The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Notes from a talk about the book "When Survivors Give Birth"

I took a few, very brief notes on the talk based on the book 'When Survivors Give Birth':

1) The numbers of women who've experienced sexual abuse at some time in their lives is about 65%.  She defined sexual abuse as sex with a child; any sex that is non-consensual between adults or any sexually oriented interaction (verbal, non-verbal) that is not consensual.

2) As professionals we need to be clear on our role with the pregnant woman.  We are NOT therapists.

3) We need to develop our network of referrals to professionals trained to provide care for women who've been sexually abused if they are experiencing difficulties with it (i.e. therapists or other specially trained people).

4) For women who've been sexually abused, control can be a very big issue.  As birth professionals, we need to clearly understand and behave in a way that is clear that the mom has the power.

5) We need to be guided by the mom's lead with regard to not only talking with her about her past experiences, but in all regards as she prepares for and gives birth to their child.

6) Ask open-ended questions and follow mom's lead regarding topics discussed.

7) Really listen.  It's her experience and she's leading the way.

8) Traumatic birth is now recognized as a precipitous factor in postpartum depression.

9) Some moms' who have experienced past sexual abuse are helped in labor by the context of 'pushing the pain OUT, pushing the baby out.' The pain is not coming IN.

10) moms who've experienced past sexual abuse are 25% more likely to experience postpartum depression.

11) With regard to baby blues vs. postpartum depression, if her mood is interfering with her daily activities, she needs to get help.  Postpartum depression may now be diagnosed up to two years after baby's birth.

12) After baby's born, regardless of how the birth went, find something positive about her and the birth that you can authentically compliment her with.  You plant the seed for validation that she may take in later.

She also provided a handout that had some very useful information.  One of the items was:

Question for the counselor, caregiver or nurse to ask him/herself when there's been no disclosure: 'Would everything that I see, hear and feel with this client seem more natural or understandable, and make more sense if she were, in fact, a victim of abuse?'

Another handout compared helpful and unhelpful responses to a woman's disclosure of an abuse history:

Helpful ones included:

Calm concern - 'I'm glad you've shared your experiences with me. It's important to explore because sexual abuse can continue to have an impact, even in adulthood.'

Acknowledge difficulty of disclosure 'I imagine it is hard to tell me these things. It takes a lot of courage and I respect you for it.'

Reinforce client's control of disclosure process - 'It can be helpful in our work together if you can share your sexual abuse experiences since they may relate to your current concerns. However I don't need any more detail than you feel comfortable disclosing.'

Acknowledge her feelings -  'Sometimes, when people talk about their abuse experiences it brings up very strong feelings. How are you feeling now?'

Assess her well-being - 'Do you feel unsafe or fearful in any aspect of your life?'