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Survivors of Childhood Sexual Abuse and Midwifery Practice: CSA, Birth and Powerlessness
By: Lis Garratt
Pages: 200
   Soft Cover
Radcliffe  2011

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Description from the publisher:

Many midwives will care for women who are survivors of childhood sexual abuse (CSA), whether these women disclose this or not. Pregnant and birthing women commonly experience their bodies becoming 'public property’, a variety of sometimes intimate medical procedures, and limited choices on where and how care is provided. For CSA survivors, who have suffered loss of ownership over their bodies as children and may experience recurring feelings of powerlessness and loss of control, these factors can combine with impersonal and medicalised settings and practices to deeply traumatic effect.

‘Sexual abuse is all about power, not sex.’ - interviewee

Many midwives also experience powerlessness and loss of control as professionals as a result of these same settings and practices, and those midwives who are themselves CSA survivors bring a particularly acute awareness of this and of the needs of survivor mothers. This unique study sets out to gain a deeper understanding of the needs of these mothers by exploring them alongside the parallel experiences of survivor midwives. It explores the insights and reflections they together bring to midwifery, and the positive results of more collaborative, personal, communicative and ultimately empowering practices for all involved.

The significance of this book is far wider than its immediate subject, for it offers us the opportunity to rethink our professional coping strategies. If we seek to make all our professional relationships ones of equality and opportunities for growth, as would benefit someone who has suffered abuse, then we can all grow and flourish.
from the Foreword by Mavis Kirkham

Table of Contents

bullet Introduction  

bullet What is childhood sexual abuse?  

bullet How the research was conducted: the problems and dilemmas of dealing with such a topic

bullet The interviews  

bullet How the interviewees responded  

bullet The impact of the research on me  

bullet What we already know about the impact of CSA on childbearing  

bullet Postnatal issues  

bullet The impact of caregivers

bullet A life sentence: the effect of CSA on the interviewees’ daily lives  

bullet The uniqueness of trauma resulting from CSA  

bullet Vulnerability: the end result  

bullet The psychological needs of birthing women, post-traumatic stress disorder and traumatic childbirth  
bullet Post-traumatic stress disorder  

bullet Re-enactment? The women’s experiences of giving birth  

bullet Powerlessness  

bullet Betrayal  

bullet Humiliation  

bullet CSA and midwives: the impact on midwives’ practice  

bullet What the midwife-survivors considered to be good practice  

bullet The pressure to conform  

bullet Coping with the inescapable: survivors’ dissociation, ‘professional dissociation’  

bullet ‘Professional dissociation’  

bullet What women want from their maternity carers and why the industrial model cannot deliver  

bullet The disempowerment of midwives  

bullet The separation of midwives and women  

bullet The disempowerment of women  

bullet Institutionalised childbirth and sexual abuse  

bullet Choice and control - the rhetoric  

bullet What is the answer? Conclusions drawn from the women’s positive experiences  

bullet Home birth – a different world  

bullet What can be done?  


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