Birth Trauma

Patterns of communication and unresolved conflict.

Childbirth trauma can be triggered by many factors such as loss of control, loss of dignity, the hostile or difficult attitudes of the people around you, feelings of not being heard or the absence of information or informed consent to medical procedures. Sometimes the birth experience you invisioned doesn’t always go as planned. There may be events leading up to your baby’s birth that you and your partner were not expecting. If you had a difficult or traumatic birth, you’re not alone, and counselling with post traumatic stress therapy can be one way to help you recover emotionally.

What is Birth Trauma?

Birth trauma is a form of Post Traumatic Stress Disorder (PTSD) that occurs after childbirth. A normal reaction to an abnormal experience. PTSD can occur following the experience or witnessing of life-threatening events. Military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape are often recognized as traumatic events. However, a traumatic experience can be any experience involving the threat of death or serious injury to an individual or another person close to them (e.g. their baby). So it is obvious, at least to some professionals, that PTSD can be a consequence of a traumatic birth.

It is important to remember that PTSD is a normal response to an abnormal (traumatic) experience. The re-experiencing of the event with flashbacks accompanied by genuine anxiety and fear may be beyond the your control. They are your mind’s way of trying to make sense of an extremely scary experience and are not a sign individual ‘weakness’ or inability to cope.

Birth Trauma Risk Factors

Risk factors for Birth Trauma include a very complicated mix of objective (e.g. the type of delivery) and subjective (e.g. feelings of loss of control) factors. They include:

Lengthy labour or short and very painful labour
Induction
Poor pain relief
Feelings of loss of control
High levels of medical intervention
Traumatic or emergency deliveries, e.g. emergency caesarean section
Impersonal treatment or problems with the staff attitudes
Not being listened to
Lack of information or explanation
Lack of privacy and dignity
Fear for baby’s safety
Stillbirth
Birth of a damaged baby (a disability resulting from birth trauma)
Baby’s stay in SCBU/NICU
Poor postnatal care
Previous trauma (for example, in childhood, with a previous birth or domestic violence)

It’s important to note that men who witness their partner’s traumatic childbirth experience may also feel traumatized as well and are also encouraged to seek help when needed.

What is different about Postpartum PTSD?

It is, perhaps, difficult to understand how a process as seemingly ‘natural’ as childbirth can be traumatizing but it has been clear for many years that women can suffer extreme psychological distress as a consequence of their childbirth experience for a complex variety of reasons which are frequently related to the nature of delivery. Postpartum Depression and PTSD is different than ‘baby blues’, which typically lasts for a few hours to a few days. Postpartum PTSD lasts much longer and requires treatment. Unfortunately, the difference between the common perception of childbirth and some women’s experience of it means that women who suffer Post Natal PTSD symptoms frequently find themselves very isolated and detached from other mothers. They also find themselves without a voice in a society that fails to understand the complexity of childbirth and expects mothers to get over their birth experience very quickly.

Consequently, women affected by Postnatal PTSD often find that there is nowhere to turn for support because even other mothers, who have not had traumatizing births, can find it hard to understand how affecting a bad birth can be. This can make sufferers lonely and depressed as they often feel they are somehow ‘weaker’ than other women because they are unable to forget their birth experience, despite being told by others to ‘put it behind them’. They may feel incredibly guilty as a result.

This is a terrible burden for women to shoulder and one which profoundly affects their lives. The nature of PTSD means that constant ruminating on the birth experience is beyond the sufferer’s control but this is constantly misunderstood, even by health care professionals. Unfortunately, for women suffering from Postnatal PTSD, their detachment from others and the lack of support provided to them can mean that relationships with friends and family may deteriorate. For example, many women end up feeling torn between their desire for more children and their determination to avoid another pregnancy. They may also lose interest in sex and these problems can place a great strain on relationships.

Worryingly, it is suggested that women may also try and avoid medical treatments like smear tests. For many women, their greatest concern is the day to day difficulties they encounter bonding with their baby who may be viewed as a constant reminder of the trauma they have experienced.

We can tackle this isolation by offering women much needed support and showing them that they are far from alone. By working together and providing women with a voice, we can help change those practices which contribute to Postpartum PTSD.

References

Linder, N., Linder, I., Fridman, E., Kouadio, F., Lubin, D., Merlob, P., … & Melamed, N. (2013). Birth trauma–risk factors and short-term neonatal outcome. The Journal of Maternal-Fetal & Neonatal Medicine, 26(15), 1491-1495.