Processing Birth Trauma
Birth can be a traumatic experience – filled with sights and sounds, which if associated with fear, can become locked into our minds. It is of course not birth itself, which is traumatic, but the circumstances in which the baby comes into the world. Birth can be a calm, empowering experience, but many factors which can emerge during labour, including a loss of control and dignity and lack of understanding and consent, can leave women with the opposite impression of their births.
The Birth Trauma Association estimates that in the UK, 20,000 women develop Post Traumatic Stress Disorder (PTSD) as a result of birth trauma each year. A further, 200,000 women may feel traumatised by childbirth and develop some of the symptoms of PTSD. These numbers are particularly high, and yet there remains little understanding of or support for birth traumas.
So what is birth trauma?
The word trauma means a deeply distressing or disturbing experience and psychological trauma is often defined as an event whereby the person subjectively experiences a threat to themselves, in some way. Within labour, some women experience a myriad of medicalised sights and sounds, equipment, difficult requests, procedures and messages. And many develop symptoms of PTSD, which might include distressing recollections of the event, flashbacks, nightmares, emotional numbness, and avoidance of places, people and activities that remind them of the trauma.
I often see women in therapy with post-natal depression or anxiety, who come to see me unsure of why they feel the way they do. I find that when they begin to talk, I’m aware that they have never spoken about their labour or how it’s affected them. And 9 out of 10 times, the birth was traumatic; something the mum is generally not aware of until we start to process it. They are often experiencing flashbacks from the labour, difficulty sleeping, avoidance of memories and pictures of the birth etc., but put this down to lack of sleep, adapting to the new baby and mood issues.
Trauma undoubtedly affects mood, however this is poorly understood. Anxiety is often a tell tale sign of trauma, with physical symptoms such as lack of sleep, or nightmares associated with dips in mood. Shock, confusion, anger, anxiety, guilt, shame, feelings of disconnectedness and urges to withdraw are just a few of the emotional and psychological symptoms. However only when starting to talk about how they feel, do women share their distressing experiences and voice that they had not understood the link between their individual birth and their mood.
So what needs to change?
We need to change the narrative – The story of our birth is often caught in glossy photos, through rose tinted social media updates and birth announcement cards. In fact it often feels like people only want to hear good news. But when a third of births experienced are traumatic we need to start being realistic, and to share our imperfectly perfect, but often very distressing experiences.
We need to listen to others – To speak openly about our experiences (when we can) and to talk about the good, the bad and the ugly. The more we listen to others less than perfect experiences, the more we will fight our inner shame, when our experiences of birth feel difficult.
We need to learn about our births – NHS Birth Reflection services are particularly helpful for women to deconstruct and begin to learn about their birth experience. Often sections are hazy and not clearly remembered, and midwives can help women understand their reactions as well as why decisions were made when they were made. Women reflect on using these services in a positive light, better understanding an important aspect of their life.
We need to get help – Therapy is also helpful in managing symptoms, and processing the birth experience. Prolonged exposure (PE), a form of CBT where we re-experience the traumatic event through remembering it and engaging with rather than avoiding it, can teach us to approach our trauma-related memories, feelings, and situations, decreasing PTSD symptoms and improving mood. Eye Movement Desensitization and Reprocessing (EMDR) is also very helpful in alleviating the distress associated with traumatic memories, altering the way these traumatic memories are stored within the brain and making them easier to manage.
We need to join with others – The power of support groups, and finding a tribe of women can make all the difference. Talking to other women and realizing you are not alone, can be very powerful.
We need to face it with help – It seems like the safest way is to avoid, but avoidance potentiates the symptoms. Gently visiting the memories in a safe place, alongside our midwives, therapists and other professional support services, is key.
We need to be kind – We need to treat ourselves with the kindness we deserve, giving ourselves time and space to process the huge adaptation our bodies and minds have had to make, as well as processing the distressing memories.
Mummas Wellbeing are here to offer advice and signposting, as well as therapeutic services. We offer psychotherapy for birth trauma so do get in touch with us if you would like to explore options. The Birth Trauma Association is another very useful resource, supporting people traumatised by childbirth http://www.birthtraumaassociation.org.uk.
Dr Jo Gee
Mummas Wellbeing - is a specialist mums wellbeing service, in Surrey, UK. We offer Arvigo, hypnobirthing, counselling, psychotherapy, nutritional therapy, massage, mindfulness, osteopathy, physiotherapy, pilates, postnatal doula and reflexology for women through fertility, pregnancy, the postnatal period and parenting.
Tel: 07933 343180