ICAN of the Cowichan Valley

Forgive me, readers, for it has been many months since my last post.  I took a little professional detour (can you detour from an already diversified path? hmmm…).  It was interesting, and among other things, gave me an opportunity to reevaluate my values and priorities. 

And now that I’m back from my sojourn, I’ve re-prioritized my work around birth advocacy.  To that end, I’ve (finally!) gotten around to doing something I’ve been talking about for years:  I just started a new chapter of ICAN, the International Cesarean Awreness Network, here in the Cowichan Valley.  ICAN of the Cowichan Valley, like other ICAN groups, will offer resources and information about cesarean sections, and provide support to women who are recovering from a c-section or trying to avoid an unecessary surgery. 

After I had Annika, I attended one ICAN meeting down in Victoria.  But for a variety of reasons, including distance (it was a 2-hour drive, round-trip), I never managed to get to another one.  I’ve always regretted that, and wished I’d had a practical option beyond suffering in isolation with the aftermath of her birth.  I did have a wonderful circle of online friends who helped me through those years, but there is a lot to be said for face-to-face, local connections, especially in the postpartum phase.  And there is also a lot to be said for a specialized group like an ICAN support group.  It’s often hard for women to talk about their experiences with surgical birth, as many people still trot out the ‘but you have a healthy baby!’ dismissals, and unecessary c-sections have become normalized in our society.  ICAN groups can offer a safe place for women to connect with others who are likely to empathize, and willing to listen without judgment to their stories.

I’m still in the process of getting the group up and running–it was only officially registered yesterday, and I have yet to plan any actual events or meetings!  My hope is to find a central space where we can gather, perhaps beginning in late May or early June, and go from there.  So, local folks, please help to spread the word and encourage people to contact me at icancowichan@gmail.com.  Local and far-flung, like our Facebook page. Thanks to all of you for helping me let people know about this important new resource.

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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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