Birth Trauma – Why Is Giving Birth Becoming More Traumatic?
A recent story in the media highlights how serious birth trauma is for women and prompts us to ask: Why is this normal and natural event so troubling for so many women?
Every birth is unique. For many women, it’s one of the most profound and powerful experiences they will have in their life.
When supported to view birth as a normal process and to believe in their ability to give birth, most women will look back on the arrival of their baby as a positive one.
But for an increasing number of women, birth is traumatic. So much so, PANDA reports 1 in 3 women view their birth as a traumatic experience.
What is birth trauma?
First, let’s unpack what birth trauma means.
There is physical birth trauma, which relates to injury experienced at birth by either the mother or the baby.
In The Project interview, mum Kelly Hume divulges how an undiagnosed abscess after experiencing a severe tear giving birth caused her years of pain and ill health.
Then there is emotional or psychological trauma. As this is less visible to health professionals, in the past it hasn’t been acknowledged as much as physical birth trauma.
Today, more and more women are coming from their birth experiencing emotional trauma. This is more correctly known as post-traumatic stress disorder or PTSD, something we normally associate with military or refugees.
How does birth cause this extreme stress disorder?
Trauma can happen from what happens during labour and birth and how a woman feels about her experience.
She may witness or experience an event where she believes she or her baby was at risk of injury or death. But trauma can also result from feeling unheard, unsafe or helpless during the experience.
What are the symptoms of birth trauma?
For some women, trauma doesn’t begin to interfere in their lives for weeks even months after the birth. But for many women, immediately after the birth they are numb and feel disconnected from their lives.
The following list of symptoms of birth-related PTSD was complied from the Australian Health Direct website:
- Repetitive memories/flashbacks that intrude into daily life
- Extreme distress when reminded of the trauma
- Avoiding situations, places, people (including partner) that trigger the trauma
- Avoiding talking or thinking about the event
- Being unable to remember the event
- Extreme mood swings, including heightened fight or flight response
- Becoming detached from others
- Poor concentration
- Difficulty sleeping
- Feelings of hopelessness, detachment, numbness
- Anxiety and depression.
What makes a birth traumatic?
The trauma that leads to birth-related PTSD is a very individual experience. Actual physical birth injury can lead to PTSD developing after.
Often a woman is told after birth she needed interventions to give birth safely, even though the interventions led to physical trauma – like forceps or episiotomy.
The story is then her body or baby was ‘wrong’, instead of looking at how she could’ve been better supported in pregnancy and labour to have a positive birth experience.
There are also many factors that increase the risk of a woman experiencing birth-related trauma, such as:
- History of sexual abuse or rape
- Domestic violence
- Migration trauma
- Previous traumatic birth experience.
How does environment make an impact on birth?
Giving birth is one of the most vulnerable states a woman experiences. To birth successfully, her neocortex (thinking brain) needs to quiet down, to allow her primitive brain to take over.
For this to happen, she needs to feel safe, supported and able to travel inwards to let her body do its work.
Mammals are designed to give birth in a way that allows labor to stop when there is a threat nearby. This an evolutionary process that hasn’t disappeared in humans simply because we no longer birth in the wild.
Being on ‘alert’ for possible threats or danger (whether real or imagined) is detrimental to the birth process. A woman’s body makes adrenaline hormones, which interrupt the production of oxytocin, the hormone responsible for contractions.
Our brains still need the sense of safety and privacy to allow our bodies to labour normally and positively.
Today, 98% of women give birth in bright, noisy spaces, filled with strangers and technology in every corner. Hospitals focus on the safety of mother and baby from the medical perspective – but there’s little room for the emotional and environmental support that’s also essential to the experience.
The sort of events that get in the way of a woman feeling safe include:
- Not being prepared for labour being longer and more painful
- Being unable to access the support, tools or environment you need
- Labour and birth not going to plan or being very different from expectations
- Not being aware alternatives or options for care
- Feeling out of control, having no agency in what’s happening
- Lack of information about what is happening, especially if the baby is taken away
- Not being listened to or supported by staff or birth support people
- Previous birth trauma
- You or your baby needing interventions during labour or birth
- Your baby suffering injury or needing medical attention after birth
- Being afraid or very anxious about birth.
It’s very common for women to say their labour and birth was normal. But as time goes on, they’re left with a sense that something was wrong and experience confusing symptoms of trauma.
How does a traumatic birth affect the baby?
Many women who have birth-related PTSD aren’t aware of the impact it has on their transition to motherhood for some time. Breastfeeding and bonding are very entwined processes after birth.
Feeling disconnected or numb can lead to you feeling unsure about your ability to care for your baby. Some mothers with birth-related trauma have problems with breastfeeding, especially if stress or separation has interfered with the immediate bonding period.
They may feel numb and disconnected from their baby, feeling as though the baby isn’t theirs, or not wanting to care for the baby because it embodies the reason they experience trauma.
Some mothers are overwhelmed with a sense of anxiety about their baby’s health. They are hypervigilant, not allowing anyone else to care for the baby and become exhausted, unable to cope with other children or daily life.
This can be viewed as ‘normal’ by many people, especially if she had a difficult birth or interventions such as a c-section.
But it interrupts the normal and very important bonding that takes place in the first months of life. Breastfeeding might be challenging and without support, may not be continued.
How do you heal from birth trauma?
The first step to healing from birth-related trauma is having it recognised and acknowledged.
It’s very difficult for women to access the appropriate support for birth-related PTSD. It’s often seen as an unfortunate part of birth, rather than caused by a birth system that is medically focused.
Be mindful many women are misdiagnosed with postnatal depression (PND) which has a different set of symptoms to postnatal PTSD. If you’re having any problems finding support, there are organisations online that may be able to help, such as PANDA and the Australasian Birth Trauma Association.
Steps towards healing your traumatic birth include:
- Seek help or support as soon as possible. You can recover from birth trauma with the help and support of professionals and your loved ones.
- Process your experience by contacting support organisations or peer to peer support groups. Talking to someone who will validate your feelings about your experience. You may also choose to seek therapy with a counsellor who specialises in birth trauma.
- Find out what you can about your experience, by obtaining your patient records. Seek the support of your doctor or midwife, or an independent support person such as a doula to help you understand the terminology and what happened during your labour. You may also need their support as you unpack the feelings you have about the event. This can also help you to make different choices about any future pregnancies.
- Don’t put pressure on yourself to be the perfect mother and take time to get to know your baby. If you have a postnatal doula, you can enlist their support to promote more bonding such as skin to skin, breastfeeding. Having an experienced person nearby can ease your mind if you feel disconnected and unsure about how to care for your baby.
- Acknowledge that birth is only the first step on your journey of a life-long relationship with your baby. Motherhood isn’t easy for everyone and is something many women grow into. A difficult birth can impact your relationship with your baby, but it doesn’t have to.
What about birth after trauma?
It can be frightening to think about having another baby after a traumatic birth experience. It’s important to remember no two births are the same. Whether you choose to have another baby or not is something only you and your partner can decide.
In the process of healing from the first experience, women may come to understand they don’t want to have more babies. This can have an impact on their relationship with their partner and is something that needs professional support to work through.
Other women might discover what they want to do differently the next time, and this often revolves around choosing different birth places and care providers.
Walking through the previous experience, safely supported by trusted people, can help you to unravel what happened and how you would plan for another birth in a different way to empower yourself.
Nurtured Birth offers both birth and postnatal doula support. To find out more, please visit this page.
We also offer a range of workshops and classes that can help you navigate your choice of care provider and become more informed about birth. Please visit this page for more information about Nurtured Birth’s workshops.