QUESTION: I have important privacy
issues surrounding the impending birth of my baby. My own history
involves sexual abuse as a child. I am afraid I will be unable to
relax during labor with strangers from the hospital staff entering
my room. I have met everyone involved in my OB/GYN practice, but can
not control who comes in my hospital room door. What can I do to relax
and have a positive experience?
ANSWER: Sexual abuse by a parent figure
breached your trust in those who should have protected you. It is
your job to be watchful, but you must also be able to let go during
labor. Consider having someone you trust who has had experience with
helping woman through labor assist you in maintaining, if not a "private"
space, at least a "protected" one. Develop an understanding with your
obstetrician about your very personal needs.
You have already met the physicians in your obstetrician's
practice but this does not mean that you have developed trust in them
to help you address your privacy needs. Two mistakes that women often
make in your situation, is to trust blindly or to be trapped in their
own distrust so completely that they are unable to accept help when
it is offered.
Talk with your obstetrician about your vulnerability
during labor. Let them know that you have personal needs that relate
to past abuse. You do not need to go into detail, simply alert your
doctor to your privacy issues. You may also request that he refrain
from writing this history in your chart, simply noting your sensitivity
to your environment. But do not stop there.
Consider hiring a doula to be your eyes and ears in
labor. They can also act as a go-between for softening rough edges
in the environment and filtering interactions with strangers. The
doula is a childbirth professional who may already be familiar with
the hospital staff and the hospital setting. She can introduce herself
to the staff as they appear on the scene and be the voice that speaks
your needs. Most importantly, she can offer you a soothing buffer
which protects you from having to be alert to every change in the
environment and allows you to focus on breathing through contractions
and letting go. A supportive companion, such as a trained childbirth
assistant with whom you can develop rapport has been shown to reduce
labor length and improve postpartum recovery according to medical
research ("The Effects of a Supportive Companion on Labor..."New England
Journal of Medicine, #11, vol. 303).
Although your husband will likely be an important
part of your birthing team, he is not familiar with the intensity
of labor. Because of his lack of experience in the hospital setting
he cannot offer the kind of support that a doula can provide. And
since your spouse will no doubt be taken up with heightened emotional
involvement in the process, he can feel overwhelmed by the responsibility
of a medical situation involving his wife and child.
Finally, after you have addressed your privacy needs
with your doctor and considered the services of a doula, you will
find that preparing yourself is key to your emotional calm during
labor. Make friends with the pain. Whether you use anesthesia during
labor or not, you will still deal with painful contractions beforehand.
You will be less likely to see yourself as a victim of labor pain
if you not only understand the labor process, but take active measures
to cope with it. Work to separate your past abuse from the healthy
pain of labor. You may even find that you come through this experience
with a sense of mastery by meeting labor pain as a healthy force moving
through your body, rather than an assault you must endure. Refer to
my book, "An Easier Childbirth" for specific exercises for dealing
with pain actively, relaxing and working through emotional fears before
labor.
You have already taken the first step by identifying
your needs. And you have traveled far enough down the road of recovery
to develop strength and readiness for motherhood. The next step is
to devote your attention to taking care of yourself, by establishing
a safe and protected atmosphere for giving birth.
