This blog post was prompted by reading an article recently by Hannah Barnes in the New Statesman on birth trauma. The article can be found here https://www.newstatesman.com/politics/health/2024/04/trauma-ward-childbirth
As a Clinical Psychologist I have treated several women, and indeed men, after the nightmare of a traumatic birth. Having experienced a relatively straightforward birth myself 23 years ago, I would say that most births involve some degree of trauma, the sense of helplessness and being out of control is strong. So, when it goes wrong, the trauma is extreme. Hannah Barnes’ raw personal description of her own birth experience really sums this up in her article in the New Statesman. The pain, the sense of helplessness and the loss of control over your body and your situation is awful enough when it is going well, I can only imagine how it feels when it’s not.
Trauma is typically defined as any overwhelming adverse experience where your usual coping strategies are insufficient to cope, where there is a risk of death or serious injury to yourself or to someone close to you. Childbirth meets these criteria because it is a life threatening situation. Even in this modern age with all the medical advances available to us, women and babies still die and are seriously injured in childbirth. The impact of a traumatic experience can be mitigated by the support of others during or in the aftermath of the event. Even a compassionate bystander can help, simply by reassuring and soothing you.
In Hannah’s account in the New Statesman, it appears that the medical staff were dismissive of her pain and distress. She was made to feel that she was failing at childbirth, and she was denied even basic pain relief or reassurance. This attitude will inevitably have exacerbated her experience of trauma, leaving her with long term post traumatic distress.
Typically after traumatic events people will present with symptoms in 4 key areas:-
Intrusion Symptoms can include intrusive thoughts, memories, feelings and body sensations. These cause significant distress and impair people’s daily functioning.
Avoidance Symptoms can include avoidance of situations, people and places that remind them of the event. This might mean it is difficult to attend clinic appointments which are a direct reminder of the birth experience.
Negative Mood Symptoms can including low mood, anxiety, panic and even suicidal thinking making daily life miserable and sometimes intolerable.
Hyperarousal Symptoms such as poor sleep, agitation, hyper-alertness and jumpiness.
Dealing with a newborn is challenging enough in itself. Learning to care for a completely helpless, vulnerable creature, with no handbook or operating instructions, on minimal sleep is no picnic at the best of times. Doing so whilst suffering with post-traumatic stress symptoms is a really big ask for anyone. Normally after a birth the new mum will be relying on her partner and wider family to offer support. However, when birth has gone badly, the partner is just as likely to be traumatised as the mother herself. Watching helplessly while someone you love is in agony, in a life threatening situation, is of course traumatic too. So, then we have two traumatised people trying to navigate early parenthood and support each other through it. It can be a recipe for relationship breakdown and severely impairs the ability of the new parents to nurture their new baby as well as they would have hoped to do.
What can be done to help?
A debrief appointment with the senior midwife can be a helpful process. These are usually offered when requested in UK hospitals. This gives the parents an opportunity to understand what went wrong, what was done about it and what lessons have been learnt. Also, the hospital’s complaints process can give parents a sense of having addressed their concerns. Having the opportunity to express their concerns and understand what happened can be powerfully healing in itself.
Talking to each other, and to wider friends and family, can help to diffuse the intense emotions and elicit support and practical help during the recovery process. This must be done sensitively though. A response that is dismissing, such as “All women feel like that during birth” is invalidating and unhelpful.
Strategies such as mindful activity, connecting with people who have experienced similar events, getting out in nature, physical exercise (within safe limits for new mums) can all be helpful in managing the symptoms of trauma.
Reading up on self-help for trauma may help traumatised new parents to understand their reactions and emotions and find realistic strategies to manage their post traumatic symptoms.
EMDR therapy can be a very effective therapy for resolving the trauma of a difficult birth, if self-help strategies are not helping. EMDR reconnects you with the memory in a safe way and uses eye movements to help your brain reprocess what has happened and let go of unhelpful emotions and beliefs. You may still feel sad and grieve for the things that have been lost, especially if the baby died or was permanently injured, but you will be more able to get on with day to day things, once hte trauma of the event is processed.
If therapy is not an option right now, my book Coping with Trauma - Surviving and Thriving in the Face of Overwhelming Events provides a very accessible guide to understanding and managing in the aftermath of such an event, whether recently, or in the distant past. It is available here:-
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