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.

VBAC? You'd have to get there, first...

So, I am part of this amazing organization, ICAN (International Cesarean Awareness Network http://www.ican-online.org/). There are about 1500 members on the yahoo support group list, the vast majority of whom have had a cesearean (or two, or three or more) and are looking for support.

They are looking for support to:
1) Deal with having had surgery to bring their child into the world
2) Dealing with other people who don't 'get' why #1 is so hard to deal with
3) Find a means to birth naturally, ie having a 'vbac' (vaginal birth after cesearean)
4) Lots of other reasons relating to 1, 2 and 3

So is it hard to 'deal' with a cesarean? Some women don't find this to be the case. I should mention, though, it is major abdominal surgery. It is necessary to cut at least a 10 cm incision in order to get the baby out (actually, it amazes me that it is this small... but our bodies are even amazing in this context... the skin stretches...). There aren't too many surgeries for which you need such a large incision, and this means that healing takes a bit longer. And it is painful. Yes, you might get some painkillers, but this doesn't really help since you are probably trying to stay alert for taking care of 1 or more children, would like to breastfeed and aren't sure whether the drugs are OK for that, and, well, just don't like the feeling of the drugs. Then there is the numbing feeling you have for weeks, months, perhaps years as the feeling struggles to return to that part of the body.

Most women won't admit they have difficulties with a cesearan. Shoot, most women won't admit they have trouble with anything having to do with birth or parenting. In my other life, I am a university researcher. I have looked at the psychological distress that women suffer after birth, traumatic or not, and I know that the one universal thing all women hear when they try to discuss their hurt is: "The most important thing is a healthy baby." Everyone says it. Nurses, midwives, doctors, healthcare assistants... husbands, lovers, mother-in-laws, mothers, sisters... everone. Perhaps I even said it once or twice in my life.

Well, actually, a healthy baby is a very nice thing. And it is important. But it isn't the 'most important thing'. Nothing is the 'most important' thing.

If you want to shut up a new mom, however, tell her that. Then she won't tell you how she feels, and you can just assume she is OK. I mean, she isn't saying she isn't, right??? (But then if she did, someone would tell her she's wrong... kind of a vicious circle, dontcha think?)

If it isn't hard enough to deal with these people, think of all the others who don't get that birth is really, really screwed up in the world (a lot of my ICAN friends think that the USA has the corner on the market for crappy birth experiences, but France can hold its own... they can't win a rugby game, but they sure as heck can ruin birth). Read books by Henci Goer, or Penny Armstrong if you don't understand what I mean. For reasons that are beyond me, women have tacitly agreed to allow medical professionals to 'rule' over what should be a very personal, private series of decisions. And then they thank them for it (oops, I forgot, if we complain we are told we are wrong).

I have glossed over so much to get to the point of this entry. Dealing with finding someone/someplace you can have a vbac. Well... you'd have to get there first. What I mean is that not only is birth being taken away from women, but so is conception. We are told we can 'control' when we have babies, through waiting, contraception, etc... then when we want them, we get more expert help (vitamins, medical treatments). It is all part of the big package, because who wouldn't want to be guarenteed a healthy baby, long before they conceive? I mean, if you need 'help' conceiving (which a shocking number of my friends are indicating these days) and some magnificent medpro helps with that, then of course you are going to trust whatever s/he says about birth. And the odds are that s/he will encourage surgical extraction of your baby, 'just to be sure'.

The medpro won't tell you that you and your baby have a much higher chance of dying from this procedure. They won't tell you that you have pretty much damned yourself to having a cesarean for the rest of your pregnancies, because no medpro in their 'right mind' would allow a vbac, except under circumstances so constrained that no one can fulfill them.

So, you want a vbac? You'd have to get there first. And by that, I mean that you'd not only have to find yourself a situation where you could, physically, have a vbac, but you have to forego the rest of the package that you 'bought' when you got into the whole birth system. How can you buy a car and then say, 'No thanks, I don't want that option'... not easy. Try telling a dr that you want his/her prenatal care, but not all the tests s/he suggests and certainly not that warped idea of birth that s/he has. They are worse than car salesmen, and can be a darn sight more compelling, because, after all, you want a healthy baby, right...?