Stopped in to visit Lactnet and noticed the discussion on abuse, trauma, and skin to skin....

Yes, mothers who have been abused and mothers who have experienced a traumatic childbirth (and these are not just a few women rarely encountered) may have difficulty with having their baby skin to skin--and even with holding the baby at all. These mothers should be offered referral to and help from mental health care professionals who understand the effects of, treatment for, and recovery from abuse and trauma, the importance and management of breastfeeding, and the importance and how-to's of skin to skin care. Anyone working with new mothers would be more effective if they take some time to identify such mental health care providers in their communities. They can be hard to find, but there are some out there. They can also be created by providing educational opportunities geared toward mental health care providers.

Women can and do find skin-to-skin experiences healing. But this is not something that can be commanded or pushed. Once a mother knows the value of skin to skin *and* has had her negative feelings about it fully accepted, she may be eager to accept help in finding a way to work toward being able to engage in skin-to-skin care. Listening is critical. And asking for permission and explaining what she is about to do/would like to do before doing anything should be *standard* practice for all health care providers, including LCs. Abused and traumatized women do not wear "be especially sensitive to my needs" signs on their foreheads, and their numbers are far greater than many people realize: For example, Belenky et al. in "Women's Ways of Knowing cite this research: 38% of women in schools and colleges had experienced sexual harassment and abuse (1 in 5 women experienced incest) and 65% of women contacted through social service agencies had experienced sexual harassment and abuse (1 in 2 experienced incest). And, here's more research cited in Women's Ways of knowing:  Herman, J. 1981, in a review of five major surveys since 1940 found that between 20 and 35 percent of women reported a childhood sexual encounter with a male family member (father, stepfather, grandfather, uncle, or brother). Because of a "conspiracy of silence" and underreporting, Herman believes that the incidence of childhood sexual abuse must be higher than these figures. Russel, D. 1986 in a representative sample of 930 women: found that 16% of women sexually abused by a relative before the age of eighteen and 4.5% abused by their father before age of eighteen. And these numbers don't address trauma in childbirth. Don't have time right now to look up the full references, but they can be found in Belenky.

I discuss this research in a presentation that I recently created but have been studying for some time: "The Woman Behind the Breasts: Understanding the Context of Infant Feeding Issues." Effectively responding to the context of infant feeding issues is just as critical to lactation consulting as effectively engaging in appropriate breastfeeding management.

Back to getting ready to give that very presentation at a conference in just a few days,
 
nCynthia

--
Cynthia Good Mojab, MS clinical psychology, IBCLC, RLC, CATSM 
Ammawell 
Website: http://home.comcast.net/~ammawell 
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