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In social networks, there is a flashmob # nasilie_v_rodah , during which the women are divided into traumatic experiences stay within the walls of Russian maternity hospitals, the humiliation and aggression on the part of doctors and medical personnel. To learn how you can mentally deal with the resulting trauma during delivery, we spoke with Oksana Brezhnev , perinatal psychologist, a specialist of the Center of traditional midwifery.

Oksana Brezhnev
Oksana Brezhnev
Oksana, if a woman after childbirth psychologically difficult trying to talk to someone happened, she often faced with the reaction of the spirit: “Just think, still give birth, and in general, doctors say thank you with a child alive.” Or the woman herself is sure that she did not cope with childbirth, and doctors saved her, and so she has no right to be angry with their aggression, and should feel grateful. How did a deal with the psychological trauma, resulting in childbirth? And is it possible to somehow avoid it?

At any risk of a person, as a rule, there are two reactions: attack, or, conversely, withdrawal, withdrawal. In psychology, this formula is known as the “fight or flight”.

So as a woman in labor is in a very vulnerable state, she is very vulnerable at this time, most likely she will choose an exit strategy in itself. She does not answer, it has no power, no resources to do so.

To avoid this situation, the woman did not feel a sense of hopelessness in the birth, it is important to prepare for childbirth. And not only in terms of health (doctors, tests, surveys), but also psychologically. It is always useful,
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regardless of how it will meet the personnel in process.

As a rule, appear particularly sensitive to aggression and humiliation of people who have already had some traumatic experience (possibly a child). If the trauma occurred and has not been worked out, then the greater the likelihood that the response to the next traumatic event will be even more acute.

Acutely can also react woman is very vulnerable, emotional, impressionable. Or a woman who at the time of birth has gone through some stressful situations: for example, it lacks a good relationship with someone of the most important people, there is no support of loved ones, “tense” situation at home, conflicts with the spouse, and so on. In general, any emotional stress on the stage of pregnancy and especially just before birth may affect the status of women and the reaction in the process. And if she is also faced with aggression on the part of medical staff, then of course it will hurt her even more.

Obviously, during childbirth a woman can be very difficult to respond to the aggression of healthy physicians. The woman did not understand what she wanted to do, she listens to advice or some guidance of doctors, and it is difficult to assess independently whether they are right or wrong, especially if it is her first child.

So again, it makes sense to prepare, if possible, go on courses to choose for themselves the appropriate hospital, doctor or midwife in advance to minimize the risk of such a situation.

If the spouses are willing to leave the partnership, implying the presence of men, it is an extra insurance when the woman next to her husband, the staff tend to behave a little differently.

It also happens that in the early days after the birth a woman hears strict instructions about feeding, diapering, baby sleep. It also plays the role of the level of training, which she already has. For example, a girl passed quality courses of antenatal preparation, communicate with professionals, who believe that trust, proven reading literature, consulted with experts and knows that, for example, water dopaivat child in the first days of life is not necessary. A medical staff provides guidance: drink! In this case, it makes no sense to resist, because resistance will only worsen the situation. Staff will clearly insist on, and the woman will try to prove that it is necessary to do differently. The trade-off here, alas, unlikely. Therefore, nurses heard the recommendations, you can thank them and make their own way. By showing flexibility in this, I do not resist, do not show aggression, but remain in their position, I do as I see fit and take upon myself the responsibility for it.

However, if a woman is the first birth, she may know the theory, but in practice it may not be as she had imagined …

Of course. Therefore, for the prevention of such situations is very important prenatal training, to understand the woman, if she has some kind of early trauma, due to which it will be more susceptible to the ill-treated staff.

Although everything here is purely individual. Someone after such situations can quickly recover, and some even for less hurtful comments in his address will experience stronger.

Oksana, and how to conduct the training yourself? You talked about the choice of hospital, physician, about the joint childbirth – but unfortunately, not everyone has this opportunity. Let’s say a woman can not enter into a contract, to take a husband. It will be on the delivery one. What does she have to do, if she knows about herself that she was vulnerable, sensitive that it can be easily hurt?

Firstly, we must understand that birth – a process is not the easiest, and the woman should prepare for it, and do not expect that all by itself somehow happen. It is important to have a common and a healthy idea of what generations and that there waiting for her. In the absence of the opportunity to visit a woman can learn courses that knowledge from books and Internet sources. Now a lot of literature on the subject: articles, books, webinars and more. But it is very important that it was high-quality literature. Blogs where women simply share personal experiences – not the best option. There you are likely familiar with the subjective experience of the individual woman, who can not be very positive, and thus only increase the level of their own anxiety. It is better to read exactly the literature, which describes the actual processes waiting a woman in travail, and the recommendation that it should be done at some point or another.

After reading them, a woman will understand that the birth – it is work that she really need to make some effort. To the woman did not have false expectations, if she would come to the hospital, and everything will happen by itself. She must be a common, hard look at the situation that awaits her. The appearance of the baby – is a miracle of birth, with whom she comes in contact, but for this she will need to try and do some work. Efforts breath, contractions – all this will have to spend in the process. At birth a woman is important to focus on themselves, on their abilities, to the fact that it helps the child, and he went out to meet her, and the problem of women – to do everything possible to help him. For this it is necessary to be adjusted.

Many women who have experienced violence in labor for a long time can not cope with this trauma. How did survive this negative experience?

I recommend this to meet with a psychologist, because it really helps a specialist to work out traumatic memories and feelings.

But in order to go to a psychologist, a woman needs to gather strength, because it means repeated contact with the situation, which she survived. It is again the same pain, it is the same experience again. And to work with the psychologist will need to once again plunge into it, say. This, of course, is not easy. But this is a necessary step to changes and psychological healing of the trauma.

Self-injury work out harder, as this experience is associated with strong emotions and inner feelings of women. The psychologist also helps maximize gently back to the memories, defuse the situation through these strong emotions. In this paper recovers the ability to trust people, which is impaired in these situations, there is a comprehensive and holistic recovery.

If we talk about self-help, it is important not to remain silent on this subject, because it is the first and most important – is the pronunciation of. In working out the traumatic experience significant stage of mourning. Crying and tears – it is a natural reaction to a traumatic situation. Therefore, if you can not go to a specialist, said this to someone from the family, someone you can trust.

It is important that it was really close to the people with whom there is a good contact. Unfortunately, not all of our favorite and native people know how to properly maintain. They can devalue the experience of women, saying, “Come on, everything is gone, forget it.” And from this “support” the woman will not be exactly the best. Therefore, undesirable that a woman is heard. The specialist will never say those words, it will support the most environmentally friendly. But if this is not possible, then ask the relatives to listen to you and support will be helpful too.

It is also important to take care of yourself. Pay attention to their state, their health, to show respect to his love and care. There are healthy food, do exercises, go for a massage – well all that will effect health, sense of self, his body.

It is important not to withdraw into themselves, not to fall into isolation, not close, and continue to live, go to a meeting, to meet with people. It may happen that a woman begins to avoid contact with the child. It is still worth the most to try to continue to interact with the baby, at least at the household level, but this is a clear signal of the need to meet with a psychologist.

Another recommendation on how to help herself – remain grounded position, paying attention to your breath. If you constantly fail to memories, do grounding exercises and techniques, bringing itself in the “here and now”.

The memories of negative experiences from birth, often exacerbated when a woman coming second childbirth. Is it possible to somehow get rid of the fear of a repetition of the same situation?

When a woman is planning another pregnancy, and the experience of previous birth was traumatic, you should think about it in advance, not on the 38th week before the next delivery. Unfortunately, I come across in my practice situations where women come with a request to prepare for childbirth already for a longer period, and in the process it becomes clear that the experience of the first birth was traumatic.

And here the question arises, what to do in the first place – to work out the experience of previous births, or to focus on the future. It is always individual. Much depends on the woman’s request, its current status and the amount of time that we have.

Come into contact with the first experience is sometimes really necessary. Give it time to realize what was then and what is now still going to be different. The task of the psychologist in this case – to help women to switch to a situation in which it is today, in contact with the baby, who was waiting for her assistance during childbirth, and on the resources that are at her now.

If a woman has no opportunity to go to a psychologist, it makes sense to try on their own to figure out what resources it has to date. And it is always, at least, the awareness that repetition of previous experience, it does not want. And then – that it has already changed, for example, the coming generations are planned as a partner, and the next will be a loved one, whose support for the first time since missing. Or she chose another hospital, a doctor or a midwife, or maybe she prepare additional courses, literature esteemed and so on. It is also very important to adjust to your baby, interact with him together to prepare for the process, knowing that your help (through breathing, posture), it will be very necessary that he is waiting for her, and you are ready to provide it.

Often there is the stress that a woman experiences during labor, leading to a situation where it is necessary to do a cesarean section. Many women then live with the guilt that they have failed: birth, “not themselves.” How to get rid of this guilt?

It makes sense to focus attention is drawn to the fact that for a woman means being a mother. After all, there are women who can not become pregnant and bear a child for various reasons. And if the family in such a situation, for example, takes an adopted child – a man and a woman are still for the baby Mom and Dad, despite the fact that his birth they have not lived together. The fact that she is not lived the birth process as she had expected, does not mean that it does not become a mother! Being a mom – is to give the child what I can give him now the care, love, intimacy.

Of course, for my mother and for the child better if the birth will be natural, but that does not mean that if the birth of a baby for any indications occurred by Caesarean section, it will not become a mother. After all, the kid next to her, they are in contact, and therefore, it is my mother. If a woman sees a caesarean as its “failure” – that she could not, not right – the problem is, as a rule, in the other. Where you can ask questions like: “What would change if she gave birth to” own “? How does this relate to the love of the child and the mother feeling? And whatever she got, if she gave birth? What feeling? And what need in a woman’s life satisfies this feeling? “.

As a rule, are opening their own theme of parent-child relationships and ideas that a woman should be and why. That is some kind of installation does not allow fully enjoy motherhood. Then we have been working with what was manifested.

Returning to the rudeness of doctors and medical staff: In your opinion, why is this happening? Why is it considered acceptable?

The reasons may be different: from professional burnout to personal problems at home.

For every woman childbirth – this is a very important event in her life, and for the medical staff – daily work. And if the doctor or midwife is not able, for whatever reasons, the third consecutive year to go on holiday and relax, to come back and do what he likes with renewed vigor, the chances are that even the most favorite thing eventually ceases to be greatly increased . Plus, working with people is not so easy, especially if these people have a lot of emotion (as in hospitals this is the case). Here, I think, agree with me all whose occupations are related to the need of contact with other people. Therefore, physicians emotional burnout, unfortunately, occur frequently.

Plus, we can not ignore the characteristics of the health system. After over each midwife of every nurse, every doctor is on the chief of that from them too, something needs. Maintain records, submit reports, and so on. It is their work environment, which can also be depressing.

And, of course, there are personal factors, because doctors are people too, and they have at home can also be a problem. And then they come to work, and here also the head physician at the Orientation meeting of morning fell on them, and it is clear that all this affects the condition of the doctor is not the most positive way. It turns out that most need the support of a doctor and emotional recovery, and in fact this is not possible – term delivery! And someone will be able to switch to the aid of a woman in labor, and ignore the fact that it was in the morning at home or in the office of the head, while others, unfortunately, no. And to vent their aggression on the whole giving birth.

Thank you very much, Oksana!

Interview Alain Khmilevskaya

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