Birth trauma refers to a distressing emotional or physical experience that can occur during childbirth. It is important to note that birth trauma extends beyond the events that occurred during labor and delivery. It also encompasses the feelings and emotions experienced by the mother afterward. Approximately one third of women go through such trauma. It is crucial to recognize that the perception of trauma is subjective and should be defined by the woman who has experienced it.
The Roots of Birth Trauma
1. The experience of traumatic birth is subjective. Each woman’s childbirth experience is unique, and what may be traumatic for one person may not have the same impact on another. Below, I am sharing a few potential events that can act as triggers for birth trauma:
Past traumatic experiences: Similar to how pregnancy can trigger past traumas (read my article about it here), invasive or non-consensual interventions during or after labor can make the birth experience traumatic for us.
2. Complications or emergency situations during birth: Lengthy or intensely painful labor, emergency interventions, inadequate pain relief, and experiencing injury during labor.
3. Poor postnatal care and lack of a healthy support system.
4. Postpartum complications: This includes issues like hemorrhage (excessive bleeding during or after childbirth), tears, or severe physical pain. Additionally, the birth of a baby with a disability resulting from a traumatic birth, the experience of stillbirth, or the need for your baby to stay in neonatal intensive care.
5. Healthcare system dynamics: The current health system often portrays patients as passive recipients, with healthcare practitioners holding the authority. This dynamic not only fosters a sense of control over women, but also perpetuates the acceptance of possible mistreatment.
6. Unnecessary and unwanted medical interventions: For example, undergoing a C-section to speed up the birth when it is unnecessary, or being manipulated into agreeing to certain interventions or procedures.
7. Staff attitudes during and after labor, for example, I have had numerous clients who were not traumatized by the birth itself, but by their hospital stay in the days following childbirth. Unfortunately, some staff members made them feel inadequate and instead of providing support with baby care and breastfeeding, they passed judgment. It’s important to note that this is not the case worldwide. In countries where the practice of “sitting month” is observed (as discussed in this article), women often have a different experience and receive more positive support after giving birth.
8. Lack of communication, such as not explaining what is happening during interventions. This experience of feeling unheard and disrespected by the medical team leaves them feeling unsupported throughout the birthing process. Additionally, there have been instances where women’s wishes were ignored by care providers.
9. Objectification: Some women have reported their childbirth experiences being treated as teaching moments for hospital staff without their consent. Such dehumanizing experiences can exacerbate the trauma associated with childbirth. Personally, I had a similar experience where I was not fully informed about the presence of a learning doctor during my birth. Although I felt protected by my husband and doula, it would have been nice to understand why he was just standing there.
10. Disregard for women’s bodily experiences like ignoring her pain and sending her home, minimizing their beliefs of being in labor or having the urge to push.
11. Expectation-reality gap: When our own, or society’s expectations of how our birth should look like, don’t align with the actual experience. For example, unplanned cesarean sections or the use of forceps, which may be necessary for medical reasons, can evoke feelings of powerlessness and violation.
12. Comparison among mothers regarding birth and the hierarchy of birth: Have you also felt this? I’m curious to know. There can be a subtle comparison among mothers and a hierarchy of birth experiences. Using language like ‘natural’ versus ‘unnatural’ can imply a hierarchy, which I don’t believe in. It’s important to acknowledge the diversity of childbirth experiences.
Am I experiencing birth trauma?
Women experiencing psychological birth trauma may exhibit various symptoms that can significantly impact their well-being. When any trauma overwhelms our nervous system, it manifests itself in experience symptoms of shutting down, such as dissociation, avoidance, numbness, or depression. Or in symptoms of hyperarousal, including increased vigilance and anxiety. Let’s explore some symptoms manifestation related to the traumatic experience of childbirth:
Hyperarousal and/or Reactivity: You may feel constantly on edge, easily startled, or have a heightened sense of vigilance. Difficulties in sleeping, feeling tense, or experiencing angry outbursts can occur. You might find yourself constantly being on guard, anticipating potential threats or danger, and having ruminating thoughts.
Numbness or detachment: You may feel emotionally numb or detached from your surroundings as a way to cope with the traumatic memories. It is not uncommon to avoid anything that reminds you of the traumatic event. This can include discussions about childbirth, medical settings or procedures, or even distancing yourself from friends, family and baby.
Psychological trauma often manifests in physical symptoms as well. You may experience changes in appetite, chronic fatigue, or unexplained health issues that cannot be attributed to a specific medical condition. It’s important to remember that after giving birth, some of these symptoms can be considered normal adjustments to the postpartum period. However, it is crucial to evaluate each person individually to determine if these physical symptoms are related to the trauma.
Flashbacks: You may re-experience the traumatic event through intrusive thoughts, vivid images, or nightmares. Certain triggers, such as visiting the hospital, hearing a baby cry, or even subsequent pregnancies or deliveries, can bring back traumatic memories of your birth experience.
Feelings of guilt, shame, or anger: It is not uncommon for women to experience intense feelings of guilt, shame, or anger related to their childbirth experience. You may blame yourself for not being able to meet certain expectations. It’s important to recognize that feelings of guilt and shame are often present in traumatic experiences. If you are experiencing these emotions, it can be an indication that you may be suffering from birth trauma.
If you find yourself experiencing postpartum depression, anxiety (article), or frequent angry outbursts following childbirth, it could be a sign that you have been through a traumatic birth.
How can we protect a mother from birth trauma?
Birth trauma cannot always be prevented, but there are steps that can be taken to reduce the risk. As you prepare for the birth, it is important to not only focus on the technical aspects but also on emotional preparation.
Take the time to reflect on your expectations and consider how you might feel if they are not met. Explore your feelings regarding possible interventions and discuss these questions with your partner, a friend, or a therapist. Engaging in stress-reducing techniques and creating a birth plan can also help you feel more prepared and empowered.
Creating a safe and supportive environment for yourself during childbirth is important. Remember, you are the most important person in this process. If possible, ensure that your birthing partner is prepared as well, serving as a bridge between you and the medical staff. Your partner can act as your voice and protector, safeguarding your space and advocating for your needs. If you and your partner are unsure or would like additional support, consider hiring a doula. A doula can provide continuous emotional and physical support throughout the birthing experience.
In addition to individual preparation, it is crucial for medical professionals to gain better understanding (and training) regarding an emotional-wellbeing of the mother and how important their role is in preventing birth trauma.
The responsibility lies not only with healthcare providers, but also with society as a whole, as the focus tends to be more on the newborn than the mother’s (mental) health. It is essential to address these systemic issues and work towards a patient-centered approach that prioritizes active participation, effective communication, and respectful treatment within the healthcare setting.
By taking these steps and advocating for yourself, you can help create a more supportive and empowering birthing experience. Remember, you have the right to be heard, respected, and actively involved in the decisions regarding your care.
Birth trauma can have profound effects on women’s emotional well-being after childbirth. Unfortunately, the stigma surrounding birth trauma often leads to underdiagnosis and limited discussion of these experiences. Many women feel uncomfortable sharing their birth trauma, fearing judgment or the perception of being inadequate mothers.
By working with a healthcare professional or therapist who specializes in trauma, you can receive guidance and support in navigating the healing process. Remember, you are not alone in your experiences, and seeking help is a sign of strength.