Birth Trauma Part 3

According to Cheryl Tatano Beck, traumatic birth is defined as “an event occurring during the labor and delivery process that involves actual or threatened serious injury or death to the mother  or her infant. The birthing woman experiences intense fear, helplessness, loss of control, and horror” she had later revised that statement to include the woman feeling stripped of her dignity.

What is the cause of women perceiving their birth experience as traumatic? It is the systemic elimination of protective care during the birthing process.

In Beck’s study of 40 women she says that there were four themes that emerged. Theme #1 was to care for the women and treating them as human beings. Theme #2: Lack of Communication.  Theme #3 was safety. Theme #4: The ends will justify the means.

With theme One: #1 women feeling they were objectified, and treated arrogantly and with a lack of empathy. The women were #2 left alone, and abandoned. The #3 birthing mother’s needs were not met by the hospital staff. An example given was of a woman from Puerto Rico who was on all fours, when a nurse brought in 20 students to observe…without her consent.

In theme Two: #1 no one communicated with the woman in labor. They were described as having conversations with one another within earshot but not directly talking with or to the laboring mother. As if she were non-existent.

In the third theme:  the #1 laboring mothers felt that the staff (nurses and doctors) did not adequately deliver safe care. #2 The mothers were not being allowed input into the care being given for their own selves and actually fearing for their own and / or the infant’s life!

In theme Four:  entailed #1 the sense that what was endured and experienced by the mothers was the sense of being “pushed to the background” as everyone around them were celebrating the baby’s healthy birth. These women #2 felt invisible, only the infant mattered.

The experiences mothers have had led to severe post-partum trauma and depression.  Beck, Driscoll, and Watson’s book Traumatic Birth goes into detail about feedback loops [pp. 10-12] that describe the interaction of the mother and child after a traumatic birth, with a listing of the causes and consequences of the cause. Sometimes even breastfeeding is difficult, creating “…intruding flashbacks, disturbing detachments with their infants, feeling violated, enduring physical pain, and insufficient milk supply…” Often the anniversary of a traumatic birth amplifies the feedback loop.

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My own reaction to the shared experiences the women in this book had illustrated the barbarism of western medical professionals, a barbarism that is completely contrary to those principles I listed from the ACOG website in part #2.

The women who tell their story of childbirth weave an astounding sense of personal alienation.  It is no wonder that there is PTSD, depression, self-destructive behaviors, socially isolationistic behaviors and pelvic floor injuries as a result of the improper calloused form of care received. Many of the women feel as though they were raped, yet most had no “history of physical, emotional, and/or sexual abuse” so birth precipitated  a sense of having “the loss of the soul”.

I only touched on a small portion of the book in these three posts. In the next few blogs, I would like to address how we can alter the outcome for women in these circumstances and possibly change childbirth for women.

Issues Part 4

The issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression?

Infant mortality is higher in teen births, birth weights of their babies lower, the possibility of premature birth and the birth defects more common in premature births. Premature birth is higher in this sector of the population, often due to violence during the prenatal period.
The rise in teen birth Indian country is alarming. “46% of Native American mothers are under 20 when they have their first child, compared with 25% of mothers of all other races . The average age for becoming pregnant has become lowered from mid to upper teenage years down to pre-teen groups of 9-12 year old girls!

“Boys and girls who experience sexual dating violence are more likely to initiate sex before age 11 ”. These issues would not have incurred had the elder women counseled and instructed their younger relatives on traditional women’s roles and young men counseled and instructed by elder males, as was traditionally done.

There were two ceremonies that were traditionally done for young girls, that are now rarely found in today’s Lakota Society. The pivotal ceremony for girls was the Isnati ceremony. This ceremony was done at a female’s first menses. The young girl would have had the instruction given by elder women regarding her role in society, especially as to virtuous behaviors, her place within society, pregnancy, and childbearing. women regarding her role in society, especially as to virtuous behaviors, her place within society, pregnancy, and childbearing.

Sexual Objectification of Native Women

Rape and domestic violence in Native populations have been on the rise, but within the teen population is another aspect to be considered: gangs. Gang rapes and gang violence is high among native youth, and the female population is especially vulnerable. Although there is a high risk, in one study it was reported that those who perpetrated dating violence did not use a condom deliberately despite “high risk activity such as sexual infidelity, involving “trains” and multiple sex partners ”.

As well as gang related violence and rape, young girls are also vulnerable to date rape. In 1994, “92% who had sexual intercourse reported as having been forced against their will ”. Women ages 16-24 experience the highest rates of rape and sexual assault. The violence that is inherent in this age group limits the ability of teenage girls to manage their reproductive health and also causes them to be vulnerable to sexually transmitted diseases.

1996, the rate of reported rape among Native women was 3.5 times higher than other races. This is just the reported rapes! Add to this population, those who have been subjected to another type of criminal activity: Sex Trafficking. It has occurred since the colonial era. It is only recently that the United States Government has classified Human Trafficking as a form of slavery.

Most of the Sex Trafficking occurs in areas near First Nation Reserves (Canada), Native American Reservations, and Alaskan Native communities. To understand the particular vulnerability of Native women to Sex Traffickers, you only need to look at the historical perspective. In the United States, the military that oversaw westward expansion ‘targeted native women for sexual assault, sexual mutilation, and slaughter’, as seen in numerous accounts of that time.

Compounding all the aforementioned issues is the accumulated impact of the historical experiences creating a “generational trauma” with increased levels of trauma response and stress that passed from one generation to the next, over several consecutive generations. The generational trauma is thought to be the ‘major contributor’ to the level of ‘poverty, violent victimization, depression, suicide, substance abuse, and child abuse’ in Indian country today. It is also thought to be the reason for generational prostitution and child trafficking in the Native families.

Traffickers exploit the areas in which this population has vulnerability. One method is to portray the sex trade as a quick way to become personally empowered and have financial independence. Another is to target those who are homeless or have been impacted by poverty.

Exploitation is done of those with mental illness, have substance abuse issues, FASD (Fetal Alcohol Spectrum Disorder), and those with who are Two-Spirit (transgender) are deliberately sought due to their vulnerability on the streets from violence, and are offered protection (Pierce and Koepplinger,3).

Next:  Part 5 – Conclusion (and references).

 

Issues Part 3

What are the issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression – Part 3

After years of encroachment upon traditional healing practices, the stage was set for an Eugenics movement. This movement “… in the 20th century began as a means of controlling the perceived increase in ‘degenerate’ population and maintaining or protecting hereditarily ‘fit’ members in society from being overrun by the genetically ‘unfit.’ (Forbes, 2)” or groups that were marginalized, such as Native Americans.

Initially, the population targeted was those with low intelligence and those with physical disabilities. But, soon it expanded to “ a program to implement ‘racial hygiene’ in the United States, eugenics essentially entailed taking the principle of natural selection and enforcing it by employing allegedly ‘scientific’ means (Forbes, 2)” The concern was that the white populace were being degraded by the influx of people with racial differences. The classifications included socio-economic, class, status and race.

…policies founded on eugenic theories (sic) started to emerge, forcing procedural sterilizations and other means of population control upon people believed to be unfit (Forbes, 2-3)”. In the late 60s and through the 70s the target was Native American people. Indian Health Services began a systematic sterilization policy.

Women would go to the I.H.S. hospital, told they needed a cesarean section (for a variety of reasons), anesthetized; and when they awoke, these women found they had been given a hysterectomy, which is what happened to my friend. She stated that she was not informed of the need for a hysterectomy. She had gone to deliver her baby, the doctors examined her and stated that she needed an emergency cesarean section. She awoke, finding that she had her uterus removed. My friend’s experience was not uncommon, “…in 1975 alone, some 25,000 Native American women were permanently sterilized – many after being coerced, misinformed, or threatened .

In 1990, a former nurse at I.H.S. reported that tubal ligations were used on women who did not want the surgical procedure. Birth control also was forced upon unsuspecting females such as Depo-Provera, without informed consent, and prior to the FDA having given its approval (this would include the mentally retarded ).

Health risks of the drug Depo-Provera are high in native populations due to Diabetes, obesity, and cigarette smoking. Many who were forced to have it or Norplant administered were not informed of the risk. A secondary aspect is the cultural issues. Irregular bleeding that is caused by these drugs can prevented participation in traditional spiritual practices.

In my own research of the issues of native women in the child-bearing years I was shocked by the high numbers of cesarean sections done on this sector of women. The rate of C-Sections nation-wide is 32.8%; whereas South Dakota is around 25.3%. But, I.H.S. rates are higher than the state average, last internet search showed it at 34%.

Why is this of concern? The health risks of women in the child-bearing years due to unnecessary surgery being conducted. Childbirth is treated by the modern medical doctors as though the baby a ‘disease’ that needs to be cut-out, rather than a natural biological reproductive process. Had the traditional practices of midwifery had been continued within the native culture, allowed to flourish, there would have been very few cesarean sections necessary in our modern times.

Other Factors Regarding Childbirth in Indian Country

Next below the black woman, the native woman is recorded as 2nd to the highest in infant mortality rates . This is due to living in rural areas with poor access to proper care during pregnancy. “Poverty is an important risk factor for poor health outcomes ”.

Compounding the issues mentioned above are those of teen and pre-teen births. A female who is younger than 18 or 19 years of age are not fully developed, in other words are still growing themselves. Teenagers tend to eat poorly, are more prone to drink alcohol, smoke, and take drugs during pregnancy.

Next: What are the issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression – Part 4

Issues part 1

The issues that affect Lakota Native women during pregnancy and childbirth in regards to:
Racism, Sexism, and Oppression

In this report, I will discuss the diminishment of access to information for native female populations of traditional cultural / spiritual values regarding reproduction, healthy pregnancies, and child-birth. As well as cutting the ties to cultural education for young native females (and males/but not discussed herein) directly addressing gender-related socio-cultural information.
Today young native females in Lakota country find they are alienated from the cultural concepts of reproduction and childbirth practices that once were available from the elder women within their family groups.

The path of traditional information is fractured, if not completely broken in Lakota country. Also access to traditional midwifery is not available in many areas.

Young women find themselves (by necessity) having to deal with doctors and hospitals that are a part of the system of oppression that conquered their people and that had forced assimilation practices upon their elders. They have also heard about Eugenics Policies to eradicate native populations, by means of the sterilization policies enacted in the 70s through Indian Health Services.

Due to historical trauma, these young women find themselves re-living much of post-traumatic effects during the pregnancy time-period and at birth. The trauma affects the decision-making process as well.

Historical Background

Initial contact with European colonists was tenuous at best. The European white settlers had asserted its dominance from the onset of settlement. Through the lens of the European settlers, these indigenous people were inferior, only due to the differences in cultural systems of governance. Almost immediately the settlers asserted dominance and control over tribes in which they had initially contacted. The tribes were left with two choices: to conform or to resist.

The colonists viewed the encountered indigenous people as an inferior / savage group. This view was based upon the fact the tribes were not Christian (hence “savages”) and technologically not as advanced as their own (incoming) settler populations. The lens of the white populace was Eurocentric/ethnocentric due differences in ideological concepts such as the differences in view, regarding ownership of land.

The indigenous people did not cultivate the land in the same manner as the Europeans settlers. The settlers could not understand the concept of joint stewardship of lands by the native populous. In their ethnocentric mental lens white settlers conceived this ideology as a waste of good farming land, and of course their ideals were superior in that the land would produce food. Land to the settler, was a resource a non-movable commodity.

From this mental idea of superiority, the desire for lands in which to cultivate both their crops and cattle, the European settlers began to broker deals with nearby tribes through treaties . If they could not gain the land through a treaty, they forcibly took what they desired.

Next week: Part 2 – The issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression.