Working with Abused Mothers
by
Cynthia Good Mojab, MS, IBCLC, RLC, CATSM
Everyone who works with new mothers--from IBCLCs and lay counselors to
nurses and doctors--needs to be prepared to hear about abuse and needs
to know what to do when they hear about it. Many women have histories of sexual
abuse, physical abuse, rape, and/or domestic violence. This is not a
rare situation. We need to know how to acknowledge what has been
revealed, we need to be able to state the limits of our ability to
respond to what has been revealed, and we need to be able to refer a
mother to a source of support that is knowledgeable about both mental
health and breastfeeding. Our ability to do this well will never be forgotten. If the health
care provider is not a mental health professional, and depending on a
great deal of context that would vary tremendously from situation to
situation, it might look something like this:
"Thank you for trusting me enough to share this with me. I imagine it
was difficult for you to do so. I'm not an expert in this area, but I
do know that many women have had experiences like yours and have
struggled with infant feeding decisions because of those experiences.
With a chance to talk with someone about what has happened in the past
and what they are feeling now, many mothers have become comfortable
with breastfeeding, and have even found the breastfeeding experience
healing and empowering. And, regardless of whether a mother breastfeeds
directly, expresses her milk and feeds it to her baby, feeds her baby
donor human milk, or formula feeds, talking with someone can help them
move toward healing, which is important to the mother and to her
children. Here's the name and phone number of a counselor (or
psychologist, psychiatrist, or therapist) I know. She specializes in
women's issues like this and has a very good reputation in our
community...."
There's a million ways to say all this, it would get changed with every
verbal and nonverbal response a mother made in the conversation, and
there ought to be a great deal of listening done by the person saying
it. But I hope it gives a general idea. The point is, saying something
like this acknowledges
what the mother has said as well as gives her options she might not
have known she had. It also requires the health care provider to have
tracked down--in advance--a mental health care provider who is
knowledgeable about and supportive of breastfeeding. This may not be
easy to accomplish.
I always address this issue up front whenever I teach pregnant couples
about breastfeeding. I talk about how comfort with breastfeeding is
more than physical--it's also emotional and social, how histories of
abuse can impact breastfeeding, and how support is available to help
mothers work toward healing and become more comfortable with
breastfeeding. I've had women come seek that support after class. It is
very unlikely that they would have done so without my first letting
them know it was all right to do and that they were not alone in
experiencing
these kinds of challenges. The same mothers that are struggling with
infant feeding decisions because of past abuse, are also the ones who
will struggle with mothering. (Although any mother can struggle with
mothering due to the inherent difficulty of the maternal role.) They
are at higher risk of
developing postpartum depression and other mental health challenges.
They need a ray of hope that help is available before they sink into
despair.
©
Cynthia Good Mojab, 2005. All rights reserved. This essay may be
printed
once for individual use.
This
text was first posted on June 28, 2005 to LACTNET, a netlist for
professionals
working in the field of breastfeeding and human lactation. It has been
edited slightly here.
Citation:
Good Mojab, C. Working with Abused Mothers. Ammawell website 2005. Url:
http://home.comcast.net/~ammawell/workingwithabusedmothers.html
Cynthia
Good Mojab, MS clinical psychology, is a private researcher, author,
educator,
and International Board Certified Lactation Consultant (IBCLC). She is
also Certified in Acute Traumatic Stress Management. She
writes
and speaks about issues related to psychology, culture and the
family-particularly
as they relate to breastfeeding. Ms. Good Mojab is Research Associate
in
the Publications Department of La Leche League International, was a
member
of the LLLI Editorial Review Team for The Breastfeeding Answer Book
(3rd
edition), and has been a La Leche League Leader since 1998. Cynthia is
the founder and moderator of LactPsych, an international email
discussion group for professionals whose work addresses the crossroads
of lactation and psychology. She is a
member
of the Ask the Experts panel on Mothering magazine's
website,
answering
questions about breastfeeding, and is an Affiliate of the Alliance for
Transforming the Lives of Children, where she was instrumental in
ensuring the family-friendliness of its annual Summits on bonding and
attachment. Ms.
Good Mojab has taught and guest
lectured for undergraduate psychology and statistics courses, and has
spoken
about breastfeeding, parenting, culture and psychology to groups,
organizations,
and the media. She is an award-winning researcher whose work was
recognized
in 1995 by the American Psychological Foundation. Her website, Ammawell
(http://home.comcast.net/~ammawell), offers breastfeeding and parenting
information and support.
Cynthia
Good Mojab, PO Box 5803, Aloha, OR 97006 USA;
http://home.comcast.net/~ammawell
(website)
|
