Impact of #domesticviolence or sexual assault on #pregnancy

Refreshing as it is (well, kind of) to hear domestic violence and sexual assault talked about more frequently in the media today, there is an aspect of that violence that is long-lasting and sadly, seldom mentioned. That is how the violence of an assault can impact a woman during pregnancy.

Pregnant survivors of violence have more challenges during their childbearing years than non-survivors do. Those challenges not only depend on the kind of abuse that the woman suffered but also when the abuse happened. Let's look at two examples of how this might look-

  • An adult survivor of childhood sexual abuse becomes pregnant and decides to keep the baby. She learns the baby is a boy. She starts finds herself repulsed by the baby. She cannot stop thinking about how she has been abused by men and begins fixating on how this future man might end up hurting her too. Although she originally wanted the baby, the idea of something growing inside her is beyond horrifying. She is ashamed to tell anyone of these feelings but starts (often unconsciously) to make decisions that reflect that disengagement like skipping her prenatal appointments and not talking about the pregnancy with anyone.
  • A domestic violence survivor who was abused by much older men including her father is untrusting of anyone and has difficulty maintaining relationships. She becomes pregnant and finds herself at a ob/gyn practice where there are older male doctors. At her appointments, she is unable to advocate for herself and ask questions when it comes to routine care. Or perhaps the exact opposite: she is very high maintenance, demanding with a highly detailed birth plan, only to turn around and at the next appointment announce that she wants to schedule a csection. 

A background of abuse has a huge impact on how a pregnant survivor thinks about herself and how she sees/thinks about others. This is not something that can be disregarded, either by the pregnant survivor or practitioners, friends, or family who interact with her. 

One of the issues that I work on with Trauma Counseling survivor clients is identifying the core issue for their visit and developing supportive tools to help them as they move through their pregnancy with confidence. We also work together to talk about what she might expect as her pregnancy continues. An adult rape survivor, for example, might call not because she's having fear around a vaginal delivery, although she really wants to "go natural". 

Emotional and physical changes as well as socioeconomic issues can complicate how any pregnant woman copes on a regular basis. But all of those are compounded and amplified in scale for the pregnant survivor who is already less emotionally equipped to deal with her changing identity. 

This is the first in a series that will look at how abuse impacts a woman in her childbearing years. 

Thank you for reading.

 

"Your body is a wonderland! Real guys rhapsodize." #pregnancy and #bodyimage

And that's a direct quote...from this article on Fit Pregnancy last week. I think it's troubling that a website which professes to be a "prenatal and postpartum guide" features an article, authored by a man (of course), that focuses on sex appeal. "What's the big deal?" some may say, or, "how fun/cute/cool!". Here's why I object to articles like this:

When the focus is on a woman's body, it's easier to disregard her feelings, her thoughts, her experience. It's easier to treat her like an object, instead of a real person with wishes, fears and dreams. When the focus is on "sexy", the focus is on the body, not on the woman. The difference is slight but important. So, here's an alternative: how about instead of focussing on how pregnancy is sexy, we focus on how women can feel good about themselves when pregnant? Not as cool, sure, but crucial. 

We need to be more concerned with how women feel about something, not less. We need less objectification of women and their bodies, not more. This is true for all women but especially true for pregnant women: she is more than just a vessel for a baby. 

 I think the intention behind articles like this is a good one. But the way that this message is delivered, with the emphasis on how attractive pregnant women are to men, is completely off base. It shouldn't even need to be said but here it is: pregnant women's bodies are not on display for the male nod of approval.

Already, everyday, many times a day, women get the message that how their body looks is more important than their mind, than what they do for work, than how they care for their family. It's more important than anything else. I think we can do better. But that means more women (hopefully you) speaking up against damaging body shaming messages. It takes a moment, yes, and sometimes it's a Debbie Downer but women dominate every social media platform except one. Even if we just took our battle to the internet, we could do a world of good. Let's use that power.

How? Share this post. Write a quick comment when you see an article like the one I'm writing about here. Facebook or Tweet why sexualizing pregnant women's bodies is a problem. 

What say you, pregnant ladies? How do you feel about articles like this? Leave me a comment below. Thanks for sharing.

{new #OutsideTheMomBox post} 5 important questions #pregnant #women should be asking themselves

There are so many things that women need to juggle on a regular basis but I feel like when you're pregnant, the issues just multiply like rabbits. You have information coming at you from every possible perspective, including the unwanted viewpoint of perfect strangers and anyone else whose opinion you're not interested in but who feels compelled to share it anyway: coworkers, cousins, perhaps even your mother-in-law. It can be hard to parse through what's important and what's noise. So, below are five questions that truly are relevant and timely:

If I were to go into labor right now, am I ready? 

Do you have a carseat installed?  Are work related projects tied up? Is care for your existing child squared away? Do you have a labor bag packed? Do you know where baby will sleep when you get home? These questions matter regardless of where you are in your pregnancy but obviously take on a greater sense of urgency the closer you are to your due date. Babies come late but some babies do come early. You being ready right now if you were to go into labor means less worry and work for you, if it does happen.

How will I best feel supported when I'm in labor? 

All attention and care needs to be on you during labor, not your partner. So, if you're worrying about how your partner might deal with your contractions or the blood or the lack of sleep that he will get, then you likely need additional support during childbirth. You also might consider getting additional support during labor if your partner is a medical doctor or nurse (these folks often have a harder time separating their training from what you might want or need in the moment i.e. not to be induced, even if your OB suggests it). It's all about you, your wants and needs during your labor. You cannot be spending time taking care of your partner, even though you normally do this. I cannot recommend enough a birth doula as your exclusive labor support. Birth doulas exist entirely for you and your needs during childbirth. Oh, yeah, they also increase satisfaction with childbirth experience and lower the chance of a csection. Pure gold.

If your doctor tells you that you need a medical intervention, do you have the information you need to respond in a way that honors your preferences for your childbirth experience?

In other words: have you taken a childbirth ed class yet? Understanding that birth is a natural, normal experience (in spite of how medicalized it has become), that women can go into labor on their own and how medical interventions can affect your labor are all part of any good childbirth education class. The two Lamaze based childbirth ed classes (traditional and survivor specific) that I teach are open to women at pretty much any week of pregnancy because I think this information in the class is valuable immediately. Say for example, after learning about how one intervention often leads to a cascade of interventions in labor in your childbirth ed class, you realize that your OB has a very high csection rate and you don't want a csection: you're likely not going to feel as nervous changing providers at week 18 for example than you would at week 28. Prep early rather than later.

Whose job will it be to care for me when the baby comes home?

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Just in case you need to hear it: your job is to care for the baby. Nothing else. If you're breastfeeding that means that you exclusively are keeping that baby alive. If I sound serious, it's because I am. Feeding a newborn is no joke; it's a round the clock job that you can't even imagine would take as long as it does until you're actually doing it. For those who are formula feeding, you may not be whipping out a breast a million times a day but you are working just as hard to sterilize bottles, measure formula, heat bottles and get baby fed. Yes, your partner can do these things too but you know as well as I do, just like we both know who does the majority of the household chores in your house, that you will likely be doing the bulk of this work. In other words, you need someone to take care of you. I didn't understand this when I had my daughter. Trust me on this, please identify someone now to be your caregiver when you get home. That can mean a postpartum doula or relative but make sure someone is there exclusively for you.

What household responsibilities can I turn over to someone else BEFORE I go into labor?

Along the same lines, you don't want to be dictating how to give the dog her meds to your neighbor in between contractions. Okay, that's a little extreme but you get what I mean. There may be a learning curve involved for whoever is stepping up or taking over. Honestly, just assume that there will be a learning curve. Again, you will rest easier and will worry less if you can hand off household care and maintenance to someone else. 

New moms, have I missed something? What essential question would you suggest a pregnant woman ask herself? Leave me a comment below.

{new #OutsideTheMomBox post} 13 #stress busters for #pregnant #women

Anxiety isn't good for any of us but it can be especially detrimental to pregnant women. For pregnant women extra stress can cause high blood pressure which can trigger preterm labor. Preterm labor can lead to a host of issues for baby: including intellectual and developmental delays, hearing and vision challenges and more. This March of Dimes article articulates many of which here. So, let's all calm down! Here are 31 ways how to reduce stress:

  1. Avoid information overload. DON'T Google everything! Find a trusted friend, educator that you can depend on for quality information. No, they won't have all the answers but they will be able to refer you to someone equally awesome when they get stumped.
  2. Find a support group. Connecting with other women is so important at this often scary, vulnerable time. Hear that they are feeling the same and learning from each other. 
  3. Start saying "no" now. I know you're a helper. I get it, I do. But the best person you can help now is YOU. Practice saying "no" to whatever doesn't feel like the uber-best fit for you and your new family. Trust me; you'll get a lot of use out of this new habit down the road.
  4. Sit on a birth ball. I can't say enough about how much I love birth balls. They keep you moving, keep your hips fluid, get you off your feet, keep your pelvis in a good position. And they just feel good! Try it.
  5. Take a warm bath. During my last trimester, I must have taken a warm bath 5 out of 7 nights a week. I listened to my breathing CD, took deep breathes, talked to Little Sun and slowly dripped warm water over my big belly. It felt great and allowed me to sleep better.

  6. Go for a walk. I didn't do a lot of exercise when I was pregnant but I did walk nightly. It helped me calm down from the craziness of a work day and kept me active and mobile,even when I didn't want to be. It felt good.
  7. Drink more water.  A dehydrated body can lead you to confuse cravings with real hunger pangs. Also a dehydrated uterus is a crampy uterus which is an unhappy uterus. You want a happy uterus. Happy = healthy and feeling good!
  8. Hit the sack earlier. Rest now because it feels so good and because you won't have as much time. If I hear one more story about a pregnant woman heading out for a jam-packed day, with nary a nap in sight, I swear! Take it easy, please. Trust me on this one.
  9. Talk to a coach. Most of my Outside The Mom offerings are ones that I wanted. Wellness Coaching is no exception. One session (or a handful!) includes simply talking to someone who has been there before can bring much relief as well as education, resources and support.
  10. Journal. In Baby Body and Soul, Tracy Gaudet recommends journaling. It was really helpful to me to write down some of the anxieties that I was feeling about the pregnancy and what I still felt like I needed to sort out before I had her. 
  11. Enjoy a chiropractic adjustment. For three-four months leading up to my daughter's birth and for over a year, I received regular chiropractic adjustments at Imagine Chiropractic. They felt great but also reminded me that I was doing good prep work for labor. 
  12. Enroll in a childbirth class. Prep and information reduces stress now...and down the road. I have a seven week, Sunday afternoon class starting in September in Durham for couples and September online for survivors. I also have other local resources for childbirth here.
  13. Ask for help more often. Boy, do I wish that someone had strongly encouraged me to start asking for help when I was pregnant. You will need help. I did. We all do but it's hard to ask. Start that vulnerable act with someone you trust & see how that goes.

New moms, what would you add to this list? P.S. Your 13 comes up in a few weeks. I didn't forget about you!