Guest post by Nicole Pichette

Giving birth is something that a woman will remember for the rest of her life. Some women have positive birthing experiences: they feel supported and feel that their wishes for the birth were heard by their health care professionals. Others, however, have negative birthing experiences, where they may feel isolated, lonely and unsupported. Imagine for a moment what special emotional obstacles a mother might face if she were a survivor of past sexual violence, rape or abuse. Feeling unsupported, isolated and unheard could become much more than a negative experience – it could become a nightmare. Women who have experienced sexualized violence have a special need for respect of their personal space and body; they may require more time for explanation before a procedure is performed and they may need more compassion and understanding from their health care provider than a busy hospital doctor is willing or able to provide. Unfortunately, the reality is often that these needs are nowhere near met: It is common for women to feel that their desires are ignored, that their labours are treated as an inconvenience, and that they are not viewed as independent people but simply as medicalized bodies. So what other birthing options are available that may provide more control in mitigating these negative experiences, particularly for women with past experiences of sexual abuse?

Fortunately, there are many choices for support available to pregnant women today. For example, we have access to midwives: medical professionals who receive specialized training in pregnancy, labour and the delivery of babies. Midwives are trained to recognize potential risks during pregnancy and labour, and can perform a safe delivery at home, at a birth centre, or at the hospital with minimal interventions. Furthermore, midwives are becoming more financially accessible to women across Canada, with some provinces covering the cost of midwifery services in their provincial health plans.

In addition, we have the option of hiring a doula. A doula is an individual who provides support to the mother and her partner (if she has one) before, during and after labour (they typically charge for their services but volunteer doulas do exist; find out more about hiring a doula in BC). She acts as a birth coach, helping the couple understand the stages of labour, what to expect, and what to do when the unexpected arises. Most importantly, the doula provides encouragement and support at every moment. Penny Simkin, an expert in the field of labour and delivery support, states that having continuous doula support has been shown to result in less use of pain medications during labour and a reduction in surgical deliveries, as well as an increase in satisfaction and psychological well-being for the mother. For a woman who has experienced sexualized violence, hiring a doula could be instrumental in creating a supportive, safe environment where the mother can labour without judgment. A doula or midwife may also be more likely than a doctor to provide care that is not rushed, cold or clinical, which can be a rarity in our busy hospitals. For a mother who is a survivor and has expressed discomfort, distrust and embarrassment at the idea of strangers handling her in such an intimate fashion, having a health care professional who is nurturing, experienced and respectful of her needs could be the difference between a terrible birthing experience and an excellent one.

Creating a safe, comfortable place to labour is incredibly important for all women in our culture. In her book The Birth Partner, Simkin stresses that if a mother does not feel supported during labour, her anxiety levels will rise and pain will feel intensified. Labour may then become physically more difficult and demanding for her as she feels tense and uncomfortable. In order to avoid this, a laboring mother should be able to express her values and her hopes for her labour and delivery, and those involved in her labour should strive to meet those needs. The availability of nurturing support-people such as doulas and midwives provide more choices to a mother as she does her best to orchestrate labour that will be remembered as a positive experience. This is especially positive for women facing specific emotional or physical obstacles relating to sexualized violence. For any woman, whether she identifies as a sexual abuse survivor or not, giving birth on her own terms in an environment where she feels supported, comfortable and not judged is an incredibly powerful experience. By approaching birth with feminist values, all of us strive to put women first, allowing them to choose what is best for their personal situation, values and comfort level.