BIRTH TRAUMA - Its a Hot Topic & For Good Reason

Trauma is the response to an event which activates the body to enter survival mode. It is subjectively determined.

Trauma envelopes all of our 5 senses and unleashes all emotions - in no typical order or set pattern. It has the ability to hide and approach us without notice. It can be folded into pieces within our nervous system and popped open like a champagne bottle when least expected. And it happens in the birth space.

We are hearing about birth trauma more than ever before, yet we may wonder did it happen to us? Could we possibly say we had/have trauma resulting from our birth experience? Or was it something that just ‘happened’ and now you are expected to glow right on into motherhood? Healthy mother, healthy baby…. right?

I’m speaking from a Childbirth Educator and Birth Doula perspective, and in approx 4 years, I will be able to add RM to my name… but for now, this is a discussion that needs to be had, here and now.

My goal has always been to endorse the power behind natural, physiological birth where possible. Once you are a Childbirth Educator and Doula, you cannot ‘unknow’ what you know about the role of hormones during the labour and birthing phase designed to work in harmony with the process as nature intended. So why are we so afraid of birth? Why does it never go as planned? Why do we even make birth plans? Who do we trust and why?

I want all mothers-to-be to have the right to be informed about EVERYTHING. How your birth can go so straight-forward at home as you wished, OR, how one simple thing made your birth centre birth plan no longer. But lets start with FEAR.

FEAR is ONE fo the biggest reason doulas are called upon. That unwavering support we provide that reminds you that every sensation you are feeling, the intensity and the pressure that envelops you is bringing your baby one step closer to you. That the pain is nothing to be feared - it is pain with a purpose. Understand the birthing process, welcome the feelings. And when you feel you can’t anymore, you probably could, but perhaps now is a good time for pain-relief? But does that mean you failed yourself? Did you give in? Are you weak? Why was this harder than you thought?

There is a fine line between pain and suffering in the birth space and I have seen it too many times to recall. As a doula, I ask is this a tough moment following a super intense surge (contraction) where she is saying enough! Or, is this something we can work through? At what point do you know in your rational mind that you really are at your limit? At what point when you look back at your birth, did it all become traumatic?

Was it that your labour was fast, surges were back to back without a break and you were left in shock? Were you transferred to hospital after a planned home birth because you were so consumed by the pain? Did you require intervention with Syntocin, or an instrumental delivery? Emergency caesarean section? Medical emergency? Were you stead fast in a ‘no epidural’ in your birth plan, but ended up having one? Did it actually work? Or just on the one side? Were you felt cared for, listened to? Did you feel coerced into making a decision? Were your wishes respected? Was your support person supportive or do you think you required more? Did you tear or suffer an injury? See: The 2021 Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill, will also include a reversal of changes made by the former National government in 2010. It will be introduced to Parliament later this year with the expectation of being passed by mid-2022.

Trauma is about how YOU felt during and after your experience - and it is relevant. All of it is relevant. Physical and/or emotional. If you feel anxious, tearful, upset, angry, irritable, have flashbacks and insomnia, or all of those intertwined, you could well be suffering from birth trauma and it is crucial that you speak up and seek support.

In July 2015, Carla Sargent published her research on Birth Trauma - available at https://www.healingbirth.co.nz/. Carla writes that “The issue of birth trauma appears to be poorly recognised within New Zealand. Consequently, maternity practitioners, primary postnatal care providers and maternity care consumers are at times unaware of the concept of birth trauma, its subjective nature and its potential implications”.

Reasons for not seeking support or seeking help included to busy caring for a newborn, embarrassed, felt it would be not well received, too scared to complain, did not want to hurt LMCs feelings, still in a state of disbelief, to what’s the point as nothing will get done about it, cost, don’t know who to reach out to (counsellor or psychologist), concerned baby might be taken away if they feel they are of unsound mind. Deeply saddening to know this.

So, if you have or feel you have suffered from birth trauma - I encourage you to PLEASE speak up. Even if you feel it’s irrelevant, it isn’t to me, I’m trained to fully support you through the process. Birth Trauma practitioners will listen without judgement, help you to make sense of what happened and why, explain and support you through a complaints process if you wish to go down this path and more. If we feel that you may need support from a medical professional or a referral is required, we will speak to you openly about this.

The more we speak up and the louder we speak up, the more we will be heard.

Excerpts from Birth Trauma in New Zealand, by Carla Sargent (2015) https://www.healingbirth.co.nz/

Did your partner feel traumatised/helpless/distressed by the birth experience? - 68% said yes, 14% said no and 17% said I don’t know

Despite a large number of partners being negatively impacted by the birth experience, just 6% were offered support for dealing with their trauma and 88% said no support was offered.

Poor pain management and/or other physical trauma was sited as a cause of their birth trauma by 42% of respondants. Pain was unbearable, emergency c-sections, physical trauma resulting in multiple surgeries to ‘fix’ things to an experience triggering past abuse.

- 58% fear falling pregnant again

- 50% had depression

- 49% had difficulty breastfeeding, or were unable to

- 45% mistrust of midwives/doctors/the maternity care system

- 44% Difficulty bonding with baby, at least initially

References:

Birth Trauma (2015) Carla Sargent https://www.healingbirth.co.nz/