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Tuesday
Sep222009

What Doesn't Feel Right, Isn't

Zipping around Facebook a couple of weeks ago was the My OB Said What?!? site.  It reminded me of an old post I wrote in 2004 right after I learned what birthrape was. I’d been quite angered by the women who used the term because, as a woman who has been raped, it was offensive. How could anything in birth be equated with the horrific experience women around the world experience? I could have closed my mind and left myself in anger, but I probed and really pressed the women to explain it so I could understand what they meant.

Reading around the Net, women have written about birth traumas and abuses, including birthrape.  Kathy shares information from Rixa Freeze’s doctoral dissertation about how some women choose to deliver unassisted because of their past experiences with medical or midwifery care. Interestingly, Rixa and Kathy used my own description of the abuses I participated in as I was learning to be a midwife. I’ve written about my sadness and sincere apologies to the women I have hurt (emotionally and physically) and that, in speaking about exactly this, I could find a place of peace inside myself. (Reference the post I wrote in 2004 above.) 

Back in 2004, I listened to the words women used to describe their pain and was told about actions that did, indeed, sound extremely coercive, manipulative and even pushing women to do things completely against their will. I went to Sarah who at the time was a Deputy Sheriff and I read through her official code book that defined things like “assault,” “battery” and “rape.”

Legalese regarding the definition of assault includes (emphasis mine and my comments in parenthesis):

“… the essential elements of assault consist of an act intended to cause an apprehension of harmful or offensive contact that causes apprehension of such contact in the victim. (“You need to have a cesarean or I will get a court order to make you have one.”)

The act required for an assault must be overt. Although words alone are insufficient, they might create an assault when coupled with some action that indicates the ability to carry out the threat. (“Open your legs. I’m going to do a vaginal exam.” And the woman tells the practitioner that she doesn’t want an exam or tries to close her legs before the exam begins.)

Intent is an essential element of assault. … the intent element is satisfied if it is substantially certain, to a reasonable person, that the act will cause the result. In all cases, intent to kill or harm is irrelevant. (I’m going to give you an episiotomy.” “No!”)

There can be no assault if the act does not produce a true apprehension of harm in the victim. There must be a reasonable fear of injury. The usual test applied is whether the act would induce such apprehension in the mind of a reasonable person. The status of the victim is taken into account. A threat made to a child might be sufficient to constitute an assault, while an identical threat made to an adult might not.

Battery definitions include: “The act must result in one of two forms of contact. Causing any physical harm or injury to the victim—such as a cut, a burn, or a bullet wound (episiotomy, cesarean, IV, internal monitors, IV antibiotics, etc.) —could constitute battery, but actual injury is not required. Even though there is no apparent bruise following harmful contact, the defendant can still be guilty of battery; occurrence of a physical illness subsequent to the contact may also be actionable (a post-cesarean infection, systemic yeast after IV antibiotics, etc.). The second type of contact that may constitute battery causes no actual physical harm but is, instead, offensive or insulting to the victim. Examples include spitting in someone's face or offensively touching someone against his or her will.

Intent: Although the contact must be intended, there is no requirement that the defendant intend to harm or injure the victim. (This allows for the belief of doctors and nurses that the procedure/intervention is helpful, but the woman sees it in a completely different light.)

Intent is not negated if the aim of the contact was a joke. As with all torts, however, consent is a defense. Under certain circumstances consent to a battery is assumed. A person who walks in a crowded area impliedly consents to a degree of contact that is inevitable and reasonable. Consent may also be assumed if the parties had a prior relationship unless the victim gave the defendant a previous warning.

Still, my biggest quibble is with the term “birthrape” because most definitions connote rape with sexual intercourse or genital to genital contact.

Among the common definitions of “Rape,” we find this: “Forced sexual intercourse; sexual assault; sexual intercourse between an adult and a minor. Rape may be heterosexual (involving members of opposite sexes) or homosexual (involving members of the same sex). Rape involves insertion of an erect penis or an inanimate object into the female vagina (gloved hand, speculum, internal monitors, amniohook, etc.) or the male anus. Legal definitions of rape may also include forced oral sex and other sexual acts.

Victims of rape suffer physical and mental trauma. Physical trauma may include cuts, bruises and abrasions in the pelvic area as well as elsewhere on the body. Mental trauma may include overwhelming feelings of humiliation, embarrassment and defilement (classic signs of PTSD). Rape victims should seek treatment at a hospital. There, doctors and nurses can treat the injuries (eek! Not for birth traumatized women), administer antibiotics to prevent sexually- transmitted diseases, and provide counseling or any other additional therapy (mental or physical) that the patient requires. The hospital team's evaluation and report will help document the condition of the patient for legal purposes.”

These legal descriptions of rape do not take into account birth trauma/abuse and trying to use these definitions to prove it would be very challenging (I suspect). I know that the majority of people reading the definition of rape and attempting to apply it to birth trauma will feel it is a stretch to do so. It took decades to believe that rape occurred in marriage or that women could be rapists, too, so expanding the definition to include birth might take a very long time and, I am sure, many, many years and a slew of failed lawsuits before anyone in the legal system recognizes birth traumas/abuses, much less birthrape. In fact, I have known of women to talk to lawyers as they consider suing their care provider and the lawyers won’t even discuss it. The typical proof of “lasting physical harm” is even abandoned as some women have had to have reconstructive surgery to repair the damage caused by their doctor or midwife. What is a traumatized woman supposed to do? I think we all know it takes an extremely powerful woman to even think about bringing a lawsuit against a perpetrator and the aftermath of trauma is not the most conducive time to do this.

I believe this is where a support system can take a major role. Women who have been traditionally raped or assaulted, including domestic abuse, have dozens of places to turn to for help and support. The hurt woman may not realize this or know how to find those resources, but they are there. I know the Internet has changed the face of helping hands, although women in domestic abuse situations still have to be careful lest their Net records be looked at. For those who are not in fear for their lives, but for their mental stabilities, the Net can be a haven for the women who need it. One former birth traumatized mom started Solace for Mothers. An organization in the United Kingdom, the Birth Trauma Association, began at the same time I learned about birthrape/birth trauma in 2004. I’ve corresponded with several of the women who keep that organization going and they are just as committed to helping women as the newer groups here in the US.

Look at that. 2004. Only 5 years of the realization of birth trauma. But, how many decades (centuries?) before were women living with the painful and scary memories of their births?

Above, I alluded to the challenge of trying to get anyone to understand the reality of birth trauma… that people will roll their eyes and think, “Why is she being so dramatic? Women have been having babies for eons.”

When I began talking to my mom about this a couple of years ago, she told me about my own birth in 1961. She said that when she went for prenatals, all the women went into the bathroom, peed in a cup and put their underwear in their purses. They would then have to sit for hours together in a hot room waiting for their few minute appointments with the doctor. When they went into the exam room, they were put in stirrups and left there until the doctor walked in, did a vaginal exam, listened to the baby and sent mom on her way. When she was in labor with me, there were four women to a labor room and when she started pushing, they moved her to the Delivery Room, put her in the lithotomy position, legs buckled into stirrups, arms put in constraints and left until someone came in to catch the baby. She remembers how horrified she was that a very young man (black, something that was an important factor in that time) kept looking at her perineum to see if I was coming out. My mom is so shy I have never seen her naked. She can’t even pee in a public place, so being stared at was, for her, humiliating.

As I asked her how she felt about the birth, she matter of factly told me that that was just the way it was. No one questioned it. She said it was always good to hear other women’s stories at baby showers, that it was affirming of her own experience, but she was too busy to consider the experience as much more than having her first child.

Women birthing in the United States have it really easy compared to some women around the world. We don’t have 1 in 8 women die at births. We don’t lose our babies like too many other countries. We don’t labor on the floor with rats and roaches, sitting in the blood of a hundred other women who birthed before us. We don’t give birth as mortar shells explode outside the window. We don’t really have to worry that our children probably won’t make it to their first year’s birthday. Women in other countries can labor for a week before someone gathers the few dollars it takes to get her to a hospital hundreds of miles away, only to know the baby has already died and the mom now at serious risk of dying from hemorrhage or infection.

Do these women have PTSD? Or do they live in some sort of Traumatic Stress every moment of their lives? Do stressors have ratings? The stress of trying to staying alive much higher on the scale than having a mother-in-law that won’t allow you to go to the hospital? What would these women think of us who are saying they have PTSD for being touched where we said we didn’t want to be touched? Would they think we are absurd? Would they think we are so privileged and take for granted aspects of life they cannot even fathom a woman would be granted.

Is Postpartum Post-Traumatic Stress Disorder (PPPTSD) an illness of luxury? If we were huddled in a migrant camp, would we really be concerned that the doctor pushed our legs apart to do a vaginal exam? Or would the multi-rape experiences overshadow the minimal intrusion the roaming doctor or midwife does.

Is PPPTSD judged by societal norms?

When I was in sexual assault self-help groups (almost always led by therapists), there was a tendency among the women to rate the abuse, almost always minimizing their own. “Well, I was just sexually abused at twelve from the guy next door. She was six and it was her brother. She had it much worse than I did.” Over and over, we had to remind each other (and be reminded) that rating the abuse discounted our own. We had to really work to learn that the measuring stick with which we measured was created by our own hearts. Continuing on that path, it is important for women to take their own experiences and not judge them, comparing them to others. “I just had my membranes stripped without permission… she had an episiotomy!” Your own trauma is just as valid as the next woman’s. I like what Jennifer Zimmerman says: “But, rape is rape. One woman may label it that way, one woman may not, but it is what it is. …if a women has her membranes stripped without her knowledge or consent, that act is a violation no matter what the woman feels about it. If she was not offered informed consent, it doesn't matter whether she is thrilled that she went into labor a day later, she was still not offered informed consent and that makes it wrong for the provider to have done it.” 

So do we start telling women who loved their births that their births really sucked? Do we burst the bubbles of those great stories we hear all around us? Were we elected to Name the Abuse of every woman we meet? 

When I had Tristan (and you can read his story here), I thought the birth experience was so great I wrote a letter to the doctor, nurses and hospital administrator thanking them for the great birth I had in their hospital. When I was pregnant with Meghann, I was talking to a group of Bradley mamas, most of whom had had homebirths. I proudly showed Tristan’s birth pictures, all green draped, lithotomy, oxygen masked, baby across the room… all the things we know now are awful! The women never said a word to me about how horrified they were looking at the pictures. It wasn’t until the whole experience was re-framed by Bradley standards that I began to see the experience as sucky and blech. Even today, the feeling of joy far outweighs the supposed-to-be horrible, angry emotions I should have had back then. It was others that used their knowledge, given to me, pulled into my own psyche, that gave the first experience the shadow it now carries. I asked the Bradley moms how come they didn’t wince and cringe when I so proudly showed Tristan’s pictures off and the Bradley teacher said, “We knew you would figure it out yourself when you were ready.”

The dilemma, of course, is what do we do? 

I say we write and speak our realities. I want women to write in blogs, write articles and get them published, write the hospital, write the doctor, write the nurses. I vacillate between asking women to write filled with their anger and sadness or if they should wait until the anger has subsided and they can write in a voice that will be heard more than a shrill postpartum patient. Angry letters are often dismissed. I think they are fabulous to write and hang onto for awhile before sending them, re-vamping them as time passes, but I’m not sure how helpful the highly charged letters are. If it is a serious part of your healing, then I say go for it. But, know that you may not get any response. If you do write, speak as unemotionally as you can. Speak of specific actions, not a blanket “She sucked” kind of way. Ask someone else to read it to see if it makes sense, flows well and isn’t defamatory. Please don’t threaten the doctor with, “And I’m going to tell everyone I know how awful you are” because you can find yourself in court for defamation of character.thrilled that she went into labor a day later, she was still not offered informed consent and that makes it wrong for the provider to have done it. 

For the women too traumatized to write, draw. If you can read (I could not in my depressions), get Birthing From Within and work through the art suggestions. They can be very telling and very healing. Showing your pain on paper can help those around you “see” what you are talking about. 

Clay is another outlet. I used to do collages. I went to used bookstores and got dozens of magazines and pieced together a collage that spoke my pain in words and pictures. I still have a couple of them. You can also do a collage of what you hope to be/look like after you pass through the storm. Painting… deep, dark colors… the canvas holding the pain through brushstrokes and pallet clumps. 

Find your own outlet. Therapy, of course. Find a therapist who gets it, though. It really is hard to have to teach a therapist about birth trauma before you can get to the meat of the healing. You shouldn’t be the teacher, you are the client. There are many different types of therapy for PTSD. These include talk therapy, medications (temporary or long-term), holistic treatments, dietary changes, acupuncture, hypnosis (although that can be felt as a loss of control to some women – unacceptable), EMDR (Eye movement desensitization and reprocessing), and more. I wish there were Group Therapy groups, but I haven’t heard of any. There certainly are enough women to get dozens going. It really is important in self-help groups to not just be in a place of “poor, poor pitiful me,” but to actively work towards healing and a whole life with the trauma assimilated into the grand scheme of a woman’s life. With the acknowledgement of PPTSD, I believe women are more apt to begin their healing. 

Oftentimes, the therapy includes telling the perpetrator how the woman feels. I’ve seen letters, heard of throwing clay/dough around the room (at his/her hands or face), speaking to the abuser as s/he sits invisibly in a chair and, for many, eventually finding the power to be able to speak to the person face to face or through a letter or email that goes beyond the write & burn stage. It can be freeing to tell the perpetrator your feelings, but really, only if the person acknowledges their culpability in the experience. I remind women that most care providers will act defensively and even put some (all?) of the blame back on her. A woman has to be incredibly sure she can withstand a firestorm before she confronts her provider in person. I believe it is much easier to accuse and confront in writing, at least in the early stages of healing. 

As a healthcare provider, it is imperative for me to listen to women, believe them when they tell me about their abuse/trauma/rape whether it was someone else who did it or even if it was me. And after my 2004 disclosure of the past abuses I participated in, I have been involved in other women’s traumas, albeit accidently. It pains me knowing my actions have hurt another. I am definitely more aware of what I do and say, but there are times when situations create a ripe atmosphere for hurt and anger.  

My wish is that all providers find a place where they can listen –and hear- those that have been hurt, whether it was us or someone else. Until we all can hear, women must keep talking, writing, photographing and screaming about birth trauma. Providers can do the same.

Maybe then, someday soon, we will all be heard.

   

Reader Comments (23)

Thank you for this thoughtful, well crafted post. I can't wait to see the comments - Would you ever be willing to craft a brochure that clients could hand out about birth trauma and what to do, or that we can give to clients who have experienced birthrape but have no name for it?

September 22, 2009 | Unregistered CommenterKristina

Pain (or suffering) is like a gas: it fills the available space, no matter how small or big. That's why it doesn't mattter if someone else's suffering was worse--and there will always be something worse if you look hard enough.

Thanks for talking about these issues. I feel so fortunate to have had two wonderful births with absolutely nothing (okay, besides that I wished I had more pictures!) that I would change. That's a real blessing for me. In part, it comes from taking a lot of time and thought and energy into what I wanted at birth and why. And being in my own turf helped too, although I am quite aware that a home birth doesn't at all guarantee perfection.

September 22, 2009 | Unregistered CommenterRixa

I had a hospital birth experience which I refer to as a rape. I wanted 1 more child so we looked into midwifery care. After we found a midwife who would attend a HBAC, we filed a complaint against the hospital and doctor with the appropriate authority. (It is in the peer review process)

We became pregnant and hired the a midwife. We had great prenatal care. Active labor was 4 hours. Our midwife missed the labor and the birth because I asked her to wait an hour before heading over. In hindsight it's for the best. I'm glad I didn't have to find out if she "talked a good game", only to throw away the birth plan during birth.

Women are different and of course will want different things during their births. Some will want to be mothered through it, some will want minimum contact. It probably just takes intense observation during labor and a lot of heart to heart during prenatals to get it right the majority of the time.

Some women would be angry that they paid for a midwife and "had to" resort to catching their own baby. We are absolutely thrilled that we had such a unique experience. We are so glad that we chose midwifery care. I would not choose an unattended birth purposely, and we were relieved that she made it for the placenta. We needed a bit very light and gentle cord traction because 30 minutes had passed and I was feeling shockish and my color was off. Cord traction is yucky, but I've made my peace with it because it was done with my best interests in mind, with my consent, and the literature I've been able to find supports this practice for the above indications.

September 22, 2009 | Unregistered CommenterJanice

I like Rixa's explanation of how pain and suffering fill whatever space there is. Everyone has their own paradigm to work within, after all.

Thank you for this very important reflection. I am always impressed with how courageous you are in examining your past actions and beliefs, and taking responsibility for them, both internally and outwardly - I so hope you are also forgiving with yourself as you move through these processes.

September 22, 2009 | Unregistered CommenterDou-la-la

As a student of midwifery and a mama pregnant with her second, I'm grateful for the awareness you shed on the need for loving attention in what is communicated. It amazes me how differently people experience their needs. I had two very-hands off midwives, and their deep allowing for me to be as I was was a large part of the inspiration to become a midwife. I feel I am well suited to identify when stepping back rather than clamoring is needed. Reading your story leaves me hoping I am as skilled at identifying when more involvement is needed, too. If we all had communication down, it would simply be a matter of speaking our needs, and hearing one another. Confoundingly, it often turns out to be much more than that.

September 22, 2009 | Unregistered CommenterTatiana

I am a CNM student. Reading this post I am also reminded of "Buy the hospital ticket, take the hospital ride". It occurs to me that at least in the hospital I learn in- a large famous one btw- this post? This is part of the hospital ride. Consent, informed or otherwise, is left at the door. It's just not "done" because women in labor are seen as not being in any condition to understand what "needs" to be done to them. From induction to augmentation to catheterization to controlling their position and restricting their movement to EFM to c/section.

I can't wait to get out.

September 23, 2009 | Unregistered CommenterPissedOffStudent

Wonderful post.

September 23, 2009 | Unregistered CommenterMorag

Wow... this has been such a powerful piece for me to read. As an OB nurse I try so very hard to get (and give) informed consent before ANYTHING I do. I do NOT do vaginal exams without express permission, every single time, and I try to make sure the woman is given informed consent before any procedure an MD may do... but I truly believe that there is always more I can learn and do, thank you for continuing to inspire me to do so.

September 23, 2009 | Unregistered CommenterBrenna

What a powerfula nd well written piece Barb! I eagerly await your first published book. That will be when?

I often worry that something I have done may inadvertently cause someone grief later. I try very hard to do good informed consent, ask permission before 'doing' things to women, and honor and respect women's wishes. But I still worry that maybe I might push a woman to hard for a natural childbirth - that's my biggest fear...walking that fine line between pushing a little harder so she will have the natural childbirth she wants or giving in when she asks for pain medicine/epidural. I recently felt I had crossed the line with a woman and had to call her in a couple days to check in with her. I had to know...I was so stressed about it....Turns out she was so happy with her experience and thankful that I had pushed her through that last biut of time (her words, not mine).

I felt such a sense of relief. But how do I know that somewhere out there, someone isn't regretful or even traumatized by something I did or said? I've only been a midwife for a couple of years and have grown tremendously in that time. But learning from my mistakes may come at someone else's expense. That's a hard thought to deal with.

September 23, 2009 | Unregistered CommenterCiarin

On the heels of this post is going to be a post about Birth Trauma from the midwife's perspective. I don't know if that is the right way to describe it, but A Midwife's Own Birth Trauma... something like that. It will be much more challenging to write than this post, which took a lot to do.

Thank you, everyone, for your kind words. This was definitely a labor of love (trite as that sounds).

September 23, 2009 | Registered CommenterNavelgazing Midwife

"If we all had communication down, it would simply be a matter of speaking our needs, and hearing one another. Confoundingly, it often turns out to be much more than that."

I think this is a brilliant observation. I also worry about things I did or said in what I believed to be a client's best interest causing distress or pain without my knowledge. I try to do at least a little summing up at my last postpartum visit "Was there anything you felt didn't go well? " "Any part of your labor and birth make you unhappy?" "Anything you would want differently for your next birth?" that kind of thing. I find it's easier to get women talking with questions like this than a more direct "Were you unhappy with anything I did?" which many exhausted, vulnerable, and emotional women may not be comfortable answering. Still, even with the best intentions, it's not possible to be the best attendant for every client, and that's something I've had to come to terms with and let go of quite a bit in my professional life. It would be so much easier if we had good communication all the time, though - so much easier to have a woman just tell me "don't do that" than let me and be upset about it later!
I do still find it breathtakingly shocking to hear what some women endure - some of the stories I've read, or even had clients tell me about from their previous experiences are so awful. I wish that the whole culture of modern medicine would shift so that having good communication and most importantly birthing women in a position of power was the norm.

September 23, 2009 | Unregistered Commenterdoctorjen

Oh, and I forgot to say - beautiful post and very well thought out. I look forward to the one on midwife birth trauma. It's something I always struggle with myself - when I have difficutly with something I saw, or did, or whatever.

September 23, 2009 | Unregistered Commenterdoctorjen

Hi Barb, interesting post. I am very uncomfortable with the term 'birth rape', I think this is because in my mind, a rape is a violent, sexual act, and I have yet to see a doctor or nurse behave that way towards a woman. I have seen rudeness, thoughtlessness, un-informed consent, coercion, persuasion, even pain caused (but never intentionally) etc etc... but never the sheer violence I 'personally' associate with rape. This post did confirm to me that I personally do not feel happy using the term 'birth rape'.

I would be really interested if you would consider writing something regarding the language we use when we get consent for a VE, not necessarily a negative post, but something informative. As a hospital midwife, VE's are part of my daily job and I am always keen to improve my communication surrounding them.

September 23, 2009 | Unregistered CommenterLiz

Liz,

I am not a huge fan of the term "birth rape" either. I feel it is more an internal word, to be used amongst other women who have experienced events at their birth that felt like rape to them, and I rarely use it outside of that. But your comment intrigues me. You say that you are not comfortable with the term birth rape because you have not personally seen something you consider to be rape. This would imply that you issue is not with the word itself and what it represents, but that you simply don't feel that these things really occur. Do you not believe these things happen because you have not seen it? Or am I misunderstanding your comment?

September 23, 2009 | Unregistered CommenterJennifer Z.

Great post. I have a few thoughts:

"I am sure, many, many years and a slew of failed lawsuits before anyone in the legal system recognizes birth traumas/abuses, much less birthrape. In fact, I have known of women to talk to lawyers as they consider suing their care provider and the lawyers won’t even discuss it."

Failed lawsuits? I can't even get past the receptionist! I am not done trying to pursue this avenue, and have learned that I should not have tried medical malpractice or personal injury, but a civil rights attorney. These women should not be trying to prove that someone "raped" them, but that their civil rights were violated. All patients have a legal right to informed consent and refusal.

"One former birth traumatized mom started Solace for Mothers."

Thanks for mentioning this. I just want to point out though that the founder of our organization was not a birth traumatized mother. She is a therapist from California who used to do rape crisis work. She realized that women who were traumatized from their births were describing them in the exact same way as women who were raped which led her to founding Solace.

"What would these women think of us who are saying they have PTSD for being touched where we said we didn’t want to be touched? Would they think we are absurd? Would they think we are so privileged and take for granted aspects of life they cannot even fathom a woman would be granted."

I think the type of women you are talking about here experience so much trauma in their lives that they become desensitized to a great deal of it, or just live through a lot of it in a dissociated state. They are already living in survival mode. They have shortened life spans, and must suffer a great deal for the long term trauma they must live with due to life circumstances. Their births may be another one of those traumas, or it may not, we don't really know much about the emotional experiences of these women. Also, just because one group of people have gone through more trauma or grief doesn't mean another group should just be grateful. If one of my pets dies, I am going to be sad even if there are others out there who may have lost 10 pets.

"Is Postpartum Post-Traumatic Stress Disorder (PPPTSD) an illness of luxury? If we were huddled in a migrant camp, would we really be concerned that the doctor pushed our legs apart to do a vaginal exam? Or would the multi-rape experiences overshadow the minimal intrusion the roaming doctor or midwife does."

If we lived in that situation, we would have an expectation of being mistreated in birth, as we would in life in general. But we live here in America were patients have rights, and people have freedoms, and personal autonomy. Women don't go into their births with an expectation that their legs will be pushed apart and their doctors will force an exam on them. I know of any woman who would expect that to happen here, and when it does, it is shocking and can be traumatizing.

"I say we write and speak our realities."

I agree!

"For the women too traumatized to write, draw."

I agree with this too! For so long in therapy I just did not have the words. So I started bringing in drawings instead, and eventually I found the words through them. Drawing or artwork is a great way to work through trauma.

"Find a therapist who gets it, though. It really is hard to have to teach a therapist about birth trauma before you can get to the meat of the healing."

It is hard, but sometimes necessary. Here is a tool from Solace that can be helpful in this regard, it is interview questions to ask a therapist to try to find one who can help with birth trauma issues: http://www.solaceformothers.org/therapist_interview.html

"I wish there were Group Therapy groups, but I haven’t heard of any."

In MN we have birth trauma workshops. Also, there a few online groups. Solace has a discussion board, another woman named Jodi Kluchar has a yahoo list, and MDC even has a forum now for birth trauma (though MDC's is public and googleable) and I think there are some others I am forgetting. There are certainly more resources available now then there were even 4 years ago after my son's birth. Many women resort to exclusive online support because some areas have no therapists or groups.

I'm looking forward to your next post.

September 23, 2009 | Unregistered CommenterJennifer Z.

Why is it birthRAPE?

The focus is on the vagina, the urethra, and the anus.

There is penetration.

The woman has said no, or would say no if she was given the chance for informed refusal.

The action has not been taken for emergency medical treatment, as in lifesaving.

The woman has suffered psychological injury as a result of the rape.

There is damage to the vagina, anus, urethra, or uterus as a result of the rape.

The woman is harassed or shunned because of the rape.

The practitioners who were involved refuse to bear responsibility for their actions, and other practitioners refuse to consider the fact that these type of actions are sexual violations.

Other women are encouraged to harass or shun the woman because of her rape because it is too much to wrap their prejudices around.

Police will mount an investigation into these type of allegations if they are reported, and practitioners found guilty will be prosecuted - if women come forward and report.

September 24, 2009 | Unregistered CommenterJanice

rape is not about sex, or sexual...rape is all about power and control......bending the wll of the victim to your own...and I experienced that first hand at the hands of an OB....so I have no problem with the term birth, or in my case, postpartum rape

How many nurses want their patients to get an epidual to shut them up? How many docs play the dead baby card to get a woman to consent to whatever? Sure sounds like rape to me!

September 24, 2009 | Unregistered CommenterJill H.

This was a wonderful post. Before I worked with birth, I worked in the domestic violence field. I know that "it could always be worse!" is a type of "perspective gaining" look-on-the-bright-side strategy, but we always reminded women in the shelter who used it that there is almost always someone "worse off" than you and just because that is true does NOT mean you have to deny or minimize or make excuses for your own trauma. It is still real and valid to feel the way you feel instead of trying to feel better because someone else's trauma "rates" more highly.

In a loosely related musing, at a certain point, looking at what could be worse or cause more suffering, becomes almost ridiculous--I'm reminded of a passage in a memoir I read once in which someone lamented about something that had happened to her brother and then said (I paraphrase), "but I guess he could have been born in 19th century India and been bitten by a testes fly and died before his third birthday." You can only really work with what *happened* to you and how you feel about it, the "what if" and "gaining perspective" scenarios can head to bizarre-ville.

September 24, 2009 | Unregistered CommenterMolly

I also don't like the term birthrape. Birth robbery, yes. But birthrape, not so much.

Great post! Thank you!

September 28, 2009 | Unregistered CommenterJaded

Thank you so much for this very academic look at Birth Rape. It's real, and women have to stop denying it to each other. I was so upset by the hateful comments on the Jezebel piece that I wrote this - http://thefeministbreeder.typepad.com/the_feminist_breeder/2009/10/women-are-the-problem-with-women.html

Women have always told other women to shut up about their pain. When is this going to get the attention it deserves?

October 23, 2009 | Unregistered CommenterTheFeministBreeder

As someone who was repeatedly molested as a child I too had an initial reaction that it was inapropriate to use the term 'birthrape' since I felt, initially, that it somehow took away from people who where 'actually' raped. I always say I wasn't raped (I admit I suffer from that mentality to 'rate' my molestation as 'not as bad as X', I think its a safety net personally), but the definition of rape listed here (which is similiar to other legal definitions I have read) says it all. "Rape involves...insertion of an inanimate object" I have read other legal definitions that also specifically list 'any part or portion of the perpetrator's body' not just listing penis and inanimate object. The more I thought about it (and dealt with my own feelings of violation during childbirth) I realized, while you are highly unlikely to see a woman beaten to within an inch of her life with seamen stains on her thighs during a 'birthrape', the legal definition still fits, it can still be traumatizing, violating, horrific, and the stigma attached to woman who say they were birthraped is, at this time, far greater I think than someone who admits to being 'date raped' (also a crime where you aren't likely to see a lot of excessive violence to the woman's person). Mothers at a very emotional and vulnerable time are being forcefully entered by hands, probes, scaples, scissors, etc. in the more private of ways. Consider it this way, if a random stranger strapped a pregnancy lady down, stripped her, forced his hand inside her vagina, cut her vagina, broke her water by shoving a foreign body inside her, caused her to contract by leaving other foreign bodies inside her, and ultimately forced the delivery of her baby, would he be charged with practicing medicine without a license? No, he'd be charged with assault, battery, and yes, probably rape too. Why do we want to say its 'okay' to do these things to a protesting woman just because the 'stranger' has a MD behind his last name? Yes, some rapes leave the woman in a worse physical state, but, just like 'rating abuse', using that as a dividing line to exclude birthrape, seemed very dangerous, demeaning, and harmful to survivors of birthrape. I will always be careful if I use the word, since it is so stigmatized and unreported/unrecognized I think the term has a lot of ability to hurt a victim of 'traditional' rape, but I have changed my initial position and see it as a completely appropriate legal and lay desciption of an all to common occurance. BTW I am a member of Solace for mothers which has helped me immensely to deal with my own traumatic delivery/postpartum period.

December 1, 2009 | Unregistered CommenterJessica

Sounds like we should all be Doctors because everyone seems to know what is best for themselves. Imagine the stress of delivering a baby or perhaps 5 every day and you are constanlty faced with people challanging what is best for the baby against what is best for themselves....Doctors are there to get the baby out, safe and sound with as little stress to the mother and child as possible. The baby takes priority unless the mothers life is threatened. Being put in an uncomforatble position where you have no sense of control and you are rightly scared cannot count as something worth risking the childs health over.

September 7, 2010 | Unregistered CommenterCharlie

I am so thankful that I read this post. It finally put into words what I have been saying for almost three years. I had planned a homebirth for my third, which was illegal for the midwife in MO at the time. Due to late decels, we transported to our small town hospital. The doctor there forced my feet back to my head, even though I was yelling that he was hurting me and pushing too hard. He pulled my baby from me, and proceeded with performing the most horrific procedure I have ever heard of. He had the baby and my husband taken away and used both his hand and a tong-like tool to completely clean out my uteris. It was so painful, I was screaming and crying, and I kept asking what he was doing to me, and he never even looked at me. My wonderful midwife just stood there, knowing she was in danger of a class c felony, looking in as much pain as I was in. I never even knew entirely what he had done until she told me a few days later. I was unable to walk or stand upright after. I have often thought this is what rape feels like, but like you, felt that was unfair to those who have actually experienced rape. Until this moment, I have never heard of birthrape, but I believe with all my heart that's what happened to me. He stole my daughter's birth from me, and then told me I was lucky he was there to do what he did. Like I should be thanking him! Almost three years later, I still deal with the trauma of this experience. Thank you for sharing this! I now know I am not alone, and I hope more can be done to prevent these sort of things from happening.

January 5, 2011 | Unregistered CommenterErin

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