Abuse and Healing

Last week the Center for the Childbearing Year offered another great presentation in its "With Women" series. This one was on working with women who are sexual abuse survivors. All new terrain for me and so sad to confront. What stuck with me most was this factoid: Of all the things a woman is at risk for in pregnancy -- gestational diabetes, preeclampsia, etc. -- what ranks highest is physical abuse. Can this be true? More women are abused during pregnancy than confront any other "complication?"

The presentation covered a lot of ground. The most useful "take homes" for me were:

• If a woman discloses past abuse, don't put her back in that time ("Oh how awful that must have been...what a bad person he was...); rather, focus on what you can do in the present to support her through labor and avoid or minimize her triggers.
• To the degree possible in our mobile, home-visit profession, create at atmosphere that conveys support to abused women: include information on how to report and get help for abusive situations in your handouts, use a canvas bag or display buttons that condemn violence against women, etc.
• Ask a woman in a safe time and place whether she has been or is being abused. Honor her response, whatever it is. Some women may not be ready to confront past abuse. You can not and should not try to coax them into a "confession" they are not ready to make.
• Remember that doulas are trained in labor support not counseling. Aside from honoring the woman's history and present situation, we can also provide referrals to individuals trained to help abuse survivors and victims. Having a pre-made contact list for area counselors, the SafeHouse and other support options is a must.
• Remember confidentiality: just because a woman has disclosed abuse to you does not mean her doctor, family, partner know about it. Before talking with anyone about this, ask her if you have her permission to do so.

After all this heavy material, I was all the more happy to end my night on a high note. Also in attendance at the session was the nurse who was my hero at this birth. This is the nurse who stood up to a horrible doctor to protect my client's integrity, not to mention birth sanctity. Afterward I went up to her to say how she's been in my heart these two years. I was ready to retell the story, but as soon as she saw me, she broke into a smile and gave me a big hug. We didn't need to say anything. We both knew which memory united us.

In the parking lot we revisited the birth a bit and updated each other on the cast of characters. As with good fiction, some individuals grow and learn. Others do not. My client is seeing midwives for all her OB/GYN care now. She is an advocate for doulas, for good nurses and for the midwifery model of care. The doctor from the birth continues to practice as she was then: alone and unsure of women's ability to give birth.

And the nurse? She is studying to be a midwife through the Frontier School, having decided any training she'd get around here would be too clinical. I couldn't have imagined a better ending.