Taking traumatic births seriously

I went to see a new doctor this past week.  I’ve been trying for five years, without much luck, to find a doctor who is a good fit for our family.  But we live in an underserved area, and unfortunately there just aren’t a lot of good choices–the doctors who are recommended most highly have full practices and won’t even take names for a waiting list.  So I had  high hopes when I went  into the new clinic on Tuesday, and I went in with a positive attitude:  this will be The One.

Unfortunately, I think I was wrong.  It was all going okay until she asked me if I had any concerns I wanted to address right away.  I said yes, there is one.  I decided a few months ago that it’s time for me to see some kind of counseling professional to go through the details of my second child’s birth, and process what it all has meant in the nearly four years since.  Although Annika’s birth was extremely traumatic, I made only one attempt to discuss it with a professional.  When she was a few weeks old, I went to see the nurse at the health unit who was responsible for counseling women with postpartum depression.  I don’t know if I was suffering from PPD per se, but I was definitely suffering emotionally, and she was free, so it seemed like a logical choice.  She was nice enough, but after I explained the situation (planned homebirth turned emergency c-section after 5 days of prodromal labour and all kinds of crazy things happening, etc.), she told me that I had to stop “wallowing” in self-pity, accept that I had a healthy baby and move on with my life.  Given the fact that I still hadn’t gotten up the nerve to remove the bandage covering my incision, and I still needed help getting in and out of bed because of the pain, I thought her remarks were insensitive and, at the very least, awfully premature.  Needless to say, I didn’t try to talk to anyone about it again for a long time.

But on Tuesday, I decided the time had come.  I’m working with pregnant and postpartum women now, and want to ensure that I don’t project my own issues on to them.  It’s a professional responsibility as well as a personal necessity.  It’s not easy to ask for help, especially with mental health issues, but I sucked it up, put on my big-girl panties, and decided to give it a go.  To be fair, I was nervous and probably didn’t explain very well, but I was assuming that a trained family doctor wouldn’t require a whole lot of detailed explanation, that she would have either seen this before or at least have some sense of how to handle it.  The conversation went as follows.

Me: “Um, well, I’m wondering if you can recommend a counselor or a therapist who I can talk to about my daughter’s birth?”

Doctor:  “Why, did something happen?”

Me:  “Well, it was really hard–I had planned a homebirth, but we ended up with an emergency c-section, and I was pretty depressed for a long time afterward.”

Doctor:  “Is your daughter okay?”

Me:  “Yes.  But–”

Doctor (interrupting):  “Well, then, why do you need to talk to someone?”

Me:  “Um, well, I want to figure it out…figure out why I’m still bothered by it.”

Doctor:  “But your daughter is fine.”

Me:  “Yes.”

Doctor (laughing):  “Maybe it’s like some kind of [laughter increasing] post-traumatic stress disorder?”

Me (feeling ridiculous):  “Well, I don’t know if I’d go that far…I don’t know what to call it, but it’s hard.”

Doctor (still laughing):  “I don’t know anyone who really does, uh, that, but I can ask around.”

Cue me feeling like a complete idiot, totally dismissed, and wishing I’d never brought it up.

Luckily, sufficient time has passed and I’ve been around the block enough times with doctors and therapists that I could handle this–I wasn’t destroyed by it, although it was humiliating.  And I could put it in context:  her reaction wasn’t about me, it was a reflection of a large, systemic problem–ongoing stigma and ignorance about mental health issues–and a smaller problem that is a subcategory of the first:  a tendency to dismiss women’s mental health concerns, particularly around pregnancy and birth.

So instead of being destroyed I got angry.  Not in the doctor’s office, of course; there, I was a good girl, laughing with her as though she were right, as though I was silly to have brought it up at all.  I played my part in the cultural script perfectly, even though it went against everything I believe in; it wasn’t like I decided consciously to play the part, it was the only choice I could make–the possibility of pressing my concerns, of insisting she take me seriously, evaporated the second she started laughing. 

What is it going to take to change this?  I was struck while Annika was a baby by how little support there was for me to access.  Once the 6-week postpartum visit came and went with my midwives, I was on my own, and there was really no one there–outside of family and friends–to provide any kind of meaningful or helpful assistance.  And while I put on a brave face and muddled through, I think women can expect more than that–I think women deserve more than that. 

If a woman is traumatized by the nature of her birth experience–for any reason, whether or not you believe her trauma is “justified”–she deserves care, and she deserves to be taken seriously.  She is not “wallowing” or making a big deal out of nothing.  Birth is a major life event, and for some women it is one that may require days, weeks, months or years to process.  Is it wrong to ask for healthcare professionals whose jobs include pre and postnatal care to assist with that?

The doctor I saw on Tuesday should not have laughed at me.  I wish I hadn’t laughed with her, because I don’t believe it’s a laughing matter.  Birth trauma is serious.  It can destroy a person’s quality of life and impair her ability to parent appropriately; it can hurt a whole family.  Women’s feelings matter; women’s experiences matter.  Birth matters.  Stop laughing, stop dismissing, and listen.  Asking for help is really hard–if a woman has the courage to go that far, give her the courtesy of going with her and doing what you can to offer some support.

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10 Comments (+add yours?)

  1. Elisheva
    Sep 26, 2010 @ 04:05:14

    Oh geez. Wanna give me her name? I have a few choice words for her.

    I’m so sorry she treated you like that. She needs to be smacked upside the head with a slimy wet fish. Several times.

    Reply

    • thejugglingmatriarch
      Sep 26, 2010 @ 04:10:10

      I wish I felt surprised–I was shocked at the time, but afterward realized how typical it is. My sense is she’s in the majority. Overall, I’m sure she’s a good doctor–but, like so many other good doctors, when the issue is not physical I think she’s probably out of her element. Anyway, I think it’s really important to emphasize that this isn’t about her; it’s a problem with the system, of which she was only the most recent illustration.

      Reply

  2. Linnie
    Sep 27, 2010 @ 22:29:53

    You ask ‘what is it going to take to change this’ – it’s people like you, changing careers, being vocal, being articulate, raising awareness. And thank heavens for people like you!

    Our medical system has pulled us so far away from appreciating the extent of the life impact of pregnancy and delivery, rendering it down to a ‘health event’ and failing to recognize the utterly complex role it plays for a woman. It’s rarely perfect and the ramifications of that can take their toll for a lifetime on countless relationships.

    My 2nd child is 4 and I’m still struggling with where/how to start dealing with the impact of my pregnancy with her and her delivery and how that’s affected my relationship with her today.

    It’s inspiring to read about your change of life direction and to read the passion in your blog posts. Apologies for the super-long comment, your post struck a chord..

    Reply

    • thejugglingmatriarch
      Sep 27, 2010 @ 22:41:59

      No apologies necessary! Thank YOU for reading and commenting. What I love about blogging is being able to connect with people.

      And yes–your second paragraph is critical. We’ve developed a cultural that holds women’s experiences of childbirth in contempt. Childbirth is either a spectacle (see any birth show on TLC, for example) or something women have no right to discuss–but it certainly isn’t ours to own or critique. I have never looked at the literature on this, but I’m curious how ideas about birth experiences might compare with ideas about people’s experiences of other major health events (i.e. surgeries where people are fully conscious, etc.)?

      Reply

  3. Mj
    Sep 28, 2010 @ 04:10:40

    I’m sorry to hear you had this experience.
    The idea of PTSD after traumatic birthing desperately needs to be brought out of the closet. When I discussed my issues with my care providers after my son’s extremely traumatic c.s. birth I kept hearing comments like “Well I wouldn’t say your depressed… but here’s the number of the post partum depression hotline”. It took me doing online reading to find the answer. It was a good, but sad to find my symptoms described so exactly.
    When I went to see my doctor I literally went over what I was going to tell her again and again, ’cause I knew I’d be crying and I didn’t want to get an other referral for ppd. I described a specific situation where my symptoms were clearly not depression and I stressed that this was not normal for me and that these events had not occurred prior to my son’s birth.
    I’m glad that I managed to get her to understand and when later a psychologist gave me an official PTSD diagnosis it was at least affirming that I knew what was wrong with me.
    Please don’t give up. You deserve to be believed and helped. It particularly touched me when you said “Asking for help is really hard”. It really is and you are brave for asking, and sharing, and helping get the word out about birthing trauma. Thank-you.

    Reply

  4. Jenne
    Sep 28, 2010 @ 23:06:56

    I’m so sorry that you got that reaction. There is very little awareness among medical professionals that PTSD and/trauma after childbirth can actually be as common as postpartum depression. There is actually a great deal of research on it and sadly, that knowledge hasn’t been transmitted to women’s health professionals.

    Have you looked into the resources at Solace for Mothers? We are developing a list of therapists who are sensitive to birth trauma. You could join our professionals group (http://health.groups.yahoo.com/group/solacesupporters) and ask if any of the professionals on there can recommend someone in your area.

    Reply

  5. steph
    May 25, 2011 @ 19:29:26

    Hi! I’ve just found your blog serendipitously after Googling ICAN because I saw your poster at Country Grocer!!!

    I had wonderful PPD support through my Doc and the mental health unit – I saw a woman named Evelyn Taylor at Duncan Mental Health and Addiction services. It was a special case because of the timing of my needs and lack of group support in the valley but don’t give up if you still need it!!! I’m happy to give you more details.

    I also had an unplanned c-section (planned a home birth with our midwife) and I look forward to attending the ICAN meetings when I’m pregnant again!!!

    Reply

    • thejugglingmatriarch
      May 25, 2011 @ 19:38:06

      So good to hear that you found the support you needed (and the ICAN poster, LOL!). I think that PPD is more well-understood than the impact of birth trauma, although the two certainly overlap. I don’t remember the name of the woman I saw the couple of times I went to MHA in Duncan shortly after my daughter was born, although I do recall that I didn’t find the experience to be positive. I’d love to hear more about your experience there, especially so that I can pass the info on to anyone else who might need it. I hope that you’ll come to ICAN meetings one day–and, of course, you’re always welcome, even if you aren’t pregnant. I live just up the way from the CG where you saw the flyer, so perhaps we’ll meet at some point? 🙂

      Reply

    • thejugglingmatriarch
      May 25, 2011 @ 19:40:49

      Oh, also, if you use Facebook, you may want to “like” the ICAN of the Cowichan Valley page. 🙂

      Reply

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