the long haul, sexual abuse and childbirth and knowing when to take a step back

For many reasons, I don’t feel comfortable to go into all of the details of the last birth I attended. Suffice it to say, it was tough for all present, but there were some real moments .of beauty and growth over the 31 hour experience. Our client was a quite and friendly woman with a nice and loving partner. Neither I nor my colleague expected the birth to go as it did, but you can not always know.

 During our time with our client, it became clear to me that she must have suffered some kind of sexual abuse possibly as a child. Although she said she did not remember what had happened to her, she only knew that when her legs were open she felt ‘vulnerable’. Over the many hours with her and her husband, he confided in us, that he was not allowed to touch her in love making and that he felt she did not know her own body. Her labour was prolonged and held at 6cm for many hours and vaginal exams were nearly impossible. She spoke to us about feeling deeply afraid she would be torn apart by birth and being terrified that her baby would also be damaged in some unknown way.http://www.gentlebirth.org/archives/abusepaper.html

As each hour passed, we tried many things to aid her in opening and allowing her baby to come through her. We spoke with her and she opened up a bit. We tried homeopathy, which worked well and she opened a bit more. http://www.homeopathyworld.com/birth18.htm We gave massage and opened a door to her allowing her husband to give her loads of loving touch, which was a beautiful thing to see. We gave space, to give them time together to work through their fears and worries. We encouraged her to speak to her baby, alone, and tell it all her worries, to attempt to connect her to her baby and the process she was going through to meet it. We gave acupuncture to aid her dwindling contractions due to exhaustion http://acupuncture.rhizome.net.nz/Book.aspx  . But in the end, time got the better of us all and we took our client to hospital to give birth to her baby. It was a difficult decision, but one I feel was right and best for all involved. Home birth is an amazing and powerful experience for mother, fathers and those who provide care in the home alike. But as health care and birth professionals, we have to know when it is no longer safe to continue at home. Factors that influence this decision are,

1. is this birth deviating from normal?
2. are mother and baby well?
3. is the care givers clinical judgement being effected by tiredness?

Our decision to discontinue this birth at home was based on a yes to all of these questions. The situation was consistently deviating from normality, from the point of view of the mothers emotional and possibly mental state. Although mother and baby were well physically, the exhaustion of the continuing labour would eventually take its toll on both and we (both midwives) had had less than 6 hours sleep(taken an small breaks) within the 31 hours we were attending this birth. Our judgement was becoming clouded by our own exhaustion.

I do not think any home birth midwife likes to call it quits with a client in labour, but at times this must be done. Our client gave birth safely and vaginally, 6 hours after we took her to hospital and she and her baby are well. I feel that although she was unable to do this at home, what she did at home will stay with her forever. The openness she was able to achieve in herself and the intimacy she was able to share with her husband was something she had not been able to do previously. She was also able to experience her own amazing strength, which carried her through that 31 hours and allowed her to face some of her greatest fears. I feel she will be a stronger and happier mother, for the time she spent labouring at home.

http://www.ourbodiesourselves.org/book/excerpt.asp?id=77