Why do natural childbirth & lactation professionals ignore the needs of survivors of sexual violence?

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The statistics are staggering. Up to 1 in 3 American women experience sexual violence during their lifetime. Nearly 20% of adult women recall an episode of childhood sexual abuse or assault.

These women often have different needs around childbirth and breastfeeding and those needs are routinely ignored by natural childbirth and lactation professionals.

Isn’t it a provider’s obligation to support WOMEN, not to promote their preferred method of birth or infant feeding?

As the paper Responding to Prenatal Disclosure of Past Sexual Abuse explains:

…[T]he perinatal period can be especially challenging for abuse survivors. During pregnancy, bodily sensations resembling disturbing elements of past abuse may lead patients to experience four categories of posttraumatic stress symptoms:

recurrent and intrusive memories;
avoidance of thoughts, activities, and other reminders of the traumatic event;
heightened irritability and other manifestations of autonomic arousal;
and negative changes in mood and cognition.

… Soet and colleagues demonstrated that sexual trauma survivors were 12 times more likely to perceive their childbirth experiences as psychologically traumatic compared to women without this history…

Inter-relationships between sexual abuse, female sexual function and childbirth provides further detail:

Sexual abuse (SA) survivors have been found to potentially experience triggering flashbacks and/or ‘body memories’ of the SA trauma during childbirth. This recalling/re-experiencing of the sexual trauma may be due to a variety of factors such as the similarity in the anatomy involved and the exposure of sexual body parts. Clinical procedures and labour sensations have like-wise been shown to be experienced by SA survivors as triggers, reminding them of the abuse …

Nearly every paper on the topic emphasizes that a subjective sense of lack of control is particularly triggering.

Control/lack of control has also been reported as the main underlying factors influencing SA survivors’ subjective evaluation of the birthing experience in a study by Parratt. Moreover, feelings of powerlessness, betrayal and humiliation have been cited as potential adverse experiences of SA ‘birthing survivors’ – as detailed in a study by Parratt…

Abuse survivors report similar feelings around breastfeeding.

For example:

Some survivors worry that if they choose to breastfeed that breastfeeding advisors will need to touch them when teaching them how to breastfeed their baby…

Certainly no advisor should touch your breasts in any situation without seeking your permission first…

And others find night feedings particularly triggering:

Some survivors mention that they find night time feeds more difficult and are more likely to be triggered and have an unpleasant experience. Obviously, this is more likely if you were abused at night…

Survivors often struggle with feelings of failure that can be exacerbated by breastfeeding difficulties:

…[S]urvivors who breast feed may find themselves saying “My baby lost weight when breastfeeding. I’m useless”. You baby losing weight is not your failure… There are some medical reasons why occasionally a woman may not produce enough milk, or a baby may not take enough milk – and if this is the case then a health care professional will be able to suggest ways forward. It does not mean you have failed…..it is unfortunately one of those things that happens through no fault of your own.

The theme that is repeated over and over again among survivors is a loss of control is especially debilitating for them. Yet natural childbirth and lactation professionals consistently pressure women to give up control to “nature.” They are dismissive when women request epidurals and routinely demean the idea of C-section on maternal request. This despite the fact that women who make these choices are often protecting themselves from sensations they cannot bear and memories that haunt them.

Should women have to reveal a history of sexual violence just to receive the care they need? I always appreciated and felt honored by being taken into my patients’ confidence about past trauma and tried to do anything in my power to make their childbirth experience more bearable. But not every provider is supportive.

… When talking to one midwife about the fact that I would chose not to breastfeed if I had a baby, she replied “Well, you don’t deserve to be a mother then!” – without exploring any of the reasons with me that I may have come to this conclusion. Unfortunately, this attitude is not totally unheard of within the hospital environment, and rather than perhaps supporting survivors to be able to overcome their fears, this attitude can close a survivor down and prevent them from getting the support which may prove helpful to them.

Moreover, if up to one third of women experience sexual violence during their lifetime, shouldn’t ALL providers offer ALL women the option of taking control of their birth experiences by choosing epidural or C-section on maternal request? Shouldn’t ALL providers offer ALL women the opportunity to formula feed if they think that is the best way to protect their mental health.

Why do natural childbirth and breastfeeding professionals routinely ignore the needs of survivors of sexual violence?

Isn’t it a provider’s obligation to support WOMEN, not to promote their preferred method of birth or infant feeding?

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  • mabelcruet

    Have there been any assault charges against midwives or lactation consultants brought by women who were touched inappropriately? If someone is saying no and pushing you away, there’s clearly no consent been given, even if what they are attempting to do is something therapeutic. There have certainly been doctors charged with assault for non-consented touching (mostly male doctors with female patients from browsing through the GMC fitness to practice judgements). Do lactation consultants think they get a bye because they are female and there is no sexual intent underlying their actions?

    • rational thinker

      I would like to know the answer to that also. I cant even count how many times on here and elsewhere women have said they told the consultant no and were touched and grabbed anyway.
      The only case I did hear something about was when a man went to the maternity ward and said he was a lactation consultant and was handling patients breasts. Not sure what did happen with that case.

  • demodocus

    Gah. Thankfully, i’ve never been sexually assaulted, but the thought of breastfeeding makes me shudder all over, even today. I bf’d kid1 far too long, and didn’t even make 11 months. How much harder must it be for the survivors?

  • StephanieJR

    Remember, kiddos, ‘I want to’ and ‘I don’t want to’ are valid reasons without any further explanation, particularly about your body. You don’t need to explain yourself to anyone unless you actually want to. I’m quoting a song here now, but you’re not obligated to swallow anything you despise.

  • PeggySue

    As if it wasn’t enough to survive sexual trauma, and do battle daily with a sense of being damaged, being retraumatized by so-called “birth professionals” is just too much. The arrogance, the judgmentalism–it’s horrifying.

    • sdsures

      You bet. *sniffles*

  • mabelcruet

    It never ceases to amaze me just how horrible women can be to each other, particularly when they think they’ve got god on their side.

    Several years ago, I withdrew from the organising committee of our service of remembrance for babies after comments made by a (very senior) midwife and one of the hospital chaplains. The service was for all parents who had lost a baby to miscarriage or stillbirth that year. One year the service was overwhelmingly Christian-all readings from the Bible, Psalms etc, prayers and all the music was holy music and hymns. There wasn’t a single ecumenical or non-faith reading, poem, song or anything. We had a couple of complaints about it so the following year I found a few poems and readings and suggested we included something like that to make it more inclusive. I was told no, that wasn’t necessary, because if the parents weren’t Christians, they shouldn’t be at the service and their babies wouldn’t be going to Heaven anyway.

    We also had a horrible situation over the bereavement pathway drawn up for the region. It was meant to promote equal access to bereavement services for loss parents, but it completely excluded those women who had chosen to end the pregnancy because of lethal anomalies. They weren’t mentioned at all-just whitewashed out. When it was raised, the initial response was ‘they got rid of their baby, they don’t need bereavement support’. It was a full 2 years before we got these parents included. And these people call themselves Christians.

    I wonder if the lactation consultant behaviour is some form of misogynistic victim-blaming? Or is it that their attitude is lactation is the overwhelmingly most important thing here, so its irrelevant if you were assaulted, just get on and breast feed, get over yourself and stop being a wimp.

    • KQ Not Signed In

      I cannot even begin to state my rage at that BS about the exclusion of parents who chose termination. Choosing to terminate for birth defects was the most excruciating, yet most loving, thing we could do for our first son. To deny our grief and say we “got rid of” our child is offensive in the highest degree.

      I’m glad we’re nonreligous because I can only imagine how destroyed I would have been to be treated like that.

      As it is, we were treated with tremendous dignity and respect by the hospital – they called in NILMDTS to take photos, gave us a memory box, clothes to fit his tiny body, and endless support.

      Who the hell are these people who think they have the right to decide which parents are *allowed* to grieve or mourn?

      I have to step away from the keyboard, I’m too angry.

      • mabelcruet

        Termination isn’t allowed here unless in exceptionally specific circumstances (the only way is if mothers life is in imminent danger-they don’t count significant impact on maternal mental health as being a suitable reason), so mothers who choose to end the pregnancy have to go to the mainland. They have to shoulder all the costs of travel, accommodation etc (and up until very recently, the cost of the procedure itself). If you don’t have the money for that, you have no other option but to carry on with the pregnancy. It’s beyond barbaric. We have a very high stillbirth rate and a high neonatal death rate here, but that’s because it includes many babies with lethal anomalies that elsewhere would have been delivered much earlier in the pregnancy.

        We also have no pathway in place for what to do with the babies after the procedure-if there are anomalies, having an autopsy to confirm that is important (in a significant proportion of cases, the autopsy will modify the diagnosis and allow for a better risk assessment for recurrence). But if you’ve had your termination on the mainland, its in a private facility and they don’t have paediatric pathologists. So if you want an autopsy, you have to find a pathologist willing to carry one out as a private case, and then get the baby transported there (at further cost to yourself). And what if you want to bring the baby home for a family funeral? There is no system in place for that-we’ve had parents bringing their babies back as hand luggage.

        It’s an appalling and barbaric system, with a government run by Neanderthals, misogynists and bigots, and that’s why I no longer work there.

        • sdsures

          Whereabouts are you?

          • mabelcruet

            Northern Ireland-working in England but still living in NI (its a heck of a commute!)

          • sdsures

            It certainly is! (I’m in Salford, Greater Manchester).

            *waves*

          • mabelcruet

            I did a locum in Manchester over summer last year! Plus my sister used to live in Didsbury so I sort of know the place.

          • sdsures

            If you’re ever in the area, fancy a coffee?

          • mabelcruet

            Absolutely-I alternate between driving to work via ferry, and flying. So the weeks I drive I usually stop half-way (Cairnryan to Southampton is a bit of a trek to do in one day!). Email is yowacat23@ gmail.com

          • mabelcruet

            We’ve had the Supreme Court rule that our abortion legislature was incompatible with human rights, and we had the United Nations CEDAW investigation committee rule that it amounted to wholesale government sponsored discrimination against women. We’ve had no sitting government for 2 years, our devolved parliament broke down in January 2017 and hasn’t sat since, although the politicians are still getting their full pay, which means nothing is being done.

      • rational thinker

        I cant imagine having to go through that, I am sorry for your loss. You loved him enough to give him the gift of mercy, when the alternative is to be born and suffer till eventual death. You did the right thing.

    • BeatriceC

      A friend of mine chose to terminate her late term pregnancy due to deformities in the fetus incompatible with life. This was a very much loved and wanted baby. She found out at 20 weeks that the baby had, among other issues, only a partially formed brain stem, not a full brain. It took almost two months and a shit ton of money, including travel to another state, for her to be able to give her baby a humane death, as death was the only option. That baby would be nearly ten now and she still grieves the loss of her child.

    • PeggySue

      I am beyond disgusted with your chaplain, though sadly not surprised. I support everything you say here. Also, I am a clergyperson. So very tired of poorly educated religious folk who feel entitled to push their beliefs on all and sundry. It’s abuse.

      • The Bofa on the Sofa

        …they will know we are Christians by our love..by our love! Yes, they’ll know we are Christians by our love….

        • PeggySue

          RIGHT?????? Grrrr…. I am dealing with some white American evangelicals now. My hair explodes about once per day.

          • rational thinker

            I feel your pain.

      • mabelcruet

        We have a range of different chaplains, and they generally took it in turns to lead the service each year. Mostly it was a mixture of religious and lay readings with some secular music, but this year there was a particularly fervent member of staff on board, and it coincided with one of the more conservative chaplains taking the lead, so all non-religious elements were stripped out. We don’t have too many different faiths around here, but there was absolutely no representation for them, or for people of no faith.

    • The Bofa on the Sofa

      I was told no, that wasn’t necessary, because if the parents weren’t Christians, they shouldn’t be at the service

      Despite this:

      There wasn’t a single ecumenical or non-faith reading, poem, song or anything. We had a couple of complaints about it

      People who attended complained, but hey, don’t worry, because no one who is there will care?

      Well, if you advertise it as being a Christian only service, then, yeah, it might keep others away….but is that what you want?

      • PeggySue

        If you are serving a community, you gotta serve THAT community, and I have news for this chaplain: most of them do not share the chaplain’s beliefs. Respect. It’s that simple.

    • Guest

      Gah, religion is the opioid of the masses and anathema to science and logic. There ought to be a universal ban on it.

    • rational thinker

      Some christians can be the most disgusting people sometimes. I had a couple tell me that if Hitler repented before he died then he will be welcomed into heaven. Then after that comment one of them proceeded to tell me that the holocaust was done by an atheist organization meaning Hitler and the German government. I find that claim funny because didn’t the German soldiers wear a belt buckle that said “god is on our side” as part of the required uniform? As for the Hitler heaven claim all I can say is that christians sure do love their loopholes. So telling people that their innocent child will be going to hell is beyond fucked up.

    • Cat

      When I was little, we used to go visit my sibling who lived in the graveyard. As a child, I just accepted that he lived in the sad, overgrown part at the back, crowded in with lots of other babies, and that he couldn’t have anything with his name on, even though there were babies in the main part with big headstones and ornaments. Maybe I just thought we were poorer than those babies’ parents? It wasn’t until I was a teenager that I learned that that was where the unbaptised babies went and they weren’t allowed to have markers, just one little plant. He would have been baptised if he’d lived longer – my father just didn’t think of it with his wife and baby both critically ill. My brother got his name on his grave eventually, many years later. But in the meantime, the lack of compassion turned at least four members of my family away from the Church.

      (I don’t tell this story often because I’m sure a lot of people would say “well, their churchyard, their rules – if your parents wanted his grave acknowledged, they should have baptised him or buried him somewhere else” . But they were numb with grief and I’m not sure they even knew they had other options, if they did – I assume you can’t just bury a baby in your garden, legally?)

      • andrea

        Some states you can legally bury in the yard if you have X amount of acres. Again, it’s a multi-people planning process that isn’t exactly easy on the fly with a critically ill spouse. Of course, some parents also have to make the icky decision of “do I bury my baby nameless in the same cemetery as other relatives…..or named in a new place?” I can’t say I’d know what to do.

      • mabelcruet

        Burial in private grounds is possible, but there are lots of hoops to go through. In the UK, a baby miscarried before 24 weeks doesn’t get registered (they technically don’t count as individual entities) so they don’t get a formal birth certificate or formal death certificate. After 24 weeks, stillborn babies have to be registered at the births and death registration office (run by local councils), and have to have their burial place recorded. There are some regulations about where you can bury someone in relation to watercourses, and the burial has to be entered onto the house deeds, so you can only bury someone on your property if you own the freehold, but this only applies to stillbirths. A miscarried baby can legally be buried at home and not entered onto the deeds and doesn’t require certification. What we generally recommend is that parents use a large ornamental planter instead of burying in the ground, as this means that if they move house they can take it with them.

        Trying to sort this all out when in the midst of grief must be an absolute nightmare. Most hospitals in the UK will offer to arrange the disposal on behalf of parents for babies who are miscarried or stillborn-we can arrange a cremation for non-viable fetuses (some hospitals offer burial as well, usually in a mass grave), and that means the parents can collect the ashes and scatter them. A sizable majority of parents opt for this in my experience, its usually simpler than them having to sort it out. Very often these are relatively young parents with no experience of bereavement or trying to organise a funeral, and I think they simply aren’t in the right headspace to tackle it. Imagine having to go to the local council offices to register the stillbirth in the same office where other parents are registering the birth.

  • AirPlant

    The one that honestly pisses me off is the party line that if you are traumatized by a past assault in a way that makes you believe that breastfeeding would be retraumatizing then you should instead look at breastfeeding as an opportunity to work through your trauma and form new positive associations.

    There is so much wrong with that I can’t even.

    • sdsures

      Agreed. Crying at the keyboard. Excuse me.

      • PeggySue

        I am sorry. I get it. I wish you didn’t have this experience.

    • mabelcruet

      I get the impression the reasoning is along the lines of a ‘healing birth’. If you have a birth that didn’t go the way you wanted (e.g you ended up with an emergent section), having a subsequent normal vaginal delivery ‘heals’ you of the birth trauma. So they are thinking using your body and breasts for the purpose it was made for will heal you of the assault.

      I can see them justifying their behaviour and attitude like that.

      • AirPlant

        I assume it is just the usual myopia about something being universally good because it was good for them. Like if breastfeeding was all roses and snuggles and happy thoughts then it must be that way for everyone regardless of previous trauma.

        The less charitable opinion is that lactivists have gone so far down the rabbit hole of mixed up priorities that when they hear of any reason a woman might have to not breastfeed their first and only impulse is to find a reason to negate her stated experience and validate their own belief that anyone who chooses to not nurse is somehow inferior and not a human making a rational choice that best fits their personal needs and wishes.

        • PeggySue

          I am not a Nice Person, so I think this is true for at least some, definitely.

          • AirPlant

            I am a card carrying member of team cranky so I have to make an effort to give the benefit of the doubt for anyone, particularly someone taking it upon themselves to share an opinion about my life where no opinion was needed.

      • PeggySue

        AIEEEEEEEE!!!!!!!!!!!

    • rational thinker

      Yeah I really hate that claim the most. I really do not think breastfeeding would help me since the mere thought of me breastfeeding makes me sick to my stomach and I get the unclean feeling. And that is just from the thought of me doing it. So I think it would add more trauma for me and I would probably start to hate the baby too.

      • AirPlant

        I think people who have not been traumatized have a hard time understanding how uncontrollable and illogical it can be.

        I was assaulted ten years ago and I honestly rarely think of it. It impact my life so little it feels almost disingenuous to mention. The most I can frame it is that It is something that happened to me the same way that when I was ten I broke my arm. After the worst of the pain and healing passed it just became a memory with no power over my life.

        My residual trauma is small and I am almost completely fine, except for one small problem. I will just be going about my day and someone will touch me. It isn’t every time but just often enough my body will go into a panic. I get shot through with adrenaline and fear and revulsion. I feel the overwhelming urge to hurt the person who touched me.

        I can’t stop it, I can’t change it, therapy has not put a dent in it but somehow a tiny helpless newborn is supposed to fix it? I am supposed to sign up for an arrangement that pins her life on my ability to touch her and just fight through whatever feelings come up and hope I don’t hurt my baby in the process? My trauma level is so small and my reactions are so intermittent and I still feel that it is just too much to ask of me when formula exists.

        • rational thinker

          They do seem to be set in the idea that breast milk is so magical it can do anything and cure everything.

          My gang rape actually doesn’t affect me that much. Maybe because I still kind of blame myself for it happening and I really dont get that much of a trigger from it.

          The physical issue for me I think is from having my chest grabbed at least ten times a day by different boys while walking down the hall at school. This happened every day for about 2 and a half years. Now my chest is such a trigger for me that I have to wear a sports bra at all times and I wont even give myself a breast exam to check for lumps. I really should be doing that cause my mom and aunt both had breast cancer. I also have a reflex of elbowing people if I am touched om my upper sides. I actually accidentally elbowed my daughter in the head last night. Luckily it did not hurt her but I feel awful about it, but it is something I really cant control.

          So I hate even the suggestion that breastfeeding will help me with the trauma of sexual assault. I think these people are so far gone with the lactivism that they will never understand the emotional triggers of sexual abuse victims, or they simply just dont care about it and think that it is not an excuse for not breastfeeding.

          • AirPlant

            The more I think about it the more it feels like the root problem is that society thinks it is entitled to our bodies. It starts with men but when you become a mother it becomes everyone. I am surprised that we all aren’t a little bit traumatized.

    • guest

      I guess I am one of those “success stories” that gets talked about with breastfeeding and trauma recovery, but even so it wasn’t exactly a magic fix.

      As a mom, suddenly I found that my breasts had a use, and that was feeding my infant children. And that was nice, to not feel totally disconnected from that part of my body anymore.

      But I still didn’t want anyone else – doctors, nurses, LCs, potential sexual partners, bra-fitters, etc touching my breasts because it reminded me of past trauma. If anything, the experience of breastfeeding made me more adamant about that boundary. Like “Are you a hungry baby? No? Then get the hell away from my boobs”