Xenia J. Kozlov
Prevention of violence was declared a top public health priority in Chicago for 2016-2020 years (Dircksen, Prachand, et al., 2016). As a key concept of social justice, public health is a privilege which should be equally accessed to everybody (Beauchamp, 1976). From this point, prevention of violence is one of the main tasks for a socially responsible practitioner, and, in terms of applied psychology, should be addressed in all levels of social living.
Traditionally, children, pregnant women, and mothers with infants are listed among the most vulnerable social groups (Whisner, Adams & WHO, 2002), and the problem is complicated with a range of specific traits of a particular environment of every mother and every child. Thus, child abuse and neglect (CAN) prevention is a direct question of social justice. Studies show that during the pregnancy and at least one year after birth, families, and especially mothers experience an elevated level of stress, which could lead to CAN. During this time, social support, delivered through communities and institutions, is more than necessary – that is why prenatal and postpartum care groups are becoming more and more popular (Risisky, Chan, Zigmont, Asghar, & DeGennaro, 2017).
The “Calming Womb” approach (Cortizo, 2019) seems to be promising while in some aspects controversial.
According to the author, the Calming Womb Family Therapy Model (CWFTM) is a “multi-modal, integrative, early intervention approach to treating mothers and their babies from conception through the first year postnatally” (p. 207). It perceives families as interactive systems, with a high probability of intergenerational transmissions (particularly, trauma) and involves the attachment theory, psychodynamic work, trauma-informed care and Eye Movement Desensitization and Reprocessing (EMDR) technique to address maternal trauma, restore mother-baby bond and supports this dyad in prenatal and perinatal needs. Accepting mother-baby relationship as a part of the social network is a definite plus because it does not pull the mother out of the context of social life and thus prevents isolation which might occur due to special needs of pregnancy and the post-partum period. Participating in groups of support may be healing by the fact of interaction with those who have the same issues and conditions, so this is an advantage as well.
Next, involving all family members in the process of therapy or intervention with keeping the focus on the mother-baby dyad is useful for revising and building relationships which consider one more family member. Especially it may have a positive outcome if started as early as possible because a mother might feel frustrated and lost after she finds out that she is pregnant. Cortizo suggests long lists of potential dangers and challenges which emerge with pregnancy and continue after delivery and adds that for mothers who are in high groups of risk these lists might be much longer (pp. 209-211). Most points from these lists can be fixed through the mother's emotional regulation, family therapy, and group support. The Calming Womb approach focuses primarily on the first condition, suggesting womb baby involvement in the healing process and establishing an emotional bond through different practices, and here is a controversial moment. Cortizo lists "womb baby needs" which should be embodied through "expectant mother practices", in particular, yoga and tai-chi practices, emotional dialogue, mindfulness, meditation, developing "acknowledgment" and "acceptance" feelings even if the child is unwanted or unplanned, and being “a peaceful vehicle” to “serve the baby” (p. 213-214). While emotional regulation, calming practices might be very useful for future mothers, imposing certain feelings and actions, - like feeling love, acceptances, working with nutritionist and breastfeeding consultant, developing tolerance toward others - usually has a fine line between healing practice and traumatic coercion. And "peaceful vehicle" sounds like a dehumanization of a mother. Feeling trapped in different prescriptions, a mother might experience so high stress that all healing benefits will be crossed out. While the author pays a certain attention to gender issues (pp. 216-217), the issue of gender inequality remains unlit, and this is important not only from feministic standpoint but also from the point of CAN prevention goals – inequality and violence are closely interconnected, as it was written above, and the newborn child is the most vulnerable individual in the family.
Concluding, the idea of Calming Womb, as well as the metaphor, seems to be interesting and promising but the model seems to be developed rather to ideal parenting conditions than to families and women who face the wide range of challenges. Though these challenges are listed in the article, further description of the method excludes various mothers' attitudes and emotional states. Keeping in mind the usual patriarchal practice of not taking a woman for a personality, even incorrect language, being used in a scientific article, can become harmful. As a person who is involved in studies on both problems, gender inequality and CAN prevention, I would like to pay certain attention to the analysis of this article to show the involuntary expression of patriarchal view while the goal is really feministic – to support a woman in the most vulnerable condition.
Beauchamp, D. (1976). Public Health as Social Justice. Inquiry, 13(1), 3-14. Retrieved from http://www.jstor.org/stable/29770972
Cortizo, R. (2019). The Calming Womb Family Therapy Model: Bonding Mother and Baby from Pregnancy Forward. Journal of Prenatal and Perinatal Psychology and Health 33(3), 207-220.
Dircksen, J. C., Prachand, N. G., et al. (2016). Healthy Chicago 2.0: Partnering to Improve Health Equity. City of Chicago. Retrieved from https://www.chicago.gov/content/dam/city/depts/cdph/CDPH/HC2.0Plan_3252016.pdf
Risisky, D., Chan, R. L., Zigmont, V. A., Asghar, S. M., DeGennaro, N. (2017). Examining Delivery Method and Infant Feeding Intentions between Women in Traditional and Non-Traditional Prenatal Care. Maternal Child Health Journal, 22. 274–282. DOI 10.1007/s10995-017-2400-2
Wisner, B., Adams, J. (Eds) & World Health Organization. (2002). Environmental health in emergencies and disasters: a practical guide. World Health Organization. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/42561/9241545410_eng.pdf?sequence=1&isAllowed=y