Addressing Birth Trauma: Take Back the Night meets Take Back Birth

Birth trauma happens for a host of complex reasons.

Among them:

(1) Barriers to accessing safe and competent care providers,

(2) Unexpected and/or unanticipated pregnancy, labour and birth, and postpartum outcomes,

(3) Practices that serve to prioritize the best interests of a ‘care’ provider and institutional policies over the needs of women and their families,

(4) The disconnect between the social expectations of perfect mothering and the lived reality of the transition(s) to mothering,

(5) How the dynamics of prior experiences of trauma can be re-enacted in the transition of becoming a mother (i.e. people in positions of authority violating fundamental rights to safety, dignity and body integrity), and

(6) Negotiating the transition to mothering in the context of interpersonal/systemic violence.

Birth trauma is misunderstood, minimized, denied and ignored because the needs of women in GENERAL are minimized, denied, and ignored.

This is at least in part why birth is a feminist issue, and why we can not talk about addressing birth related trauma without talking about systemic violence against women more broadly.

I brush only on the very surface of this argument in what follows.

I firmly believe we need to talk about the needs of women prior to becoming pregnant, and consider how the factors that produce birth trauma are intimately and inextricably linked to the politics of women’s oppression and as an extension of violence against women.

Take Back the Night meets Take Back Birth

How can we begin to address what contributes to birth trauma without talking about what it means to be a ‘good’ woman, which often means serving the needs of others, contorting oneself into whatever others’ need in order to feel loved, valued, appreciated and ultimately, safe.

Many of the women we’ve worked with, who seek counseling for birth trauma, describe situations within which they felt they could not have said “no” without risking judgment, harm or shaming by family members and/or their ‘care’ providers.

The desire to avoid these feelings is often misunderstood by women (and society at large) as their own personal failure to prioritize self-preservation over the feelings of others.

Sound familiar?!

“Why didn’t they/I just say “no”?

Well that’s a loaded question, isn’t it?

Rather than blaming the victim or oneself for not speaking out on her/your own behalf, we must question how it has come to be that women find themselves in positions where it feels safer in the moment to ‘consent’ to practices they don’t want rather than risk being constructed as ‘disruptive’, ‘high maintenance’, ‘one of those women’ ‘crazy’ ‘needy’ etc.

I believe that addressing/reducing birth trauma is fundamentally about supporting women’s agency prior to pregnancy, questioning how it is women are groomed to become self-sacrificing, ensuring women are provided with care that maintains their sense of safety and well-being regardless of what (un)expectedly arises, respecting body integrity, and listening and responding appropriately when, regardless of outcome, the birth was not entirely or at all positive.

This, in addition to recognizing that many women will ultimately feel compelled/coerced into making ‘choices’ in the transition to mothering based on how they feel others will feel about them making particular choices or not, at a time when they are intensively vulnerable to and dependent upon, the emotional and physical care of others.

 

 

 

 

 

 

 

 

 

The transition(s) to fathering.

“I just want to be a good dad”.

We have heard this statement hundreds of times over the years working with men – men who have long been fathers, and men in the transition to becoming first time fathers. We have shared space with many  capable and caring men that are just not sure what to expect in becoming a dad, who may be feeling uncertain, conflicted, and/or ambivalent, amidst a myriad of other feelings, including joy and excitement.225490_5583575534_7758_n[1]

Pregnancy, labor, and the postpartum period impact men in a variety of ways. Men have shared with us their thoughts and feelings of experiencing intense love, shame, fear, sadness, frustration, confusion, inadequacy and anxiety about being ‘good enough’ as a dad and partner.

Sometimes this has to do with their own experience of being parented, and the relationships they did or did not not have with their own father(s)/father figures.

Often times, men move through these feelings alone … not sure who to confide in, or who would understand. Moreover, many men have experienced previous trauma themselves, often compounding feelings of uncertainty about the upcoming birth or parenting of their child(ren), and their capacity to be a safe and nurturing presence in their children’s lives.

Some men are silently coping with fears about how their partners are managing – themselves secretly worried about whether or not what they (or their partner) is feeling is ‘normal’.

If you have questions, or are concerned about what you’re feeling/thinking, please do not go through the transition to fathering alone.  We are pleased to offer counselling service to men who could benefit from exploring past or current concerns that may be impacting them in day to day life, as they look to becoming new fathers, and/or would like to be more equipped partners to an expectant or new mom.

Confidentiality is always paramount.

‘Good Enough Mother’ (G.E.M) – Part 2

"I'm not a bad girl! You're a bad mommy!"I’ve been meaning to write this post for a while – since November. This post is inspired by the conversations I had both online and in person with participants who attended one of my presentations at the Birth and Beyond Conference 2013. For those who did not attend, the presentation was entitled, “Good Enough Mother”.  I can honestly say I was not expecting more than 3 people to attend this talk, including the moderator for the session. Needless to say I was quite panicked when I learned less than a week before the presentation over 45 people were registered to attend.

Some background

I worked as a doula for close to 20 years, and for the longest time I worked with clients who had the resources to pay me a fair wage for my services. I watched as women and their families consumed all that was purported to bring about a desirable (= ‘natural’) birth. I worked alongside women developing birth plans, exploring options, discussing the most notable childbirth preparation classes, and offering referrals to my most cherished midwives.

My work in the birth community was fueled by a deep passion and commitment to women’s reproductive justice. Alongside my birth work, I was employed as a counselor working with women and children living within, or fleeing from abuse.  My doula work was profoundly shaped by the lessons I learned from the women who shared their stories of survival with me.

In 2007 I entered grad school and brought with me the rich experiences I had while working in the community. During my time in school I had the opportunity to be part of a team conducting research with pregnant women transitioning to mothering in the context of historical trauma (childhood sexual abuse, Aboriginal women and refugee women). Their narratives revealed a powerful desire to create idealized families, which were based upon social, cultural and political discourses of what it meant to be a ‘good mother’.  However, their lived realities precluded many of the participants from possessing the privileges that would allow such possibilities – privileges such as access to timely, adequate, and effective social and health services.  The resulting feelings of shame, inadequacy, & self-doubt haunted women throughout postpartum and beyond.

The “Good Enough Mother” presentation

What began as my own ruminations about the seemingly endless performance demands placed on women to conform to cultural norms of the “good mother”, morphed into a presentation on challenging the ways we in the birth community participate in, if not contribute to, notions of what it means to be a “good mother”. The conversations were passionate.Passionate

At the outset of the presentation, I asked participants to:

  • Reflect on your own practice – ask yourself what role you are potentially playing in perpetuating a divide between ‘good’ mothering & ‘bad’ mothering
  • Question how well intended messages can wound

Social, cultural and political discourses have traditionally problematized women who have been unable to ‘successfully’ transition to the role of mothering.  Such discourses have left little room for women to story their own experiences of pregnancy & the postpartum period, without fear of social isolation, criminalization or the pathologizing of their responses.

I asked: What are we doing when we speak birth?

  • Dominant strands of discourse circumscribe/prescribe our journeys into motherhood
  • Discourses provide the space for some stories and experiences to be legitimate, others therefore become ‘illegitimate’

Who are represented as illegitimate mothers?

  • Mothers who use substances
  • Mothers who are subjected to violence
  • Mothers who are homeless
  • Mothers who are incarcerated
  • Mothers impacted by poverty
  • Mothers who are ‘under’-educated
  • Mothers who engage in sex work
  • All of us ‘other’ mothers

Over the years I have come to question how the language we use, and expectations we (unknowingly & unintentionally) place on pregnant women who seek our care, may contribute to the very problem so many of us began this journey to stop – the narrowing & prescriptive manner within which birth was/is being constructed.

Are ‘we’ really a movement offering an alternative to the biomedical model? Or are we (re)creating a polarized environment wherein only one kind of birth is the ‘right’ kind of birth?

Talking birth

As a doula and childbirth educator, I often used words & phrases such as: “trust  your body”, “surrender to the process”, and “reclaim you power”.

In the “Good Enough Mother” workshop, I invited participants to consider this language and the messages they send, through a critical lens.

Here were some workshop participants’ responses*:

Coming out of this session I felt frustrated. It was as if a huge issue had been dumped on my lap and no solutions offered. It was challenging, but good, to be made aware of how our language can induce shame in others …

It was provocative, but I felt it was missing the point in terms of how messages can be interpreted. Perception is everything and I feel that if a woman is coming from a negative place, no matter how we relay a specific thing, it will come across as negative to her.

But …  my message, maybe even the most important part, was as ‘care providers’ we needed to think about the broader context of women’s lives. We needed to think about how our practices (including how we ‘talked birth’) may be unintentionally shifting blame onto women for ‘failing’ – failing at pregnancy, birth, postpartum = mothering. This is not about our individual practices as much as it is about how those seemingly innocent aspects of our practices come together collectively to marginalize and shame women; particularly women whose lives are lived at the intersection of a constellation of vulnerabilities.

Without questioning what role our language may play in setting women up, we unintentionally participate in the framing of some choices as “more informed”, “correct”,  and “educated” than others, and this may be hurting the very women we are working so hard to serve. A workshop participate reflected on the message of the workshop:

I went to ‘Good Enough Mother’ looking for answers, and instead I got way more ( I mean waaay more) questions!! Answers aren’t easy, and I realized how important it is to question the messages I am sending to women.

I am hoping to encourage our birth communities to think more deeply about the messages we are sending – specifically to the women in our practices, but also to women more generally.

Can we create spaces to hear these stories?

I attended Jodi’s session and found it refreshing. I, myself have been birth shamed by both the medical and “natural” community simultaneously. I was blamed by the medical community for having a midwife and rejected by the “natural” community because my birth was so medical and controversial. It isolated me. It shamed me. I was relieved to be part of a conversation about us that have been treated like we weren’t “good enough.”

Another participant shared:

As a doula, I felt somewhat like an imposter for not having the intervention-free birth that I had envisioned. I would share my birth story with other moms and doulas, but I felt the need to justify all of my actions and to explain all the medical reasons that led to an induction so that I wouldn’t be judged.

(To read further – My Birth Shame: A Doula’s Confession)

Surely the intention of our work is not to leave women feeling isolated, ashamed and compelled to justify their choices. After years of  hearing such stories, of supporting women ashamed that they didn’t ‘do birth good enough’ …I am left wondering if there is a relationship between rising rates of birth related trauma and our collective culture of birth shaming?   Advancing a specific ideal of  the ‘right way’ to be pregnant, birth & transition to mothering necessarily means that many women will fail to ‘accomplish’ it. Let’s continue to work for the widening of possibilities of women …

A maternal community is essential for the empowerment of mothers.

–  Sara Ruddick, Maternal Thinking: Towards a Politics of Peace

We must move beyond a transition to mothering as a form of “moralism.” 

 

* quotes used with permission
** top image is not my own

Are you a ‘good’ mother?

Are you a ‘good’ mother? Notions of what it means to be a ‘good’ mother are deeply rooted in often contradictory, historical, political, social & economic discourses. Dominating the parenting section in bookstores are books advising women about what they need to do in order to achieve success as pregnant women, as laboring women, and as postpartum mothers, often in “ten easy steps”. There is an over-abundance of parenting and mothering magazines, which have proliferated exponentially over the past two decades, in fact, ‘good’ mothering has become consumed by consuming – the right products, the right food, the right sling, etc.

Clearly, there is no shortage of advice for women who embark on this significant transition. At the foundation of this literature are narrow and prescriptive assumptions about ‘the good mother’ – who she is, what she looks like, and how she must behave in order to ‘achieve’ the label of a ‘good mother’.

Furthermore, the divisive ‘camps’ within the birthing movement have contributed to the narrowing of possibilities for women.

Come join me at the Birth and Beyond Conference where we will continue the dialogue about what it means to be a ‘ good’ mother. In this workshop, participants will be encouraged to critically reflect on how dominant messages of mothering restrict possibilities for women/mothers, silences their voices, and makes marginal, stories of mothering that diverge from the normative representation of mothering. Participants will be invited to consider how their own biases and politics regarding pregnancy, birth and mothering contribute to the very discourses that potentially (however unintentionally), harm women’s transitions to mothering. I argue that we need to widen our understandings about mothering by supporting a shift from (the unattainable) ‘good’ mothering as it currently conceptualized, toward the concept of ‘good enough’ mothering (g.e.m).

This important conversation builds on emerging data from our CIHR funded research study entitled, “Embodied Trauma: The Influence of Past Trauma on Women During the Transition to Motherhood”, Principle Investigators Dr. Helene Berman & Dr. Robin Mason.

Social media & rape culture

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I am an abuse ‘survivor’.

This isn’t something I have shared in an online space before, but since the Steubenville rape, reporting & verdict and now Rehtaeh Parsons, I have felt compelled to speak from my own experience.

For those of us who have experienced being violated, there is no end to the ways in which one blames oneself … you analyze the incident(s) down to the tinniest little detail, wondering if/where you could have made different choices. Thanks to the f*cked up news coverage, the victim in the Steubenville rape case will have a detailed digital record of all the ways in which she was to blame for her own rape. Rehtaeh Parsons is the latest victim of the rampant cult of apathy toward men’s violence against women, which includes the RCMP’s unwillingness to continue investigating the circumstances that lead to Rehtaeh’s suicide.  As her father blogged:

Rehtaeh Parsons thought the worst outcome for her case would be no charges against the men who raped her but we all know better. The worst thing that could happen would be charges. That they would be found guilty, and that Rehtaeh would sit on a court bench and listen in utter disbelief as they were given parole, or a suspended sentence, or community service. All for completely destroying her life while they laughed.

These horrendous rapes have brought back nightmares.

My abuse occurred before smart phones and social media.

I remember my abuser wanting to ‘record me’ so that he could share with his friends … I am only grateful that he didn’t have access to a smart phone, or own any kind of recording device (without careful planning) that would have made his fantasies a reality … that I don’t have to live with the sickening knowledge that my violation(s) – my abuse was available for public consumption & judgment. That I wouldn’t ever come to see this abuse (re)presented online, and subjected to public commentary.

Thanks to the news coverage & some people’s ignorant responses, I am left wondering would I have been a sympathetic enough victim? What would I have been wearing? Would I have appeared to be enjoying ‘it’?  Would I have been drunk? Apparently, rape isn’t a serious offense if your not a virgin, you wear tight clothes and/or are drinking. Ya, same old, same old … but with the presence of an international audience.

How does social media participate in the reification of a culture of rape?

Like the argument – guns don’t kill people, people kill people … (but ACCESS sure plays a/the significant role!), smart phones don’t rape people, “people rape people”; however, access to an instant virtual audience has added another level of perpetrating that is unique.

Smart phones and the capacity to record and instantly upload has fooled many into thinking they are movie directors, entitled to record & distribute the images of others. By-standers are too busy trying to capture the next video that may go ‘viral’ than be an ally to those in desperate need …

Social media invites every person with access to the Internet into the ‘jury’ box.

And yet, social media may be the very vehicle we will utilize to (re)create the culture(s) that will demand an end to the culture(s) of compliance that (re)produce ever evolving possibilities for perpetrators of violence.

…  how many victims would wish for video evidence of the horrors committed against them because they ‘testimony’ alone wasn’t enough?

… and yet how many victims are profoundly impacted by the distribution of their abuse?

Today I am deeply sad and angry.

Tomorrow I will once again turn that anger into something productive.

What will you do?

 

 

 

 

(Re)launch of A Safe Passage

Welcome to the re-launch of A Safe Passage – a web site dedicated solely to supporting survivors of abuse through the transition to parenting, family and friends looking to support a loved one through the transition, and professionals working with survivors. There are some exciting new changes to the site I’d like to share with you.

But first some background.

I have been a doula since 1996, and a counsellor working with women survivors of abuse since 2002. Early on in my doula career, I had the opportunity to attend a workshop with Penny Simkin, entitled “When Survivors Give Birth”. This workshop planted the seed that gave life to A Safe Passage. It was during that workshop that I learned how childhood sexual abuse later shaped women’s experiences of pregnancy, labour and birth, and the postpartum period.

However, what my career as a counsellor working with woman abuse survivors was teaching me, was that pregnant women were not only grappling with the lingering impacts of childhood sexual abuse, but many pregnant women were also subjected to interpersonal violence within their present relationships. And yet, the birthing communities and the communities who worked with women survivors of abuse did not appear to sit around the same ‘table’.

This meant that pregnant women were falling through the gaps when seeking information from either the counselling community (who were not generally equipped to discuss with women the unique transition to mothering and the triggers associated with this transition) or the birthing community (who were not generally equipped to discuss issues of abuse, trauma, and safety with their clients).

Speaking at Take Back the Night – Birth violence and violence against women.

There needed to be a space where professionals from all communities working with pregnant and/or parenting women and their families could ‘gather’ – virtually or otherwise.

Thus, A Safe Passage was born.

Since its formal inception in 2006, A Safe Passage has existed as a virtual space to serve the diversified needs of survivors of abuse, their families and care providers.  By offering validation to survivors of abuse, a recognition of their sources of resiliency and mechanisms of coping, normalizing the range of thoughts, feelings, and behaviours associated with the transition to parenting in the context of abuse, and offering information on resources, survivors of abuse have felt less alone in their transition to parenting.

And indeed, they are not alone:

“According to the Centers for Disease Control, every year in the United States more than 300,000 pregnant women experience some kind of violence involving an intimate partner, and about one-quarter of women country report having been sexually or physically assaulted by a spouse, partner, or boyfriend at some point in their life. Domestic violence is a leading cause of injury to American women between the ages of 15 and 44 and is estimated to be responsible for 20 to 25 percent of hospital emergency room visits by women.”

People have reached out to me via email and telephone from as far away as Japan, and as close as the neighbour up the street, wanting to learn more about the possible impacts of abuse on the transition to parenting – for either themselves, a loved one or a client.

No call is left unanswered – something quite remarkable considering that A Safe Passage does not receive an ounce of external funding. That brings me to the workshops offered by A Safe Passage, which is the only source of funding we receive.

Workshop for midwives in Pretoria, South Africa

A Safe Passage workshops have been offered around the world: from South Africa to Winnipeg, New Brunswick to Seattle. Hundreds of health and social service professionals have dedicated their time and resources toward learning how to better support survivors of abuse through the transition to parenting, and to take care of themselves throughout the process.

Massage therapists, correctional volunteers, family physicians, doulas, midwives, child protection workers, outreach workers, psychiatrists, registered nurses, hospital administrators, nutritionists, academics, psychologists, social workers, to name just a handful of professions that have been represented at workshops.

Creating circles of support exercise

The workshops provide a space for individuals with diversified lived and professional experiences to share, network and bridge connections that in daily practice are difficult to achieve. Fostering interprofessional education (IPE) opportunities and alliances has been a very rewarding part of the A Safe Passage workshop experience.  I am looking forward to Birth and Beyond 2013, which will be held right here in London, Ontario where I will once again have the privilege of presenting alongsideWorld-renowned birth professionals.

A Safe passage workshops have been delivered in living rooms with 8 participants and conference centres with 300 participants, in 2-hour presentation formats (e.g. body mapping for birth professionals, and 2.5 full day workshops; however, the message is always the same:

Supporting survivors of abuse through the transition to parenting requires deep introspection into how our own bias, judgement and fears impact how we provide care (or not) to survivors, and thus requires a deep commitment toward changing how one practices to account for the emotional, physical, spiritual and mental well-being of our clients.

Yes – it begins with the person/professional who holds the position of relative power in the relationship to create safe(r) spaces for survivors of abuse.

Sliding scale registration and workshop bursaries have served to allow participants from all walks of life to share their lived experiences, learn and share with fellow participants.

And the ‘new’ aspect of A Safe Passage?

Well, in addition to a new look and blog, the site will soon be expanded to include information for male/transgendered survivors of abuse transitioning to parenthood. Over the years, I have seen first hand the impact trauma histories can have on men (re)becoming fathers, and until now the resources available on A Safe Passage have not reflected this awareness. It’s time for that to change.

I have also created a LinkedIn account to link individuals and agencies that are working in the area of trauma and/or parenting. Sharing resources and expertise is an essential aspect of the work of A Safe Passage. You can also join the conversation on Twitter @ASPassage, on our facebook page A Safe Passage, and let’s build a community for professionals on Linkedin:  A Safe Passage: Supporting Survivors of Abuse through the Transition to Parenting

If you have any suggestions, resources, or information about upcoming workshop opportunities, please send me a message info@asafepassage.info

Embracing possibilities for survivors of trauma,

Jodi