Posts Tagged ‘Midwifery’

“I’m scared I’m going to harm my baby…”

April 28, 2016

mia brochure photoWhat do you say when you hear the words “I’m terrified that I’m going to harm my baby”

Those words are ones that would be hard to say if you’re a mother. But if you’re a professional, be it a midwife, a health visitor, a doula or a counsellor, they can be hard to hear too. Those words represent an ultimate taboo.  A mother wanting to harm her own baby…..

But just wait a minute. If you are very astute, you will have spotted my deliberate error there. Can you see it? They are not the same thing. “I’m terrified I’m going to harm my baby” is not the same as “I want to harm my baby”.

If you hear a mother say “I’m terrified I’m going to harm my baby” the chances are she is suffering from an anxiety disorder, and she is not a danger to her baby. She is about as dangerous as some-one with fear of heights, who stands near(ish) a cliff and says “I’m terrified I’m going to jump off”.  You wouldn’t call the crisis team in this instance would you? Instead, you might say “no you’re not, you’re just scared”. It’s the same with mothers. If a mother is anxious (and especially if she is suffering from perinatal or maternal Obsessive Compulsive Disorder) then she might talk about suffocating her baby, but she can be reassured that she isn’t mad or bad, she is scared.  And of course, if you make the mistake of reacting like she is mad or bad, and call the crisis team, you certainly aren’t going to ease her anxiety!

To find out more about perinatal mental health problems, come to my workshop for birthing professionals on Friday 10th June 2016. For details, click here 

Mia Scotland, Author of “Why Perinatal Depression Matters” and Perinatal Clinical Psychologist.

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Written two years ago. My tribute to Sheila Kitzinger. RIP Sheila.

April 29, 2013

 

  • Sheila.  Oh Sheila.  What can I say?  You brought me into a hypnotic state with your wonderful story telling approach to speaking. I watched and listened in awe.  My subconscious took it all in, and I was hooked. You were amazing.  It was so gripping, my conscious mind remembers nothing.  I  took away, that women matter. That birth matters. And we can all do something about it. I felt joy, empowered and excited. Thank you.  What I wrote down was that you are the first person to talk about something that should be talked about a lot more.  Drug companies.  You told us that you had approached the Advertising Standards Association, to complain about an advert that Bayer has produced, with dodgy statistical claims about maternal death in childbirth. The ASA upheld your claim. The advert was changed.  Go girl! You also said that Doulas protect birth.  And Doulas protect women.  Thanks Sheila.  Read her book, Birth and Sex: the power and the passion, by Sheila Kitzinger.

Birth Trauma – Can it be fixed?

January 21, 2013

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The word “traumatised” has become like the word “starving” and the word “depressed”.  It has been watered down,  from something quite serious and potentially life threatening, to something we flippantly say when chatting about our experiences.  We might say “I am absolutely starving” instead of “I’m famished”.  We might say “I was so depressed” because our Christmas pressie turned out not to be the long awaited diamond ring.  And we might say “it was traumatic” when we mean “it was horrible”.  But we all know that to actually be starving means something very different.  And we might or might not know that to actually be depressed is a miserable state of being, a condition, not a fleeting  emotion.

So what about trauma?  If something was really scary and upsetting and horrible, were we traumatised?  Well, to a psychologist, trauma is as much about the aftermath of an experience, as it is about what actually happened. It is about how it leaves us feeling, long after the event.  It is not always about what actually happened, or even about how bad it was at the time. I’ve heard some birth stories that are so horrible, my insides are shrinking when I hear them.  But the mums are fine with it.  In fact, sometimes, the mums are remembering the experience fondly (I kid you not!  It must be the oxytocin).  I hear other birth stories that sound wonderful when described.  But the mums are sobbing with grief and horror while they tell me, even when the birth was years before.  How can that be?

Trauma is about the injury, not the event.  It’s like breaking a bone.  I might fall down a big flight of stairs, and walk away unscathed.  On the other hand, I might trip up over nothing, and break my ankle.  One cannot predict this, or control it.  The person who broke their ankle is not weaker or more stupid, and they cannot “pull themselves together”.

So when we are listening to a birth story, we don’t need to know about the event. We need to know about the reaction to the event. I want to know “can you talk about it without crying”.  I want to know “does it impact on your dreams”.  I want to know “do you try to shove it to the back of your mind, but you find it impossible”.  I want to know “what impact is it having on your life”.  I want to know “how long ago did it happen”.  If it is less than a few months, and the person is telling me about it, the chances are, she will be okay.  Usually, I’m hearing the story years later, because the person is pregnant again, and this flares up the previous trauma.

Is birth trauma treatable?

Yes.  I have been treating trauma for over 20 years, with an enormous amount of success.  It is treatable.  I promise you.  Time isn’t always enough. Some people go all their lives traumatised, until they receive treatment.  War veterans have suffered for decades with PTSD , until a short course of treatment lifts it.  And it can really feel like something has been lifted.  As one person once said to me “it was here – in my forehead – I couldn’t get rid of it – always there – always in my way.  It has gone.  I can’t believe it, it has totally gone”.    There are treatments out there that work.  We aren’t exactly sure what the treatments actually do, we just know they work.  They seem “move” the memory from the “I’m not safe” (threat activated) part of the brain, and lay the memory to rest in the “it was awful but it’s over” part of the brain.  While traumatised, the person feels as if it as just happened, and the body and brain are in a state of hyper-arousal.  This might involve nightmares, flashbacks, irritability, moodiness, tearfulness,  sleep problems , anger with your loved ones, constant memories of the incident, and efforts to push it out of your mind unsuccessfully.  If you are a new mother, it has even more consequences, because it interrupts the process of bonding with your baby.  Furthermore, the normal chaos that comes with adjusting to a new baby is heightened to create a potentially miserable cocktail.  Fathers can be traumatised by the birth too, but they often go under the radar, so we know very little about this. Mothers have been going under the radar for a long time, because many cases of PTSD were misdiagnosed as post natal depression.  We are only just beginning to realise how common post natal depression is in fathers (almost equal to mothers, in some studies) and the fact that this might be related to birth trauma in fathers.

In our society, we are led to believe that we should be able to control our emotions, but if we have been traumatised for 6 months or more, then trying to control it may exacerbate the problem. This is because, with PTSD, the more we try to “control” the emotions (in other words, the more we try to push the memory to the back of our minds), the more the problem anchors itself in the brain, because you are preventing the brain from processing  the event properly.  This is where therapy can help.  Therapy enables the brain to change the memory, so that it becomes processed into the “history” part of the brain rather than the “I’m not safe” part of the brain.  Before that, the memory seems to be stuck in the “oh my god I’m not safe and this is awful” part of the brain, leaving the person with “symptoms” as outlined above.

There are many effective therapies out there. I’ve tried a few of them. I now mostly use the rewind technique (a hypnotic technique, taught to me by the Human Givens Institute) which seems to be the most effective, the quickest, and the least distressing.   It can be one session.

I am now teaching this fast, fairly painless and effective technique to professionals who find that they want to help parents let go of the horror of a difficult birth. It’s a two day course which gets great feedback. It gets great feedback on the day, but also great feedback when people start applying the technique. There really is nothing better than knowing that you have made a dramatic difference to some-one’s life. To find out more about the upcoming training workshops, go to http://www.traumaticbirthrecovery.com/courses-for-professionals/

Mia Scotland

Clinical Psychologist

http://www.yourbirthright.co.uk

 

Five things you shouldn’t let the NHS do for your labour…

December 3, 2012

ImageI was at the wonderful Association of Radical Midwives conference last week, and the gorgeous Virginia Howes talked about the new fly on the wall documentary coming out in January called “Home Delivery”.  It’s a refreshing change from One Born Every Minute.  She showed us some excerpts from One Born. There were gasps of horror and tears in the room from the midwives (honestly!  They don’t usually watch it).  I felt sick, but I wasn’t shocked.  It’s what I see as a doula in some hospital births.  As I wondered why they were so shocked, it dawned on me that they don’t see it!  They are used to working in their own individual way, and don’t see other midwives in action like I do.  They don’t feel the enormous change in the ambience within the room at shift change – for the better or for the worse, depending on the midwives.  I wanted to say “but this is what happens. I see it all the time”.  And I realised that my horror and anger that I feel when I do see these things happen is justified.  I’m not being touchy feely or over sensitive or radical.  It’s not okay.  So, here are the five top things that happen in a lot in hospitals (the last one being on the phone) which conclusive research (and the law in the final one) suggests should not be happening.

Five  things you shouldn’t let the NHS do:

  1. Induce you before 42 weeks on the grounds of being over dates
  2. Tell you to put your chin on your chest and push hard
  3. Cut the cord soon after the baby is born
  4. Get you to lie on your back on a bed
  5. Tell you that you can’t have a home birth on the grounds of staffing shortages

Trust me, NONE of these are evidence based.  They all, in my opinion, contribute to more danger than less. Number one:  The national statistical outcome data suggest babies born after 42 weeks fare better than born between 41 and 42.  Number two: Valsalva pushing compromises the oxygen your baby is getting, exhausts mum, and has not been shown to speed up second stage. Number three: Cutting the cord immediately after birth is plain dangerous, but hospitals in my area are still doing it  (see TICCTOCC). Number four: Lying on your back for labour creates all kinds of problems for your pelvis and baby’s exit. Number five: Being made to have a hospital birth when you wanted a home birth could jeopardise your safety, as recent research suggests that mums are safer at home, and it potentially goes against EU legislation regarding dignity and human rights (see the work of Elizabeth Prochaska, who also gave an inspirational talk).

Okay, so here comes the apologetic sloppy bit.  I know our NHS is wonderful.  I know midwives work hard, tirelessly, compassionately and selflessly.  I know things in the UK are fabulous compared to so many other places in the world.  I love our midwifery in our country.  Maybe that’s why I care enough to get annoyed enough to write this article.  What do you think?

Witch Hunting, Halloween, and Birth

October 30, 2012

ImageIt’s Halloween!  My kids want me to wear my green mask, ugly crooked teeth, dry haystack hair and cackle loudly at my children!  What fun!  But spare a thought for all those hundreds and thousands of women (and some men) who were sought out and burned alive at the stake.  These were our healers and midwives.  The more successful they were at healing, the more  magical and therefore dangerous they were thought to be.  Some “witches” used herbal remedies very successfully, including ergot for labour – today’s drug ergometrine is a derivative of this. But their skills were literally burned out, and then stamped out with legislation and slander.  For example, women were not allowed to study, and  practicing midwifery without having studied it was outlawed.  Sounds a little like the plight of today’s independent midwives in England, and yet England has a very powerful midwifery base compared to places like the United States. (Independent midwives in England are at the brink of being effectively outlawed). It also sounds a little like the plight of midwives all over the world who are being struck off or jailed, or who’s midwifery services such as the Albany Practice are being closed down. The media enjoy a frenzy if a home-birth midwife runs into trouble, but seem to revere doctors who may well be accountable for many more deaths.  I know that I, and many more midwives in this country, see the witch hunt continuing.  The battle of the sexes to take control of healing and childbirth continues to this day.  Thank-fully, we are not killing midwives any more, and thankfully, they have a greater voice.  Let’s keep listening to them, for they are wise, and gentle. This poem helps us to revere and respect the poor old witch.

 

: “Halloween Witch”

 

: Each year they parade her about,
: the traditional Halloween Witch.
: Misshapen green face,
: stringy scraps of hair,
: a toothless mouth beneath her deformed nose.
: Gnarled knobby fingers twisted into a claw
  protracting from a bent and : twisted torso that

  lurches about on wobbly legs.
: Most think this abject image to be the creation of a
  prejudiced mind or : merely a Halloween caricature.
:
: I disagree,
: I believe this to be how Witches were really seen.
: Consider that most Witches: were women,
: were abducted in the night, : and smuggled into

  dungeons or prisons under the secrecy of darkness to be
: presented by light of day  as a confessed Witch.

: Few if any saw a frightened normal-looking woman
  being dragged into a secret room filled with

  instruments of torture, to be questioned until she

  confessed to anything suggested to her and to
: give names or whatever would stop the questions.
:
: Crowds saw the aberration denounced to the world as a
  self-proclaimed Witch.

  As the Witch was paraded through town enroute to be
  burned, hanged, drowned, stoned
: or disposed of in various other forms of Christian
  love, all created to free and save her soul from her
  depraved body, the jeering crowds viewed the results

  of hours of torture.

  The face bruised and broken by countless blows bore a
  hue of sickly green. The once warm and loving smile gone,
: replaced by a grimace of broken teeth and torn gums
  that leers beneath a battered disfigured nose.
: The disheveled hair conceals bleeding gaps of torn
  scalp from whence cruel hands had torn away the lovely tresses.
: Broken twisted hands clutched the wagon for support,
: fractured fingers with nails torn away locked like
  groping claws to steady her broken body.
: All semblence of humanity gone,
: this was truly a demon, a bride of Satan, a Witch.
:
: I revere this Halloween Crone and hold her sacred
  above all. : I honor her courage and listen to her warnings

  of the dark side of man.
:
: Each year I shed tears of respect when the mundane
  exhibit their symbol.
:
:
: angel 6-26-99 Petals and Thorns poetry by angel