT a minority in any way shape or form.
Like
Janet, I have a number of things that we can do to support women suffering
this. Nothing is impossible. It all comes down to someone actually
recognizing there is a problem and then be willing to do something about
it.
once
again, I mean no disrespect for anyone on this list. I only ever want
people to think from a different view point for a few
seconds.
with
light and love
Jo
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