Ir­ish women and se­cret preg­nan­cies

Women con­ceal preg­nan­cies for a va­ri­ety of rea­sons, but there is of­ten a his­tory of trauma

The Irish Times - Weekend Review - - NEWS REVIEW - Tanya Sweeney

The baby girl was still­born. Her mother gave birth in a car in Birr, Co Of­faly on March 29th, fol­low­ing a “con­cealed preg­nancy” and pre­sented at Mid­land Re­gional Hos­pi­tal, Tul­lam­ore, af­ter­wards. It was an­nounced this week that a Garda in­ves­ti­ga­tion is un­der way fol­low­ing the dis­cov­ery of the in­fant’s body – which is be­ing treated as a “tragedy”.

Sylvia Mur­phy-Tighe is un­der­stand­ably up­set by such sto­ries. She knows from her work as a mid­wife and mid­wifery lec­turer at the Univer­sity Hos­pi­tal Lim­er­ick that con­cealed preg­nan­cies still oc­cur i n Ire­land– and are more com­mon than most of us think.

As part of her PhD at Trin­ity Col­lege Dublin (su­per­vised by J oan Lalor f r om t he School of Mid­wifery), in 2015 Mur­phy- Tighe car­ried out a study, called “Keep­ing It Se­cret”, of women who had gone through con­cealed preg­nan­cies.

Thirty women ap­proached her. Many wanted to help other women in a sim­i­lar sit­u­a­tion by deep­en­ing the pub­lic’s un­der­stand­ing of their ex­pe­ri­ence. Some had con­cealed mul­ti­ple preg­nan­cies. Two were preg­nant at the time. Of the ba­bies born to the women, six were adopted and five spent time i n fos­ter care. There were seven peri­na­tal deaths.

Their preg­nan­cies oc­curred be­tween the ages of 15 and 35 ( the study’s re­spon­dents were all over 18 by the time of in­ter­view) and the women were of var­i­ous na­tion­al­i­ties in­clud­ing Ir­ish, Pol­ish and Bri­tish. They came from v a r y i ng lev­els of ed­u­ca­tion and had “all sorts of jobs” dur­ing their preg­nan­cies.

“These women de­scribed their fear [of be­ing preg­nant] as paralysing,” Mur­phyTighe says. “It’s not de­nial. They were fear­ful, and that i mpacted their abil­ity to come for­ward [and present a preg­nancy] ear­lier. They felt that if the news got out, there would have been con­se­quences in terms of em­ploy­ment, a part­ner, or a family home.

“Those women never got help, they never told any­one and they grieved that loss. They blamed them­selves, they suf­fered from post-trau­matic stress syn­drome and de­pres­sion, mourn­ing the loss of their baby,” says Mur­phy-Tighe.

One re­spon­dent ban­daged her ab­domen through­out her preg­nancy. An­other admit- ted that when she show­ered, she never looked down, and told her­self that she had a cyst or tu­mour.

Chief a mo n g Mu r - phy-Tighe’s find­ings was that health­care prac­ti­tion­ers “need to do bet­ter in terms of how they reach out to women in early preg­nancy”.

“Health­care pro­fes­sion­als need more of an un­der­stand­ing of the sense of fear these women ex­pe­ri­ence. They need to un­der­stand that these women may be liv­ing with do­mes­tic vi­o­lence. I’ve heard of the most unimag­in­able trau­mas in those in­ter­views: women who were met with a vi­o­lent re­sponse by a part­ner when they told them of the preg­nancy, and coped with all of it in se­cret and in pri­vate.”

Cop­ing re­sponse

Also, she says, “we need a greater psy­cho­log­i­cal un­der­stand­ing in preg­nancy, es­pe­cially around how trauma can af­fect a woman’s cop­ing re­sponse,” she says. Eleven re­spon­dents in the study men­tioned ex­pe­ri­ences of early life trauma, in­clud­ing sex­ual as­sault or abuse. The early trauma had never been dis­closed, so when they found them­selves with an un­ex­pected and of­ten un­wanted preg­nancy they didn’t feel in con­trol of their bod­ies or lives.

A c ul t ur a l nar r a t i v e around moth­ers who ex­pe­ri­ence con­cealed or unas­sisted births has long ex­isted, says Mur­phy-Tighe. They’re seen as young, naive, afraid to tell their par­ents and with­out the means to ac­cess a ter­mi­na­tion or raise a child. Mur­phy- Tighe’s in­ter­vie­wees, how­ever, did not all con­form to these profiles.

“The lit­er­a­ture of­ten talks about women be­ing in de­nial or hav­ing a men­tal health is­sue,” she says.“What I heard from these women, time and time again, is ‘ we’re not bad, we’re not mad, but this has hap­pened in our l i ves’ . They’ve re­counted neg­a­tive ex­pe­ri­ences [with the health­care sys­tem]. One par­tic­i­pant told me that she had never ex­pe­ri­enced such a lack of em­pa­thy in her life.”

The mid­wife and lec­turer would like to see an ef­fort on the part of State agencies, such as the HSE, to up­date cri­sis preg­nancy guide­lines. She would like to see women sign­posted to con­fi­den­tial and non­judg­men­tal ser­vices with pro­fes­sion­als who are trained in trauma- in­formed care, or those who can iden­tify signs of do­mes­tic abuse.

She would also like to see a move away from a psy­chopatho­log­i­cal un­der­stand­ing of con­cealed preg­nancy and an ac­knowl­edg­ment of the mul­ti­ple fac­tors in­volved.

“We need a greater psy­cho­log­i­cal un­der­stand­ing in preg­nancy, es­pe­cially around how trauma can im­pact a woman’s cop­ing re­sponse,” says Mur­phy-Tighe. “Peo­ple tend to think that this is some­thing that doesn’t af­fect that many peo­ple, but that’s not strictly the case.”

Any­one af­fected by these is­sues can ring the Sa­mar­i­tans helpline 24 hours a day on 116 123, or ac­cess the HSE Cri s i s Pr e gnancy Pro­gramme by vi si t i ng cri­sis­preg­

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