The whole guilt thread has reminded me of an old story about a WIC Mom I
counseled several years ago, and the hard lessons it taught me.
She had a history of several pregnancies and was a very heavy smoker. (I
recall in the vicinity of three packs a day) She had a history of a
miscarriage, two premature births and an infant death from SIDS. Smoking is
of course a risk factor in all of these things. I asked her if she had been
able to cut down on her smoking this pregnancy, and she looked at me blankly
and said. Why? I was shocked to realize that she was unaware of the risks
smoking had for her unborn child., despite her poor pregnancy outcomes!
I stammered a bit, then as gently as I could explained the risks the unborn
child faced, that smoking was associated with miscarriages, premature births
and SIDS. That it wasn't the only factor, but one she could do something
about. She didn't take the information very well. I recall her saying,
"They told me that I didn't do anything to cause my daughters death"
Now, I know somewhere along the line, someone wanted to spare her guilt from
her child's death from SIDS, and the premature births. But the risky
behavior continued, pregnancy after pregnancy. Now, its possible that the
mother was told, and her guilt kept her from hearing, I will likely never
know. The mother was rough around the edges, a *tough* woman, and she let me
know in no uncertain terms that she was unhappy with my advice. As I recall
her exact words were: "Are you telling me I killed my baby?" in a rather
confrontational tone. I will never forget that, and my response was
something along the line of, no one will probably ever know the answer to
that, but smoking is a risk factor for the baby you are carrying. She got
very angry with me, and left upset. I never saw her again, and heard through
the grapevine that she miscarried that pregnancy as well.
I did a lot of soul searching after that encounter. Certainly I never wanted
to make the mother feel like she caused her infants death. My telling her
the truth caused her pain. Her reaction to me, caused me pain, and I myself
felt guilty for causing her pain. I hated causing her pain. especially after
she had lost a child. I replayed again and again how I could have handled
the situation better.
But somewhere along the line, the mother didn't *get* the message that her
smoking was possibly affecting her babies. Perhaps if she had known the truth
earlier, she could have been spared even greater pain. Perhaps her very
tough lessons might benefit someone else later, perhaps she will tell others,
and others can benefit from her experience. Now that she knows the truth.
So, when one withholds information from a woman to spare her guilt, somewhere
along the line, she may encounter someone brave enough to tell her the truth.
Then you will have a woman given inconsistent information, and left to
flounder on her own wondering about the consequences of her own actions, and
what she could have done differently if she had only *known*. Even worse,
you may have a mother who really doesn't think that her choice has any
consequences. If we don't educate all women (all people in fact), on
breastfeeding, they may never know that there *is* a risk to not
breastfeeding.
I think that most of the time HCP do educate women on the consequences of
their choices. If truth be told, I think that the problem comes because some
HCP providers themselves aren't necessarily sold on the superiority of
breastfeeding for infants. Thus it because *not worth it* to live with the
guilt...of causing another pain explaining the consequences of their own
choices.
Sorry this post is so long, and I hope not too repetitious on the subject.
Sincerely,
June Rychlik, BS, M.Ed.
Lawrence Massachusetts WIC Program
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