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Reviewed for AIMS by Kicki Hansard
Published in 2004
So many light bulbs went off in my head when I first got my hands on this book and it all made so much sense! This book is written for both survivors of childhood sexual abuse (CSA) as well as for those of us who care for them during the childbearing year. Penny and Phyllis are doulas and childbirth educators and Phyllis is also a psychotherapist. The combination of all their knowledge as well as their experience of working with CSA survivors makes this the go-to book for anyone who is a CSA survivor as well as anyone who wants to educate themselves on things to consider when supporting CSA survivors in the childbearing year. Penny and Phyllis are also two of the founders of DONA (Doulas Of North America) and created the very first official training courses for aspiring doulas. It took them 8 years to write this book.
The book is divided into four different parts, each focusing on different areas. In part one we get to read about the long-lasting impact of CSA on the child, the adult and also how this impacts on a woman during pregnancy, labour and birth and in the postnatal period. The authors’ knowledge is interwoven with stories from survivors. This part of the book is very helpful to get an overall idea of possible triggers, how survivors can protect themselves from a traumatic birth experience, as well as all the clinical challenges for survivors and how their caregivers can support and help to ensure a positive experience. Statistically we know that 1 in 4 women are survivors so the chances are great that if you are working in maternity you will definitely be supporting survivors.
The second part of the book is all about communication, with some great examples of how birth workers can ease communication and give the space for survivors to disclose and talk about their abuse. There are even scripts showing how some phrases and word choices could make it more difficult for everyone involved and how to really consider how we talk to women to prevent a break-down in communication. Penny and Phyllis also talk about the power differences between women and caregivers, unhelpful ways of reacting to a woman who discloses as well as practical solutions to ensure the promises caregivers give are kept. There is also a section on self-help methods for survivors to prevent and manage distress during childbearing and suggestions for good communication with the caregivers.
Section three is specifically about clinical challenges and solutions, and here a few other authors have contributed towards the book. A midwife gives a detailed explanation and scripts for supporting survivors through pelvic examinations. We have another midwife who gives suggestions on how to prepare and follow through on a care plan for survivors. Finally, an obstetrician has contributed with a chapter on how to support informed decision making and advocacy. This section is mainly for medically trained caregivers but also gives survivors a really good idea about what practical steps they can take to feel more in control of the care they receive.
In the final part of the book you will find appendices and resources to use in your work as a birth worker or as a survivor. Most of the forms and questionnaires can also be found on-line and they are really useful to have access to and use in your work, especially the trigger form, which will really help you to pin-point areas that might be more difficult for a survivor and then plan how to deal with those situations.
Overall, I would go as far as saying that anyone who works with women during pregnancy, childbirth and in the postnatal period should have this book on their bookshelf. The care and considerations talked about in this book for CSA survivors makes so much sense, and as you read it you will keep coming back to the fact that ALL women should be supported and cared for in the sensitive and kind way this book describes. The book is full of stories from survivors, outlining how the care they received helped them or how some things that happened to them during their maternity experiences traumatised them more.
It’s an easy to read book in terms of how it is written but it is also hard to read at times, when you learn what survivors endure and get an understanding of how the smallest things can make the biggest difference for a woman’s birth experience.
The book might appear a bit pricey but I would say it is worth every penny. It’s the kind of a book that you will keep going back to and as there is nothing else really on the market that comes close to this book, it’s well worth the investment.
Kicki Hansard is a doula, doula course facilitator and AIMS supporter.
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