Title: Message
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.
"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke
----- Original Message -----
From: Dean & Jo
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

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