Thursday, July 17, 2008

What it is like to go through perinatal trauma

So everyone knows that women can have a hard time regarding pregnancy and birth. And most people would agree that having a miscarriage (which I consider a type of perinatal trauma) is an upsetting event. Many think a cesarean (c/s) is hard, and I tend to agree -- it is abdominal surgery after all!
Yet. So many people refuse to acknowledge a woman's right to feel anything negative about a birth, a miscarriage, whatever. They don't do it directly and overtly, their refusal is pernicious and stealthy. "Yes, it was hard but the main thing is a healthy baby" is what most women hear when they open their mouths about the birth. "You can have another/You already have children" is what we hear when we have just had a miscarriage. It is as though we are incapable for thinking for ourselves, and the possiblity that we might have two opposing feelings in our simple minds (we are the weaker sex after all...) is impossible. "Yes I love my baby. I do hate how her birth happened, though."
Most people think that their fabulous wisdom, packaged as above (with perhaps slightly different wrappings) is enough for us women who have gone through perinatal trauama. The proof: we shut up.
Big surprise. The reason women shut up is because those simple sentences, usually coming from the people they feel closest to, are a clear message that our pain is not worth their time, and worse, we have no 'right' to be feeling that pain. So we shut up.
Some of us look for support elsewhere; most of us shut up forever.
How do I know this? Well, obviously, I have BTDT. But in addition, I have been working with a graduate student on this whole question of birth trauma and post-traumatic stress disorder (PTSD) for a few years. That student is about to defend her thesis. From the start, we have been harangued for 'making birth into something ugly' -- as it if it was our fault that women are routinely maltreated during birth. Snort.
When my student, Anne (take a bow, dearie... you deserve it!), started looking at this question she interviewed women about their birth experiences. At first, these women were reticent to talk, and then they exploded with details and information once they knew they were 'safe' and wouldn't be put down for having these feelings. Anne found in that first sample that nearly 10% of the population had either PTSD or severe stress with regards to their birth experiences. This is high compared to other studies which usually find about 6% of women (which is still high imhsho). We suspect that it was because this was a group of women with a relatively low SES, which makes the problem even more evil.
Another fabulous student (Natalene... your turn to bow) looked at both IVF and miscarriage and how these events impact women. Lo and behold, she found that women feel very emotionally traumatized from IVF, their intimacy is damaged, they feel objectified. When we went to publish the article, the ob/gyn's who refereed the journal said, "Yes, that is obvious, so should we publish it?" But it hadn't been published before. And if it is obvious, why are so many people refusing to change the system to make it more humane (particularly in France)???
And then there is the reality that is coming up right now on the ICAN support board. Everyone deals with their trauma differently. No one can truly 'know' what another thinks or feels about her experience, there is no right or wrong. Which brings me back to the start of my blog.
Perinatal trauma is here to stay. It is hard to go through. Most women need to be heard and comforted, not lectured. And if you have any contact with any such woman (it would be hard not to, over 50% of women suffer at least a miscarriage in their life, not to mention the skyrocketing c/s rate of +30% in the US) then let her speak. Do not judge her. Let her have her feelings, and cherish her all the more for expressing them.

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