I use a prenatal technique taught by Penny Simkin in a full day Midwifery
Today conference workshop she did with Phyllis Klaus back in 1996. I
strongly recommend the audio tape of that class [see ordering information
below] because the technique has so dramatically affected each and every
client I work with, survivor or no.
The technique, called "The Triggers Worksheet," is designed to help
survivors of sexual abuse figure out ahead of time what parts of the birth
process may be problematic in terms of flashbacks and other abuse-related
reactions. The doula or midwife will spend about 2-3 hours prenatally doing
the worksheet with her client, but it's time very well spent. I've had
clients with no abuse issues who nevertheless found the worksheet to be
wonderful because it demystified the birth process in a non-scary way.
The basic technique is to go through a list of common birth practices,
interventions, and birth sensations and describe them bluntly with vivid
detail. The client then tells the doula or midwife if she had a strong
reaction, a mild reaction, or no reaction at all. When the list is
finished, they go back and look at all the "reaction" topics and clarify
why they are an issue, then develop strategies for making them more
tolerable/less likely to happen/less scary.
For example, I might say, "In a hospital birth, there's often a lot of
traffic in the room during the pushing stage. There may be a lot of nurses
or family coming in and out. Your bottom will be exposed to the room and
you might not know all the people there." A mom might have a strong
reaction to this and say "I really don't like the idea of being naked in
front of strangers. It's very scary to me to be exposed that way." I would
then use active listening to help her expand on that idea, and arrive at a
couple of ways to limit traffic and exposure. Or she might discover after
thinking about it that it's not so scary after all.
Clients who have not been abused react with a bit of shock to many of the
worksheet topics, but upon looking closer realize they can probably handle
it. We may strategize or write a birth plan for one or two "hot topics,"
but most of the time the best use of the technique is to remove the "fear
of the unknown" issue from the equation. I've seen this worksheet session
dramatically raise the confidence level of my clients, and all of them have
said it was well worth the time. Kudos to Penny for this great technique.
It's a godsend for me as a doula as it makes an enormous difference in how
much I know about specific nitty gritty issues in the client's life as they
relate to birth.
-Jennifer Rosenberg, doula
Save $3.00 on the Midwifery Today conference tape set "Counseling
Techniques for Helping Sexually and Physically Abused Birthing Women,"
Penny Simkin and Phyllis Klaus, teachers. Regular price $26. Email firstname.lastname@example.org or
call 800-743-0974 to order. Mention Code 940. Offer expires April 14, 2000.
Reprinted from Midwifery Today E-News (Vol 2 Issue 11 March 17, 2000)
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