So much emotional trauma can be prevented even AFTER a woman or client has been physically traumatized during labor or birth. Ideally, you can prevent trauma during birth with compassionate and evidence-based care, but if a woman seeks your assistance and services after she has been traumatized by another provider’s harm or poor care, you can be a trustworthy provider and provide the support she needs.
In addition, one in five women are survivors of rape, according to the National Sexual Violence Resource Center (NSVRC). Obviously, because of the personal nature of sexual assault and rape culture, many instances of rape and sexual assault go un-reported, and unrecognized, sometimes even by the victim. That means a lot of women and a lot of your clients and patients likely have a history of trauma.
But if you don’t have personal experience with trauma, it can be hard to know what to say or do. You might fear saying the “wrong” thing and fall back on old adages, which are often the worst things we could say, since many of them center around covering our uncomfortable feelings.
Here’s a quick guide on what not to say to a previously traumatized person, from a survivor:
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- Anything that sounds like a shrug. Saying, “That’s so common,” or anything like that can make someone feel like they’re just a number and that their humanity and experiences don’t matter.
- Not saying anything in response to her disclosure – either in person, or if she revealed it in paperwork. I’m thinking providers are under the false impression that they will further traumatize women if they engage in a conversation around her abuse, but they are actually being fully dismissive by ignoring any disclosure. For all you know, you might be the first person she felt safest to reveal this to, and not saying anything strongly suggests either you don’t care or that you aren’t listening/haven’t read her chart.
- “I’m sure there was a good reason for…(your c-section, episiotomy, pelvic checks, being yelled at during labor, etc.) or, “You might not have fully understood what was going on,” or, “I’m not sure what their reason was, but physicians always practice with your best interests in mind.” First of all, you know that third one isn’t true. There are providers who commit malpractice. If a former provider harmed her, siding with her provider or openly excusing them or defending them tells her that you don’t believe her and aids in silencing her. And if you don’t believe your patients or clients, are you really working for them? We’re so used to dismissing women’s concerns as overdramatic and overblown. It’s sexist and so ingrained in our culture, particularly medical culture. If you feel defensive about peers who might have harmed her, ask yourself why you are willing to believe them over her. Is it because of the prestige of a medical degree? Classism? Racism? Sexism?
- Deciding that she’s trouble or a difficult patient. This mirrors exactly how we treat rape and sexual assault victims in the rest of society. If you are afraid of a person who discloses that she was harmed by someone else, ask yourself why you are threatened. Is it because you believe “good patients” are never harmed? Or that you believe “good patients” should keep harm done to them private? Or that no patients are ever harmed by providers? Examine what is causing you to respond with victim-blaming.
- “At least…” Truly, if you hear yourself even thinking a sentence that starts with “at least” DON’T SAY IT. It’s the quickest way to dismiss a person. You are not helping her “think positively” or “reframe”. You are transparently brushing her valid feelings of anger or injustice aside.
- Thinking she should be grateful and telling her so, or telling her that she’s “lucky.” (For being alive, for having a healthy baby, for having a live baby.) This has roots in paternalism and sexism; I can’t think of any instance where we might tell a man he got off lucky after a traumatic situation or an assault and to “be grateful.” This language is extremely damaging, because you are essentially telling a woman that all she deserves and can hope for in life is survival, at best – that her feelings, experiences, mental health and happiness don’t matter. This shows a blatant lack of compassion for another human and might shine a light on how you might devalue birthing women, mothers or what you think birthing women do and don’t deserve.
- Believing or saying that she somehow “attracted” or “manifested” her abuse or trauma. I sometimes see this in midwifery and doula circles as a prevailing belief. It’s a dangerous form of victim-blaming that helps you feel in control with the (false) belief that when bad things happen to people or when they are abused, it’s because it’s somehow their fault because they just weren’t focusing on the right things. The world might feel safer if think you can protect yourself from abuse and trauma by positive thinking, but it’s magical thinking, and it’s extremely harmful to tell victims they attracted their abuse and trauma – this is truly one of the most re-traumatizing things you can say. Just as it is not acceptable to tell women that they were raped because they were “wearing the wrong thing” we are also victim-blaming when we tell women they attracted medical abuse and birth and sexual trauma.