Woman Abuse and the Role of the Doula-Long

[asafepassage]

Hello All!

I was at a fabulous conference here today on London dealing with the issue of infant/child homicides in the context of woman abuse. Key note was Dr. Peter Jaffe, a world consultant on the impact of woman abuse on children, among MANY of his specialties...he resides here in London and heads the Centre for Research and Education on Violence Against women and children...one speaker was Dr. Barbara Lent who raised issues for Family Doctors in working with women who are at risk of being harmed or murdered by their partners. She again raised how doctors are in a unique position...long relationship, continuity of care, relationship of trust etc..to screen and respond to abuse...reminds me of our relationship we have with our clients or atleast what most doulas would pride themselves on...

Although difficult to deal with abuse issues all the time, workshops like these keep me passionate in my quest to have all doulas (because my love and respect of doulas and our work is so profound), to have specific and thourough training on how to work with survivors of abuse...not just childhood sexual abuse survivors, but woman abuse survivors as well. I am always curious as to why as a profession we shy away from this training...and I have been fortunate to have such open and honest conversations with many doulas who have shared with me their fears, apprehensions and personal struggles with the idea of supporting woman abuse survivors. The issue that I constantly challenge my colleagues to face is: YOU ARE WORKING WITH SURVIVORS!
If you are working with women, you are likely working with a survivor 50% of the time...if you are working with teens, aboriginal, disabled, poor, substance using, mental health issues, you are looking at an even greater % of survivors.

We need to challenge ourselves to think abour why we beleive our practice does not include women who may be in abusive situations...what would we do if she disclosed? Not getting the training and not asking will NOT prevent a disclosure from happening if a woman needing your help turns to you. Postpartum is the most risky time in the childbearing year for women and as doulas we are right in the mix of things...

This is long-winded I know...I come from a place of concern...a concern for our clients, their babies and our own physical, emotional and spiritual health if we do not start looking very seriously at our roles as health professionals working with women who may be survivors of abuse and position ourselves with others who are working to end violence against women and children.

With care and compassion,
Jodi

[earthgirl]

I have been to your website, and find it very insightful. I do plan on taking a workshop in the near future. I believe this is an important issue, that is often overlooked. Thank you for bringing much needed attention to it.

[asafepassage]

Thank you for your response and receiving this message in the spirit it was intended to be heard.

P.S. I love your quotes

[syncreo]

Jodi,
You obviously know I think the work you do is very important. I think what you said above is important and worth a discussion. Glad to hear the conference was so great.

[asafepassage]

Shawna you have been such a wonderful source of support for me and I have cherished it (-:

I was invited today to speak at a conference for The National Advocates on the Rights of Pregnant Women in Atlanta to speak to this issue...it was brought to my attention today by an organizer of the conference that a 14 year old, 9 month pregnant woman in the US was recently killed by strangulation, by two men her partner hired to kill her to avoid being charged for statuatory rape. Her name was Chelsea Brooks. Until we get it, we need to hear that the NUMBER ONE CAUSE OF DEATH IN PREGNANT WOMEN IS MURDER...

I think we need to revise couse outlines, issues of abuse and truama need to be included in all types of training we receive, from infant massage, to postpartum services, childbirth education etc....we cover the benefits of breastfeeling in just about every type of prenatal/postpartum/newborn care class in existance, yet what are we doing to ensure that the women we provide education to are safe or have the resources to assess resouces if they choose to? We can inform, educate and provide services to women all we want, if she is not safe....what then are we really doing for her? In our silence we become part of the problem.

And I get it...I really do...I am scared at times, question if I can do this, hear the stories, not cry when I hear a horrible story, I have nightmares...but the reality is pregnant woman are abused---bottom line---and we are a potential HUGE source of support for her, but on the flip side a real liability if we are not aware.

AND I am not saying at all that people need to rush out and get training on how to assess for abuse or respond to it...Lets just begin a discussion, lets talk about our fears, our concerns and our experiences. Given the research, as many as 400 women in the All Doulas members group alone, are survivors--if not more, given that survivors are over-represented in helping professions-this is a tough issue to look at if it has been or currently is our own experience. I really do understand. BUT If we really care about the babies we are witnessing coming into the world, then we need to care for the moms bringing them into it...

My Friday Thoughts...it has been one of those days.
Jodi

[syncreo]

Jodi,
Thanks! and your welcome!
What is your feeling on training in this area? You offer a workshop that is seperate from 'regular' doula training and childbirth ed. cert. but in your ideal world would the cert. trainings include a section on this topic or would an additional training be needed to cert. or do you think we should seek out this additional professional training on our own? What kind of resistance do you see to incorporating this topic into certification requirements?

I agree that we should all have some knowledge in this area if we work with women - especially during such a vulnerable time. Having worked and studied women's issues for years, having even worked in a crisis centre I know I 'missed' seeing the signs of a client who was struggling with her memories of her abuse. It was only after taking your workshop that I realized this and kicked myself for not using the skills and knowledge I had to recognize how often I would come across this situation in my doula work.

Now that I am in the midst of redesigning our childbirth ed. workshop I am thinking about how do we incorporate this into the training? My initial thoughts are to have flyers and resources set out for women to pick up during breaks, having your flyer on our bathroom wall is important, and perhaps mentioning the fact that women often experience abuse while pregnant or in the postpartum period and offer out the local resources of how to get help. Do you think it needs a bigger piece?

I would really love to see this discussion get going and hear what others have to say.

Cheers,
Shawna

[asafepassage]

Shawna said:

"You offer a workshop that is seperate from 'regular' doula training and childbirth ed. cert. but in your ideal world would the cert. trainings include a section on this topic or would an additional training be needed to cert. or do you think we should seek out this additional professional training on our own? What kind of resistance do you see to incorporating this topic into certification requirements?"

I think any of these would be great! Ideally, I would like to see the topic introduced in all the training, with certification requirements for each type including continuing education mandatory in this area before certification is approved, and submission essays on the role of the doula /CBE/PPD in supporting survivors of abuse. I am not even sure how this is possible when it doesn't feel for me like there is general acceptance from "our" community that this issue is a priority. Many people have viewed this thread, but why are people not engaging? I am really interested in exploring this.

DONA has had issues of abuse at their last few conferences, yet this is still not a universal topic in their training, but is left to individual trainer to include it at their will...I think it needs to be a directive, and we need to be demanding this training be recognized as important fromour training/certification organizations.

The process to get continuing education credits awarded by some of our organizations are TOTALLY prohibitive due to time, cost and anti-collaborative regulations, for instance DONA does not approve CE for training happening 6 weeks or 150 miles from any DONA training. That is so limiting for those of us who want to offer CE credits to doulas taking the training as an incentive.

And how can we begin to support women making informed choices and feeling empowered if they come from a place of shame, self-loathing, fear etc...that often comes with abuse. Through our own understanding we can come to see how and why women are found making the choices they do in childbirth, even when they appear to "know better". Until we know more about the issue of trauma and its impacts on childbearing women, our analysis is way too simplistic in how we view the debate on medicated/unmedicated/home/hospital/breatfeeding etc...

Here is a link to a great little booklet on the role of the Childbirth Educator and Woman Abuse...

http://www.beststart.org/resources/a...nce/index.html

it will give you some great ideas about including it in your class. As for posters etc....I have a couple for you and Jill for the clinic from a couple of the conferences I have been to. In our classes we also begin by saying something like:

" We acknowledging that women (and men) respond to the news of pregnancy and birth in very different ways, sometimes with conflicting emotions, worry, anxiety, fear and that sometimes these feelings are related to past issues such as abuse or trauma. We have resources available should you request it" We can also make sure to build in women only activities, and then in this seperate group, discuss issues of abuse in pregnancy and how it often gets worse PP even if the abuse has decreased during the pregnancy. I don't think we need to be extensive, just create an awareness for our clients that this may be an issue, they are not alone and help is available.

I love that we are talking about this Shawna, even though you and I could meet any day to do so right here in London...thank you for engaging with me in this thread!

I would love to hear from others as well.

[syncreo]

Jodi,
Thanks for your response. I will definitely take a look at the handbook - thanks. As far as training goes I think it is slowly happening - trauma and abuse are part of the study guide for the Lamaze cert. and it was brought up in our training and discussed how we would cover it in class. I don't believe it is one of the 'required' topics but hopefully this will change. I think with strong advocacy and more and more of us asking for this to be included there will be change.

As far as why this thread seems to be a discussion b/w you and I - not sure why and it is difficult to speculate. One reason may be that it is a sensitive topic and requires there to be some trust for people to feel safe discussing it. Perhaps as you post more and post in different forums the trust will build and others will start to know that it is ok to talk about this and will share their views.

I believe doulas do care and do want to be informed - just keep talking Jodi :-)

[arlenesro]

As an addition to being a doula, I have been trained and certified as a domestic abuse counsellor, including parent against parent, parent against child, child against paretn, eleder abuse etc. It was one of the most worthwhile traings I have had. I am more alert with my clients in terms of attitudes and feelings. Most towns in NJ have DV counselling teams which is how I got my training.
http://doulasofcentralnewjersey.com

[asafepassage]

I agree Shawna...I think it is an issue we care deelpy about, from my experience with doulas in the workshops, it is more a sense of being overwhelmed with the issue, rather than not caring about the issue, that doulas remain generally silent on the issue of woman abuse in the childbearing year.

I am also wondering if it is from past experiences with dealing with sensitive issues in this format that people are not engaging in this discussion...I know you know who I am so you can trust how we will dialogue together (trust, respect, kindness), but that has NOT been my experience with this topic on other lists...and one of the reasons I "lurked" for a bit before joining All Doulas...if people don't know who you are they may be uncomfortable with "talking" with you???

Cheers!

[ctowndoula]

Quote:

Originally Posted by asafepassage Ideally, I would like to see the topic introduced in all the training, with certification requirements for each type including continuing education mandatory in this area before certification is approved, and submission essays on the role of the doula /CBE/PPD in supporting survivors of abuse.

I think the biggest problem with this is that most of the organizations are run by volunteers and this means a LOT more work for them. There also don't seem to be "standards of care" that are set for this in the doula community. There isn't a core cirruculum that can be EASILY bought or given to doula instructors. I know I cover this but really can't give it the time and energy that it deserves in a two day training. If you had a supplement that I could add to my course that would teach the basics in 15 minutes...I would jump at the chance to add it to my own. Not that I haven't done some homework and tried to really know my stuff here, but you certainly have given this way more time and thought than I have.

Quote:

Originally Posted by asafepassage DONA has had issues of abuse at their last few conferences, yet this is still not a universal topic in their training, but is left to individual trainer to include it at their will...I think it needs to be a directive, and we need to be demanding this training be recognized as important fromour training/certification organizations.

Our local networking group is having a Doula Day conference here in May 2007. This is one of the first topics we decided on having in the line-up. There are those that see the importance. Again, write up a "standard" that most org's can agree to (kinda like Polly's book on birth balls)then hand it out for free or low cost and you might see it more. My

Quote:

Originally Posted by asafepassage The process to get continuing education credits awarded by some of our organizations are TOTALLY prohibitive due to time, cost and anti-collaborative regulations, for instance DONA does not approve CE for training happening 6 weeks or 150 miles from any DONA training. That is so limiting for those of us who want to offer CE credits to doulas taking the training as an incentive.

I had no idea this was the case, but then I am not DONA. Perhaps focus on having an "Advanced Training Option" through certifying orgs? I know that CAPPA has an Adoption and Advanced Comfort Measures trainings. Something like that perhaps, but for Supporting Survivors?

Quote:

Originally Posted by asafepassage And how can we begin to support women making informed choices and feeling empowered if they come from a place of shame, self-loathing, fear etc...that often comes with abuse. Through our own understanding we can come to see how and why women are found making the choices they do in childbirth, even when they appear to "know better". Until we know more about the issue of trauma and its impacts on childbearing women, our analysis is way too simplistic in how we view the debate on medicated/unmedicated/home/hospital/breatfeeding etc...

We all have our own life experience that makes certain topics more important for us then for others. Perhaps this issue needs a "face" or image similar to ICAN. I think your website is a great start for this type of thinking. I am sure it is frustrating, but know that you are making an impact. You are encouraging thought on the topic even if you aren't getting lots of responses.

I have really appreciate you as a resource. Please don't get too discouraged to keep posting these things. I know from being the "adminstrator" of our local networking group that as doulas we tend to be rather creative and passionate, but not TYPICALLY organized in our approaches to change. Doulas can't be community activists b/c we can't afford any press that even hints at something bad. Our image is our business.
I have really enjoyed reading your posts.

[asafepassage]

What a thoughtful response...and I absolutely agree. I am going to look over your response when I have a little more time to answer the post. Thank you for your time and energy!

I want to be really clear as well that I know this issue is important to us as doulas, I have taken the silence not as dis-interest AT ALL, as much as maybe not knowing where to "jump in". I can't wait to see this dialogue continue! We all have wonderful gifts and passions that we bring to the table...I am grateful that I have this to offer other doulas and our clients.

Look forward to hearing more!

Cheers,
Jodi

P.S. I would LOVE to put together a little training module that other trainers could use on issues related to abuse if this is something that people may be interested in. It could be really brief and just include some of the very basics on issues of abuse and then direct participants to other more intense programs. I am in the process of getting some funding and this process is HUGE so when I get some time, I will really look at making this available. What a great suggestion!