I tought I was toooo busy at this end of the semester to answer any of
the stuff on Lactnet, just read it takes long enough... but... Zena's
story about sexual abuse and breastfeeding prompted me to come in...

Dear Zena, I admire your courage in disclosing such personal history
with 2000+Lactnetters. I am sure it does contribute to help us helping
sexually abused women we see anywhere in our practices...

In fact, I do agree with your saying completely. Most of the women I
have seen who had been sexually abused earlier in their lives experience
problems, first with sexual relationships, then during deliveries...
Being a perinatal nurse, teacher, and consultant, I often see women
prenatally, during their labor and delivery, and postnatally at the
hospital and in their homes. Many of those women get complications
during labor and delivery, going directly to cesarean sections if not
assisted correctly by an open-minded nurse..., and even then, since the
hard part is often to deliver vaginally.

I had the great opportunity of working with some women that I have
followed prenatally, then during their labor and delivery, and also
postnatally (that's a privilege of private practice on top of full time
teaching job!). When I know about the abuse before the L+D, I can help
the woman work through visualisation and support and the help of the
husband, and then during the L+D, and postnatally. I also often refer
them to a psychologist. But I realize that I am often the link, the
important person who knows, and who is there all the time during the
many months of the pregnancy, the L+D, and the postnatal experiences.
That is frightening for me but also so rewarding.

But I would also say that generally, for any woman I work with in L+D,
when something is going wrong during the L+B and that I don't know about
the abuse, for example, a very slow labor or labor arrest, I ask the
question more or less directly...(not easy but important when you have
established a good relationship with her). Sometimes it is fear of
tearing, sometimes it is abuse, sometimes it is something else...but
there is always something special, not physical stuff, hindering the
descent of the baby. If we can work out at least a little of this matter
together so that this woman can deliver her baby vaginally, then boy!
the breastfeeding part is soooo easy!

I have also worked with women who only experience difficulty when
putting the baby to the breast; they often have mixed feelings about the
role of the breast and my job is to work with them on this matter.

I think it depends probably on the type of abuse they sufferred, the
reality of the abuse or the feelings still present in mind and body
after the years... I truly believe however that being able to breastfeed
their babies gives these women a lot of empowerment, a boost of
self-confidence in their capabilities of being a good mother and also of
being an 'o.k.' person. Of course, they need extra help and extra
support from their husband, their significative others, and from bf
supporters, but I am convinced we can make a real and long-term
difference in these women's lives, if we just put the effort it
demands...

Sincerely. Louise


Louise Dumas, R.N., M.S.N., PhD
Professor-researcher in Nursing Sciences
University of Quebec in Hull
(Western Quebec where we had our first snow yesterday and it is still on
the ground!)

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