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Dear Ms. Rosenthal,
Solace for Mothers, Inc. (www.solaceformothers.org) is a non-profit organization designed to support women traumatized by their childbearing experiences. In only one year since its formation, more than 550 women have joined the Solace for Mothers internet forum to support each other in recovering from trauma and stress related to childbirth.
The vast majority of the stories posted to our forum describe not emergency situations, as might be guessed but, rather, violent abuses suffered at the hands of health care providers. These events are taking place in American hospitals, both to privately- and publicly-insured women. Women are discussing care that feels to them more like rape: being coerced and lied to, and information being withheld about what is to occur next. Women are being held down, forced into surgeries, and cut into without their consent. They are experiencing actual verbal abuse from providers, and feeling tremendously dehumanized as a result. We want to stress that this is not part of the natural birthing process nor an extreme emergency. These experiences are sourced in procedures and routine practices that are now presented to the woman as a mandate. Women’s cries of “No!” “Don’t!” and “Stop!” go unheeded.
Researchers and women on our forum have identified a lack of informed consent and the ability to choose or refuse maternity interventions as a major risk factor in developing traumatic stress symptoms after childbirth. We are writing to ask you to seriously and thoroughly investigate this form of violence against women. We anticipate that the results of this investigation will then lead to adjustments in existing public health policies and the enforcement of patients’ rights laws.We are attaching a bibliography for your convenience. The documented outcomes of PTSD and traumatic stress following childbirth include difficulty bonding, cessation of breastfeeding, and tremendous challenges adjusting to motherhood - even suicidality. Negative effects on relationships with partners and others, clinically diagnosable anxiety disorders and depression that interferes with daily functioning are astoundingly common. While much interest has been given of late to the significant problem of “postpartum depression,” which affects 10-20% of birthing mothers, little light has been shined upon the more ubiquitous issue of trauma following childbirth. Remarkably, credible research indicates that trauma is more than twice as likely as depression in the perinatal period, affecting 25-33% of women whose births were marked as “normal” on their medical records.
Ironically, many of the practices we describe are being performed in an attempt by providers to protect themselves from possible litigation. This is not mere speculation on our part; as you will see, the same assertion is rife in the professional literature. Remarkably, however, women most often find themselves unable to take legal recourse, even when a lack of informed consent and refusal leads to PTSD. Lawyers simply will not take these cases, because there is a dearth of precedent-setting outcomes to support the expectation of a successful suit. Further, peer review by health care providers is insufficient and ineffective as a monitoring and deterring device. As in any other violent situation, poor women, uneducated women, and those most impacted with traumatic stress are least likely to successfully advocate for their own rights. We believe that policy at the federal level would help to right these inequities.
We trust you will agree that no matter what healthcare reform looks like, it is imperative that the rights of birthing women to informed consent and refusal be honored. Mechanisms must be made available to hold accountable healthcare providers who violate women’s rights.Sincerely,Solace for Mothers, Inc.
621 East Campbell Avenue
Suite 14
Campbell, CA 95008
Bibliography
Ayers, S. (2007). Thoughts and emotions during traumatic birth: A qualitative study. Birth 34(3): 253-63.
Beck, C. (2004). Birth trauma: In the eye of the beholder. Nursing Research January/February 53(1): 28-35.
Beck, C. (2004). Post-traumatic stress disorder: The aftermath. Nursing Research 53(4): 216-24.
Beck, C. (2006). Pentadic cartography: Mapping birth trauma narratives. Qual Health Res 16(4): 453-66.
Davies, J., Slade, P., Wright, I., Stewart, P. (2008). Posttraumatic stress symptoms following childbirth and mothers’ perceptions of their infants. Infant Mental Health Journal 29(6): 537–54.Maggioni, C., Margola, D., Filippi, F. (2006). PTSD, risk factors, and expectations among women having a baby: A two-wave longitudinal study. Journal of Psychosomatic Obstetrics & Gynecology 27(2): 81–90.
Olde, E., van der Hart, O., Kleber, R., van Son, M. (2006). Posttraumatic stress following childbirth: A review. Clinical Psychology Review 26: 1–16.
Olde, E., Kleber, R., van der Hart, O., Pop, V. (2006). Childbirth and posttraumatic stress responses a validation study of the Dutch Impact of Event Scale – Revised. European Journal of Psychological Assessment 22(4): 259–267.
Swahnberg, K., Schei, B., Hilden, M., Halmesmaki, E., Sidenius, K., Steingrimsdottir, T., & Wijma, B. (2007). Patients’ experiences of abuse in health care: A Nordic study on prevalence and associated factors in gynecologic patients. Acta Obstetricia et Gynecologica 86: 349-56.
Swahnberg, K., Thapar-Bjorkert, S. & Bertero, C. (2007). Nullified: Women’s perceptions of being abused in health care. Journal of Psychosomatic Obstetrics & Gynecology 28(3): 161–167.
Thomson, G., Downe, S. (2008). Journal of Psychosomatic Obstetrics & Gynecology, Volume 29(4) 2008: 268 – 273.