Sexual Abuse Triggers During Labour and Birth
I have started writing a book on creating a safe space for pregnant, labouring and birthing women who have been sexually abused. I don’t claim to be an expert on this very sensitive subject matter. Nor do I claim to have covered every aspect of it in this book. For a very comprehensive and thorough analysis on this subject matter please read When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse in Childbearing Women by Penny Simkin and Phyllis Klaus. I am putting this book for numerous reasons. I am putting this book together because I live in a country where women are more likely to be raped than literate. A country where, according to the Medical Reasearch Council, one in three girls under the age of 18 has been sexually abused.The MRC’s study also states that by 2009, 40% of all victims who reported rape to the police were under 18 and 15% were under 12 years old.I am putting this book together because of my own personal experience. I am putting this book together because abuse is so prevalent in our birthing facilities. I am putting this book together because I see what a difference knowledge, skills and the correct language can make. I am putting this book together because of my mother. I am putting this book together for all the women out there who have, or will still some day, give birth. This book springs forth from a series of tutorials called Compassion tutorials started by midwife Robyn Sheldon. They are a series given to the 4th and 5th-year medical students at the University of Cape Town during their Obstetric and Gynaecology rotation. I teach these tutorials along with Robyn, Caitlyn Collins and Alexia van der Velde. We teach at Groote Schuur hospital, Mowbray Maternity hospital and New Somerset hospital. These tutorials were started to address the high incidents of abuse from caregivers towards women birthing in the labour wards. With the 4th years, we focus primarily on the concept of compassion in the context of the labour ward. Often students are rather traumatised from attending births and how women are treated and this is very much the focus discussion amongst meditation, learning skills when attending women in labour and understanding better the emotional and psychological aspects of labour and birth. These tutorials are usually well received and have been deemed a success. By the time the 5th years are in their gynaecology rotation, the students have hardened from their experiences, sometimes the Compassion tutorials fell a bit flat because they seemed not to deal with the real issues the students were faced with. One day, I decided to tackle the subject of compassion from the perspective of working with women who had been sexually abused. Something shifted. The feedback was very positive from the students. I have now been regularly speaking on the subject matter for the nearly two years. Over and over again I hear the words, “I wish I had had this information sooner – it will certainly change the way I work with women in the future.” That feedback is enough to make me want to spread this message far and wide. I will touch on two aspects of what I share with them here today: I emphasise the prevalence of sexual abuse in South African society. As mentioned previously, 1 in 3 girls will have experienced some form of sexual coercion before the age of 18. Let that sink in. These statistics made me think that we needed some sort of sexual abuse universal precautions in place...
Read MoreA Story of Surrogacy
I met her when she was pregnant with her fourth child and was planning her first home birth. I got to attend that birth as her doula – after three hospital births, this was a very different and empowering experience for her. She loved being pregnant and she loved giving birth but four children were enough for her and her family. She decided to take on being a surrogate mother – A woman who agrees to give birth to a child resulting from artificial insemination or the implantation of an already fertilised egg and who surrenders any parental rights to a third party. A big thing to decide to do but she felt very strongly that she wanted to do this for someone else. She met and carried the child for a single man. They became good friends and as she had trained as a doula as well, she was able to educate him on the options available in bringing his baby into the world. He went from wanting an elective caesarean for his child to attending hypnobirthing classes with her and planning a water birth in a hospital with midwives! I attended as her doula. She laboured well, but sadly, due to various circumstances, a cesarean became necessary. This mother who had birthed her babies (one of them breech) with no issues was suddenly wheeled to the theatre where for the first time, she underwent this operation. There was obviously a lot of emotional (and physical) recovery after this but she did say at one point that she felt that she felt that in order to be able to give the baby away, to not bond or attach herself to the baby, him being born via caesarean was necessary. A few years later, she chose to walk this road again with another couple, a couple who had lost their son in an accident. They were quite clear that they were taking no risks that their baby was to be born via elective caesarean. Again, I walked this path with her as her doula, and there was much processing about the previous birth and preparation for the imminent caesarean birth. One of the things she was able to request and implement was a ‘natural caesarean’. On the day of the caesarean, I fetched her from home. It was strange to be attending a birth that was scheduled – for both of us I think. We had planned to go for a walk together first. I took her to The Company’s Gardens and we walked and talked until we reached St.George’s Cathedral where we sat quietly for a while. Then we lit a candle each. Then we went to the hospital. I have to admit to it being one of the most beautiful, and dare I say, ‘holy’ caesarean births I have ever experienced. There was no idle chatter, everyone felt fully focused on this event – there was a real reverence for this gift that was being given. She even admitted that although she had been terrified of this second caesarean, it was actually a healing experience for her. She is now pregnant again for another couple. This time, it is twins! Again I will be attending as her doula and an obstetrician has agreed to assisting at a VBA2C (Vaginal Birth After 2 Caesareans) for twins. The parents are in agreement. We wait and see… Shared with...
Read MoreA Little Drop in the Ocean
This last Saturday, after weeks and months of discussion and deliberation, the board members of The Compassionate Birth Project, were finally able to meet and discuss their ideas and to receive valuable feedback from the midwives working at some of Cape Town’s busiest and highly stressed MOUs (Midwife Obstetric Units) – Mitchells Plain and Hanover Park. It was a very informal meeting and we all sat in a circle and introduced ourselves. We spoke about our passions and why we were there. We spoke about our children. Robyn introduced the project and the proposed modules for The Compassionate Care Training Course for Midwives and MOU staff. We wondered about how these would be received. What would the feedback be? And for us, more than anything, it was of utmost importance that we were not telling these midwives, who work so hard and who have done so for so many years, relentlessly, under conditions, which are far from ideal, what it was that they needed. We wanted to hear from them what their needs were. The feedback was amazing. I don’t think anyone of us ever thought it would be received with such open arms. And such a sense of relief. Finally! Finally something for the midwives! Something to take care of and nurture and support the midwives! These bastions of strength who, day in and day out, make sure, that mothers and babies are alive and safe. It was a small meeting. A small circle of women in a room in Rondebosch. But I think to everyone present, the power held in that little drop in the ocean, was...
Read Moreand remember what peace there may be in silence…
“Go placidly amid the noise and the haste, and remember what peace there may be in silence. As far as possible, without surrender, be on good terms with all persons. Speak your truth quietly and clearly; and listen to others, even to the dull and the ignorant; they too have their story. Avoid loud and aggressive persons; they are vexations to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself. Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time. Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism. Be yourself. Especially, do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment, it is as perennial as the grass. Take kindly the counsel of the years, gracefully surrendering the things of youth. Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here. And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive Him to be. And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.” – Max Ehrmann, “Desiderata“ With every birth I walk away with something new. or what I know to be true is reiterated or reconfirmed. What peace there is in silence… How those words resonate as I sit behind the young mother gently pressing on the part of her back that she has indicated is needing a gentle touch as she lies on her side labouring. Her friend…who has been with her all night sleeps behind me. We don’t speak. We convey everything purely through our bodies and through touch. Our communication is through the silence and respect and reverence we have for this process. The wind howls and the windows rattle. And whether or not it is clear to you, no doubt the universe is unfolding as it...
Read MoreEmbracing Traditional Midwifery
Here is the video from my talk at the 2015 Cape Town Midwifery and Birth Conference where I shared my journey and path to midwifery.
Read MoreThe Media and Childbirth
Last week I was hired to play a midwife in a commercial. I also had to help dress the set, which obviously was a hospital room. I tried to de-medicalise the set it as much as possible, getting rid of unnecessary machinery and having the mother as upright as possible. But it was interesting to see how we still fall back on the old stereotypes of childbirth, dramatic, stressful, painful… In her documentary film, Laboring Under an Illusion: Mass Media Childbirth vs. The Real Thing, childbirth anthropologist Vicki Elson explores how birth is portrayed through the media. She juxtaposes this with footage of ‘real’ birth – without the dramatic voice overs and music and tension. It is a hilarious take on how we have allowed ourselves to be influenced through television shows, films, comedies, reality shows, etc. What has the media taught us about birth? That pregnancy is awful. That you will feel ill throughout, have insufferable cravings and make your partner’s life miserable. In a nutshell – your life is over. Oh…and antenatal classes consist of mothers sitting in circles hyperventilating. And the birth? Well, birth inevitably is triggered by the mother’s waters breaking, and flooding the supermarket. In reality, only 15% of women’s waters break at the onset of labour, and sometimes it is more of a leak than a gush. Also, it will usually happen at night, when she is in bed, at rest, when it is dark. In films, once waters break, the mother is then suddenly in full blown labour and pain, she screams and flails, sometimes falling backwards, conveniently knocking over a pile of tomatoes, peaches, apricots (insert colourful soft fruit). She grips at her partner desperately, whilst her partner, in a sweating panic, tries to help her. In reality, labour starts slowly and gently. Often a mother will keep the little twinges that are niggling to herself, enjoying them whilst she gets on with her day. There can be many, many hours of these little twinges and niggles before things shift gear and move into the next phase of stronger labour. Cut to the car ride. Which feels more like a cops and robbers car chase. They are breaking all speed and safety records, putting their lives and others at risk to get to the hospital in time. Mother is screaming. Father is panicking. Birth seems imminent. In the real world, moves to the hospital are usually slow and mothers are encouraged to stay at home until ‘active’ labour kicks in. They are sometimes sent home if they arrive at the hospital too early. Now we are pushing. She has been stripped of her clothes and her persona and is on her back in a hospital gown, in a hospital bed, surrounded by people shouting “Push! Push!Push!” Perhaps, leading up to this moment, she had been planning a natural birth but now she is screaming for an epidural/caesarean and a great joke is made out of the fact that there is not need to be brave. She is also surrounded by lots of hospital equipment. It all feels very dramatic. Finally, the baby is born, or rather, it feels as though it has been rescued. And all is well. Or is it? Phew…tough one. This last bit is quite true actually and is often how birth can play out in a hospital setting. But which came first? Have we allowed ourselves to think that this is what birth is like? Or that this is how it has to be? How many women think, that they have to give birth on their backs because that...
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