My special Mother's Day

On Mother's Day this year, I attended a speech given by Ina May Gaskin at Town Hall in Seattle. There were over 800 people of them, many midwives and doulas but a surprising number of expectant parents. She spoke on her story as a self-taught midwife in the 1970s, described some of the keys to a healthy safe delivery and how important it is for those who care about birth to advocate for increased access to midwives and better obstetric practice.

At the end, it was opened up to the audience to ask questions. During that it became clear to me that Ina May is not familiar with Solace for Mothers as a resource for women who have had traumatic birth experiences. I should have gotten up and mentioned it but I didn't want to sound like an advertisement. Sometimes I just don't know how to deal with public relations!

One of the things that Ina May said she wished for was to have all of the birth advocates be better connected and able to work together. I share that desire with her and really hope that my current efforts will be able to bring that to pass. I really feel that we need an online social network that gathers birth advocates together in the same place and use platforms like the Care2 petition site, facebook, online forums, Change.org and Salsa Democracy to use viral advocacy techniques to bring a strong, united voice to what would truly improve maternity services in the United States and the world. I guess that's my job isn't? Since I am on the CIMS Grassroots Advocates Committee... Big plans, in progress... I just wish it was all ready and that it was common knowledge in the birth community!

I wish that I had had the opportunity to sit down and talk with Ina May but if that had been doing to happen, I should have attend the MAWS conference the Friday before. When prioritizing my desire to see her in person, I had to decide between being away from my kids all day Friday and leave them with a babysitter or be away for 2 hours on Mother's day Sunday and leave them with their dad. It was a tough decision but I chose to have more time with the children and be away from them on a day that's supposed to be especially for me as a mother anyway.

Someday I hope that I can meet and talk with her because I have so much respect for her work, especially on the Maternal Mortality Quilt. I would love to see a complimentary effort to honor and remember mothers who have experienced trauma and PTSD from their birth experiences. For each mother who died in childbirth, I am sensitive to the fact that if they lived, they likely would have been deeply traumatized by their experiences and their memories of being close to death. People traumatized by life events and who live afterwards know the special hell that comes from surviving something horrific and terrifying. I want those mothers to be remembered to. For women who experience trauma, they often find that they become shadows of themselves. They are the walking wounded and we need to be just as aware of them as we are aware of the family members who lost a woman in childbirth. I don't want what that would look like, whether it would be a Solace (thinking Support in Overcoming Labor And Childbearing experiences) quilt or a paper sculpture in the shape of a tree with leaves symbolizing one of the 1.4 million mothers who are traumatized each year. I had a nice talk with Penny Simkin about this and she is encouraging me to come up with something good and a plan to enact it. If you have ideas, please help!

Anyway back to the event with Ina May. After the questions and answers, there was a Birth Fair with birth and baby organizations and services from around the Seattle area. I met the midwives at Puget Sound Birth Center. When I told Val that PSBC is the most highly and frequently rated out of hospital birth center on The Birth Survey, she literally started crying she was so happy!

I was so glad that I was able to attend with my mother and my good friend Shawnette who became a doula after she attended Willem's birth as a volunteer doula. It was a really nice event and obviously, as seen by this post, inspired a lot of ideas and renewed energy and drive for me. It was definitely a special way to spend Mother's Day and a special thanks to my husband and children who were willing to facilitate my attendance.

Birth Trauma Round Up

I've been meaning to get around to this for awhile. Each day when I read news articles and blogs, I'll bookmark it if its something I want to come back to or if I have something to say about it, or agree its important and needs to be said again and again until the right people listen. Generally, the articles that stand out to me are on the topic of birth trauma. So here is an anthology of birth trauma related articles over the past few months. On analogies: Keyboard Revolutionary: An Interesting Parallel

So what does it mean when another wielder of authority says, "Do what I say or your baby will die"? Are they looking out for your best interest....or are they a bully, a rapist, an abuser, deliberately playing on your unignorable instinct to protect the ones you love in order to get what they want from you?

And when its seen like this, how obvious is it that a mother can come away from her birth experience with PTSD?

Raising My Boychick: Just Like Athletics: Exploring a Childbirth Analogy

Rather than coerce with stick or carrot, what we do in athletics (again, thinking especially of charity racing; a particularly apt comparison to birth as it is physical effort that benefits another) is cheer, support, encourage, commiserate. No one stands at the sidelines of a charity marathon yelling “give up! it’s not worth it! stop trying to be a martyr! you’re not going to win a medal!” Nobody whispers in their ear when they’re doubting, “take these drugs [that will actually make running harder], let us drive you to the finish [we'll tie you behind the car], finish in five minutes or we’ll whisk you away for surgery [for a torn ligament you don't actually have].” No one tells an athlete she can only have a “trial” of running if she has no food or drink, if she’s hooked up to machines that purport to measure how hard her muscles are working, that take her blood pressure and heart rate and temperature and send it all to the medics’ station and meanwhile are hindering her movement and reminding her she’s on a clock and she’s not running fast enough (or running too fast and they’ll “have to” stop her “for her own good”.

The analogy works well. What would happen if hospital birth attendants had this analogy called to their attention? It seems so simple, yet a strong paradigm shift is engendered in it.

On feminist activism:

Courtroom Mama: Feminism Behind the Veil

[How many women] suddenly realized that grown-ass people in a medical office were calling them “mommy” and telling them what to do as though they themselves were children. And the fact is, for a number of women of relative privilege (cis-gendered, heterosexual, middle-class, etc.), the journey into motherhood might very well be the first point of friction with patriarchy. Many of us lucky enough to not feel the weight of oppression can manage to skate by with just our carryon baggage, but add a pregnancy or a child to the mix, and suddenly you’re “actually” a woman, or rather “just” a woman.

Fertile Feminism: Mainstream Feminism and Motherhood

That’s why I’m so pleased to have discovered all the feminist mother blogs that have been springing up recently, and why I want to work with feminist mothers to help bring your voices and battles and mainstream feminism together. It’s been all too easy for childless feminists to ignore motherhood, and it really, really shouldn’t be. We need to listen, learn and become allies to mothers by not only centring your voices but using our own to advocate for mothers everywhere.

The previous two articles both discuss how stereotypical feminists (or rather the dominant cultural idea of feminism) doesn't understand the issues facing mothers in dealing with injustice in maternity care. It now appears that some "majority" feminists are becoming aware of what us feminists in the minority are facing. Like Courtroom Mama, my first run-in with patriarchy may very well have been in my first birth experience and it certainly played a large part in coming to self-identify as feminist. I too felt, before birth trauma, that feminist history afforded me a "post-feminist" spot in my world.

On cruelty:

Henci Goer: Still Cruel Maternity Wards

We have a culture of impunity in maternity wards. Once pregnant, a woman effectively cedes her right to autonomy and bodily integrity to obstetric staff who sometimes—on grounds of fetal welfare, self-protection from malpractice suits, or mere convenience—manipulate women into compliance in ways that would be considered fraud in any other venue. Without fear of being called to account for it, they can bully, coerce, humiliate, and threaten. And, yes, they can physically mistreat or even sexually assault them

It is this that needs to be exposed. In her article, Henci links to recent news stories that highlight some of these abuses. Its starting to be uncovered but it still seems to far-fetched so far from the norm, but then what is normal seems irrelevant because of its normalcy. It seems the media has not just captured the sameness of these outrageous cases with the outrageousness of the "normal" cases. The whole history of hospital birthing has been this way and its just sick.

The Unnecesarean: Women Have Right to Complain about Mistreatment During Birth

I really believe that someday, our daughters or granddaughters will be amazed that any woman was ever arrested for refusing a c/section, or operated on against her will, or prevented from moving or eating or making noise while she labored to birth her baby. They’ll regard much of what is still considered normal today as cruel, and uninformed, and backwards. And they’ll be right. But only if we keep refusing to be silenced.

It exactly this that I could not and would not believe before I contemplated becoming mother. It seemed so blatantly wrong that it seemed impossible that it could be indicative of systematic injustice. It really did feel like just being pregnant and giving birth that I was going into a dark and dirty underground system. ACOG has been labeled a cartel and for good reason.

Amy Romano @ Science and Sensibility: Patient safety, disciplinary action, and the marginalization of midwives

But whether disciplinary action is against midwives or physicians, is punishment the best way to deal with breaches in patient safety?

When this question is posed to someone who has experienced birth rape, the answer is: They have to held accountable somehow. If its not through a hefty check from their administrators, then it needs to be some censuring from their superiors. If not that, then it needs to be criminal charges. When a woman is feeling like her OB or midwife is entering her body with the same force and skillful manipulation of a rapist, yes, the provider must be held accountable. RH REality Check: The Cure for An Ailing Maternity Care System

The idea that maternity care should be evidence-based, safe, and efficient seems like a no-brainer but one key goal to note is how these imperatives lay the groundwork to minimize “overuse, underuse, and misuse of care practices and services.” We need to make sure we’re providing optimal care to all women by guaranteeing women are able to access the services they need if they need them. However (this is a big one), let’s also start from a place of understanding that pregnancy is a healthy state of being – not an inherently sick state – and so let’s also minimize the amount of unnecessary interventions that now drive up costs and place women and newborns at risk for poorer health outcomes.

It must be said: the "overuse, underuse and misuse of care practices and services" are causing trauma to new mothers, rendering it exponentially more difficult to care for their babies in their early years. Its not yet known what sort of long term effects can be had from a traumatized mother in early life, but there are studies that show that children of depressed mothers are more likely to experience depression, children whose parents experienced PTSD are more likely to experience PTSD after a potentially traumatic event. Are our children being hardwired to face life's challenges with disorder? Its not just about health care costs, its about a mother's sense of confidence in her ability to care for her children. Its about the baby's sense of being cared for and loved. Michel Odent equates these early unnecessary challenges to a threat to humankind. He even poses the question "Can humanity survive?"

Its starting to sound pretty melodramatic and that's exactly what I would have labelled it before my experience, and before I learned that I was not alone. I find its a coping mechanism to write in this manner and that I cannot be objective and unemotional when I read the stories of birth trauma at Solace for Mothers and the MDC birth trauma board. Some of it seems so fundamentally, viscerally wrong that I struggle to articulate how and why it is so wrong. So instead, I try, though my blog to illustrate, highlight and show case examples so it can become clear to others without my feeble attempts to spell it out.

Bound and Gagged

In a dark room with no windows,
a drug coursing through my veins
that left me bound and gagged.

I lost my mind and coudln't move.
I was no longer myself.
I was lower than dirt.
A wounded animal to be put to sleep.
I heard whispers of "just put her out of her misery."
"Get that thing out of my sight. I can't deal with her now."

Locked in a room.
I heard my screams in my head, but I couldn't get them out.
A terrible nightmare but with the crashing, debiltating knowledge that this was reality.

Powerless to stop the penetration.
Unable to resist orders.
Catatonic and numb.
Unable to move.
No where to run since my legs were tethered to their place.

The torture ensued.
My body defiled, and abused.

I lost all power.
All determination and will.
If coherent speech had been an option,
the thoughts were drowned out by the screams of my mind.

Then it was all over,
the drugs had worn off.
The figurative bounds released.
And I was torn and broken, discarded and pushed aside.

Down the hall, I hear a distant
"Next!"

ANNOUNCING: Solace for Mothers Online Community

Since Willem's birth, I have been looking for ways to prevent and help other mamas who have been traumatized by their birthing experiences. I am pleased to say that I've been able to partner with Jennifer Zimmerman, a mother who experienced a traumatic birth 3 years ago, and Sharon Storton the excutive director of Solace for Mothers to create an online community for women suffering the effects of traumatic birth.

Here is the official announcement:

This message is to announce a new online discussion board called Solace For Mothers, An Online Community For Healing Birth Trauma. It is for women who have experienced trauma around the process of giving birth. For these women, giving birth has left them feeling deeply disappointed, traumatized, or even violated. We want these women to know that they are not alone, that birth trauma is very real, and that other women have had similar experiences and feelings. We have created an online community as a place for women to begin or continue their healing journey.

In the online community, there are different categories and forums, and the topics covered are issues that often come up for women dealing with birth trauma. It is our hope that women can virtually support each other on their healing journeys in this online community, and perhaps eventually connect with each other in the real world if they choose.

There is an introduction page here; http://www.solaceformothers.org/forum.html, and from this page you can register for the discussion board. Due to the very personal nature of this subject, we have made an effort to keep this community private, and women must register before being able to enter or view posts. If you do not fall into the category of a woman suffering from birth trauma, or if you would like to see a preview of the community before joining, you may visit this link to do so; http://www.solaceformothers.org/preview.html. This link is not the actual community and you will not be able to view members' posts from there, it will simply give you an overview of the topics covered.

We are sending this message out via email and posting it to online communities and to lists in order to reach these women. Please send this message to anyone who you feel may benefit from it.

Sincerely,
Jenne Alderks and Jennifer Zimmerman
Creators and Moderators of the discussion board

Supported by Sharon Storton and the Solace For Mothers team

The Accomplice to My Shame

I realize now.
I live in a climate of willfull ignorance, refusing to be aware.
Instead, hiding behind my excuses.
"I didn't know."
"I was just doing what I was told."
But now I know.
I will not do what I'm told.
Because what I was told is not right.
The abuses against the vulnerable,
the women heavy with new life,
ought to be called crimes against humanity.
But now I know,
I'm not the victim.
I am an accomplice.
With that knowledge, a bitter, revolted wave washes over me.
I cannot have peace knowing this is what I did to myself.
My own refusal to be more aware, to find what I needed to know--
Its out there, because I've found it now--
has made me the unknowing partner in the abuse
that left me damaged and weak.
After the hurt, I had a choice.
I could have desired to not know.
Never to acknowledge my part in it.
I could have blamed everyone else besides me and say,
"I was victim to my circumstance. They were wrong and I couldn't have known."
And then become a self-indulgent coward.
Participating in the type of cowardice that makes it possible for people to allow and participate in all the injustices and crimes of the world.
Perpetuating abuse by turning a blind eye.
But I learned.
Choosing to be unaware of another's suffering,
even my own, is no excuse for inaction.
I cannot chose willful ignores that exonerates me from culpability,
releasing me into a stupor of cowardice and irresponsibility.
I am facing the part of my blame.
Taking responsibility for my ignorance and inaction.
With this insight, I can choose to not be a victim again.
I will not let that abuse happen to me
And will work so that it does not happen to others.
I am aware. Now I know.
I will no longer be an accomplice to my shame.

This is another poem inspired by the text of the Gospel of Mary Magdalene and the commentary of it written by Jean-Yves LeLoup. The text of the gospel is as follows:

Then it entered into the third climate
known as Ignorance.
Ingornance inquired of the soul:
'Where are you going?
You are dominated by wicked inclinations.
Indeed, you lack discrimination, and you are enslaved.'

I feel that consquence of PTSD after childbirth, was in large part caused by my wicked inclination to avoid responsibility for the birth my child and hand it over to those who would take the responsibility upon themselves who for fear of culpability and litigation would act conservatively and agressively when treating my pregnancy and child. I did not have or did not seek out the discrimination (another word being discernment)to learn what my responsibility and role in birthing my child would be. I had false assumptions of my responsibility, my provider's responsibility and the roles we could play respectively. Because I did not take the time to make myself aware of the realities of birthing in a hospital environment, I became enslaved to their policies, their time schedule, their need to clear beds out quickly. And because of my ignorance, which is some ways could be labeled willful, I became one of the causes to my hurt. In the end, I was an accomplise because I did not seek out the information to make more appropriate decisions.

After my child's birth, I turned to research and publications about appropriate labor support and found that the information was out there that would have told me to avoid the controlling, rigid hospital environment for the birth of my child. I found that information after the fact and realized I hadn't educated myself and take the responsibility I needed to in order to prevent the abuse that was perpetuated against me. Of course, I know better now, so I can make different choices in subsequent pregnancies. I also have a level of empathy for other women who may have experienced similar feelings of rape, and control over their bodies in a sensitive and vulnerable time.

The experience also gave me an understanding of the power of God to create and bring forth life, the love he has for his children, and the awesomeness of life and existence. I have increased faith in God's processes of how babies are born, and the inate ability of the women of God to birth babies in love, gentleness and joy, all the while, experience the stuggle and labor of childbirth. The act of birthing a child is so very awe inspiring with the contradiction of love and joy in the midst of pain, and struggle. It is a real world example of the principle of the gospel states that we must know pain and suffering to understand happiness and joy, or else remain in total innocence knowing neither.

My experiences of PTSD after childbirth

Some of my friends may have noticed that I have not been myself in the last few weeks. There are a lot of reasons for this, some of which I understand and I'm sure some I don't. Since Willem was born, I have been plagued with memories from his birth. I have experienced flashbacks where memories loop over and over again and I cannot stop them. I experience flashes of anger as I recall the way I was treated by the hospital staff. I can recount the ways in which I felt violated, belittled, and ignored. These feelings are strongest when I'm trying to fall asleep at night so I have spent many times (such as this one) awake, struggling to fall asleep but I can't because I cannot get these thoughts out of my head.

For many months, I couldn't talk about my experiences or even birth in general without a flood of memory. My husband and I would spend hours whenever the topic came up (which was frequently) going over the time when I was laboring to give birth to our son. A couple of times, my sleepless nights resulted in my husband being awoken by my crying and then together we would talk through the whole experience again.

I was sad and hurt because of the treatment I received but afraid that other women everyday since then, maybe even as I'm writing this, are experiencing the same type of degradation and disrespect. I don't want that to happen to another woman and so I know that some action is needed to prevent it.

I began considering becoming a midwife so I could ensure that I never was as insensitive to a laboring woman's needs as the midwives who were responsible for my prenatal care, labor and delivery. I realized that they weren't responsible for my care and my ability to give birth. They were supposedly assisting me in my responsibility as a woman, and a new mother. I wanted to be sure that I was also a help and a support, not an authoritarian, imposing figure of punishment and manipulation. I quickly realized that I am not prepared or willing for a complete career and educational change as going into the medical field from child development. But I realized that the role of a doula or labor assistant would be a complimentary type of family and parenting education to the type of educator that I am already trained to be. I started looking into the educational requirements that a doula needs to be certified and found that a strong understand of the physiological process of birthing as well as the ability to comfort and support a laboring woman in the way she feels she needs to be comforted is necessary. So I started researching and learning about the process of birth, how it is best accomplished without medical interventions and "aggressive management."

In this period of learning and thinking of changing direction in my education, I began to be more verbal about my experience which I realized could be considered traumatic since I was still dealing with negative emotional effects from it. I joined some online groups for women who dealt with traumatic birth experiences and found that I was not alone. I knew I was not depressed because I only became angry or hurt when recalling those events, and did not feel down at any other time. In my research and learning, I discovered that it is not uncommon for women who endured difficult birth experiences to display symptoms of Post Traumatic Stress Disorder. I read some the definitions and descriptions and found that I do display many of those symptoms. Since realizing that, it seems that a Pandora's Box of recollection and feeling has been opened. The thoughts and memories that once plagued me intermittently now wouldn't go away. They were always there, on the periphery of every thought and action of my day. I had a diagnosis, a reason, an explanation for why I was broken and dysfunctional.

I was able to give birth to my beautiful almost 7 pound baby without drugs and in a hostile environment where I had people telling me that I couldn't give birth without drugs, that I would need to be induced, that they—"the experts", the doctors, midwives and nurses—could take over and make my body do what it couldn't do on its own. But I believed that my body was capable of giving birth safely, naturally, without the "help" of interventions that could potentially harm me or my baby. And because I was able to be strong, to stand my ground and endure, I was treated that there was something wrong with me. That if I didn't receive their "help," my baby would be hurt, or killed or that I could die. And then I come away from that experience knowing that I can allow a baby to grow within my body and then pass through my body as he/she enters the world, feeling vindicated. I learned that it can be done, that it's not scary, or unbearable. But I was still scarred. By people who instead of helping me though a time of tremendous effort and concentration did everything in their power to make it harder for me, by insisting I remain in positions that are empirically shown to be ineffective and more difficult for a laboring woman, by pushing drugs and interventions that are shown to increase the occurrences of complications and needed interventions, when I could do it on my own. I needed people who would offer me confidence, strength, encouragement and measures to help me be more comfortable to make the process easier. Instead they made the whole experience harder and as I come to find out—traumatic.

And then there are other issues. Why am I having such a hard time putting this experience behind me when other women have experienced much worse? Giving birth to a child is always an emotional event and every woman I know has been able to put it behind her. No one that I know of has ever "suffered" long lasting emotional effects like I have. So what's wrong with me? This sense of inadequacy is probably why its taken so long for me to start talking about this with other women, especially other women who have given birth and are mothers.

Another thing that has kept me from talking about this experience (outside of the people who were there) is that it's been too painful for me to do so. I still have a hard time talking about it without breaking down, yelling, crying and having the bitter resurgence of anger rise up within me. I've even tried to refrain from talking about it with my husband and my friend who acted as my doula because I don't want to annoy or alienate them. I don't want to expose people whom I love and care for to a flood of negative emotion, anger and drama. I'm also especially cautious to share my feelings with friends who have not yet had children or encountered the mentality of doctors and hospital staff when it comes to pregnancy and birth. I don't want to scare them.

A couple of weeks ago, I was finally able to express to the hospital where Willem was born that their staff may have been responsible for the maltreatment of me as a patient. In telling my story to the nurse manager, I was very proud of myself that I was able to remain calm. Upon hearing my description of the events, she promised me that she would call a review board with all the midwives and supervisory OBs to review my case as it sounded to her like there was some breech of hospital policy and violations of my rights as a patient. I have been waiting to hear about the results of that meeting (it will be in the form of a letter that will tell me nothing, but I still want to know that it happened). In the last two weeks, my emotional distress has reached a new height causing me to act in ways that I wouldn't typically act.

I have become very vocal about distrust for doctors, especially OBs, midwives and nurses and the medical interventions they routinely offer to laboring women, as well as my disappointment in the number of women who trust their doctors without understanding the potential risks of those interventions. I had learned some about the side effects of interventions in childbirth and knew that I didn't want to expose myself or my baby to them. I also looked at childbirth in a spiritual way—women were created by a Divine Creator who made women's bodies to be capable of giving birth without medical interventions and put medical technology on the earth to help treat women and babies in case something went wrong. I believe in the power of women to carry, nourish and birth their babies and I was sad to hear of so many of my sisters who were so scared of the pain of childbirth and instead opted for an "easier" way. Even though that easier way often leads to complications that make the whole process more difficult and potentially damaging to mothers and babies. Some women I talked to experienced stalled labor, C-sections, seizures, long term pain and difficulties, had babies born who were not breathing or had to spend weeks in the NICU because of the "care" they received. I am worried about my friends and the countless other women who are not informed of the potential side effects of standard ..:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />OB care during childbirth. Since I had a difficult experience without any of that, I just don't want anyone to experience anything similar or worse to my experience.

I feel that I was spared from a set of problems that I would rather do without. Because of the curvature of my spine (scoliosis) I am pretty confident that an epidural would not have been able to be placed properly in my spine so the likelihood of nerve damage and the resulting complications were high for me. I consulted with my chiropractor on this and was validated in my concern. Her professional recommendation was that it was a good thing that I didn't get the epidural.

Who knows is this explanation is helpful in explaining my actions of the last few weeks. I am seeking help to deal with the PTSD. I start meeting with a psychologist on Wednesday and hopefully, I'll be able to let go of the anger and hurt and I feel. I want to be able turn that bad experience into something good and channel my energies into making birthing more comfortable and safer for other women. I also know that I can turn to my Savior to find comfort and peace, where he can help me let go of my grief because he has suffered it for me. Unfortunately, it's not as simple as it is to say it. There is a process that I need to work though and I am making progress and starting to be able to move forward.

Many of my current decisions are being based on that experience to make things better. The main reason why I am seeing a chiropractor is to reduce the curve of my spine so my next labor will not have as much back labor. My current focus in my scripture study is to understand more about the resources God intends to use for our health and well-being, part of that the use of drugs in childbirth. As I also talked about, I'm studying a new area for my education as I am working to become a doula. I'm also starting research on PTSD that occurs after a traumatic birth experience and how it can be prevented in the future. One of the big answers to that question is by having supportive, sensitive birth attendants (doulas in particular), which is a big reason why I'm heading in that direction.

I hope I have not offended anyone with my actions of the last few weeks. I am trying to make sense of a difficult period of my life and that is why I've written this explanation—to explain to my friends why I've said and done some of the things that I have. I hope you can understand.