What happens when birth doesn’t go to plan? Healing from a difficult birth experience
For all of us the transition to being a mum is a huge life event. For many women their birth experience happens just as they hoped and wished for, but for many women their birth experience is not at all what they expected. Their birth is not what they planned or hoped for and this can leave women starting the journey of being a new mum feeling very vulnerable and distressed.
A difficult or traumatic birth occurs when women find some aspect of their birth traumatic, distressing, and/or fearful. It doesn’t matter what you found difficult, it’s your birth and if something felt fearful, frightening, scary or out of control then that is your story. Never let anyone belittle or dismiss this.
Currently, around 30% of all women find some aspect of their birth traumatic, which equates to over 150,000 women per year. That is a lot of women starting the journey to motherhood feeling difficult emotions.
Yet, birth trauma is not well recognised or identified. I want women to be able to find support in discussing their birth because leaving birth trauma untreated in the long term can lead to enduring health issues both for mum and her family such as depression, anxiety, sexual difficulties or finding it hard to bond with your baby.
Trauma at birth encompasses more than life-threatening medical emergencies such an emergency caesarean or a bleed, just as often it can be about the care and language we give to women in labour. Often women tell me it is how they were treated or spoken to that distressed them the most. This might be being ignored or dismissed by staff or feeling unheard or not listened to.
It is often a lack of kindness or care, staff not introducing themselves or not respecting a woman’s wishes during birth, or women feeling coerced during labour to make rapid complex choices whilst they are tired and in pain.
Take for example, Emily who comes into delivery knowing her midwife and having had lots of antenatal discussions about her birth preferences. Emily then has a long painful labour ending in a caesarean birth and a postpartum bleed. She perceives her birth as positive, despite it not being the birth she hoped for. Emily had someone by her side throughout explaining to her what was happening, reassuring her, allowing her to raise concerns and fears. This helped in sustaining a sense of control and choice, including for example, immediate skin to skin after birth in theatre.
In a different scenario, Anna comes onto a busy ward to meet a midwife she does not know who is courteous but not especially warm. The midwife keeps leaving the room for long periods of time and Anna is increasingly worried that her labour is progressing quickly and she might deliver on her own. Anna feels out of control and scared. She does not get a chance to ask about pain relief much and by the time she asks for an epidural, which she wanted, she is told it is too late. When the baby is born he is placed on Anna’s chest immediately uncleaned, which she did not want, and when Anna asks the midwife to take the baby and clean him the midwife makes a comment to Anna – “that’s unusual”. Anna transfers to the postnatal ward where everyone comments on how lucky she is to have had such a fast birth, but she doesn’t feel very lucky or happy. She starts to ruminate about what the midwife said, doesn’t sleep all night, feels guilty about not having her son on her chest immediately after birth. Anna has a rapid four-hour vaginal birth with no complications or medical intervention. But she also has trauma from her birth experience.
How do I know if I have had a birth trauma?
With birth trauma we would expect to see a changing mood, fluctuating from sad to angry/irritable to tearful to guilty. This usually occurs alongside constantly rethinking about your birth and feeling that you cannot stop these thoughts. You may be replaying your birth in your dreams, thoughts or see visual flashbacks of moments such as a comment made, a doctors’ face, blood on the floor, or the baby not crying after delivery.
Women often feel unable to relax or feel on edge all the time and may be overprotective of their baby or check on their baby all the time. Women often find it hard to hear other people’s birth stories or see other pregnant women or small babies. It might be hard to return to your hospital or you may avoid seeing medical professionals.
Sometimes these thoughts and feelings fade over the first few weeks after baby is born. If they don’t and they are still there most days for a good portion of the day at three, four, five months postnatal and/or are affecting your day to day life then I would encourage you to seek some support.
What might help?
The key is to try to find someone who you can be courageous enough to talk to and tell your story and to know they are really listening and hearing you. Many women dismiss their feelings or feel guilty talking about their birth experience, please don’t!
It is possible to have a bad birth experience and still be a good mum and love your baby very much and we must allow women the space to process their birth. A healthy baby is not all that matters.
Often women are never asked about their birth story and so these traumatic feelings and emotions remain. I have met women in their 70s who have told me about their birth trauma for the first time.
Commonly, I encounter a woman in a second pregnancy with undiagnosed post-traumatic stress disorder for years as result of her first birth. It is not uncommon for women to never have another child because their birth experience was so traumatic.
Who you speak too depends on you, who do you feel comfortable with? This might be your partner, friend, a midwife, your health visitor or your general practitioner.
If this is too overwhelming sometimes writing it down in a blog or using a journal can help.
Online forums can be very helpful as it allows us to speak anonymously, this might be via twitter or a peer group forum. There are some great birth trauma campaigners on Instagram, see @mumologist and her campaign https://www.makebirthbetter.org
Various other factors can help birth trauma such as:
- Diet, try and eat on a regular basis, plant-heavy meals. Ask friends to cook for you or buy you’re a meal subscription plan rather than baby clothes!
- Regular exercise is a huge help. It doesn’t need money or equipment. We can all walk around the block with our baby. Or try a free 5-10-minute session from an online resource such as fitnessblender.com. If you like walking look at http://mentalhealthmates.co.uk/walks/ which is countrywide.
- Trying to get sleep (no mean feat with a newborn I know) if you can’t sleep at least lie-down and try to physically rest.
- Social support, who nourishes you? Who makes you feel listened to and heard? Or makes you laugh? Seek out these people.
- If you have friends and family locally great. Let them help you!
- If you don’t have friends or family close it can feel so so lonely as a new mum and mother and baby groups are not for everyone. There are some great apps to link in with local mums, look at Mush and Peanut. In London look at the amazing https://www.takesavillage.co.uk in South London or in North London https://www.mumologist.com/the-village/ Meditation/Breathing can really help, it takes practice, but you can do 2-5 minutes a day at night and over time it will help. You need to commit to it, but it can quickly become a powerful daily routine for you. Free apps include Headspace and Calm.
- Psychological or physical therapy. Face to face individual therapy is the NICE guideline treatment of choice for Post-Traumatic Stress Disorder after birth trauma, your GP can refer you or in many areas, you can self-refer, try putting IAPT into Google for your area.
Personally, I think after a difficult birth we could all benefit from reconnecting with our body, we often blame our bodies for failing us, dislike our body after birth or feel disconnected from our body. We may also have had perineal injuries or be left with pelvic floor issues such as incontinence. Anya Hayes blogs about this beautifully http://www.selfishmother.com/author/anyajoeli/
Yoga and Pilates can really help with settling back into our postpartum body or having a massage or a lovely technique called closing the bones https://www.closingthebonesmassage.com/about/ Medication. For some women prescribed medication is what they want and/or need, see your GP to discuss this. Many women take medication in the postnatal period so please don’t be ashamed about this or worried to ask for medication.
Herbal supplements I like to recommend that can also help are oral Magnesium or as Epsom Salts in the bath, all safe in breastfeeding. You can buy these from any good health food stores. You could also try Lavender capsules to help sleep and anxiety or Bach Flower Remedies such as Rescue Remedy.
Most women feel significantly better within 12-18 months with the right care. The key is to find what works for you, there is no right or wrong. So, for one woman this might be a course of NHS trauma-focused therapy coupled with a Magnesium supplement for another it might be using a daily meditation app at home and a weekly yoga class alongside eating really well and good support from friends and family.
It can seem never-ending and terrifying to be traumatised by birth, but you will get better, it can take time, but you will. Please reach out and try and tell someone how you feel, that can feel so scary to do but is often such a relief to finally be able to share our feelings about our birth experience with someone.
Birth Trauma Resources
Annual Birth Trauma Conference run by myself in East London each December, free, book via myself, next one 9th January 2019.
PTSD piece by myself below,
How to heal a Bad Birth Brujin and Gould
A Guide for You, Your Friends and Family to Coping with Post-Traumatic Stress Disorder Following Birth by Kim Thomas
Fine (Not Fine): Perspectives and Experiences of Postnatal Depression by Bridget Hargreave
Moods in Motion: A colouring and healing book for postpartum moms by Karen Kleiman, for some women art can really help birth trauma and this is a lovely colouring book that can help anxiety, promote mindfulness.
Mumologist, clinical psychologist, feminist, birth trauma expert Suzy Reading, lovely feed on self-care
Mothers Wellness Toolkit, all things motherhood and especially Pelvic care/Pilates
Wild Fig Nutrition, postnatal nutrition
When the Bough Breaks, all things maternal mental health, US based
The Sex Doctor, sex and sexuality including sex after birth
Contributor: Dr Rebecca Moore is a perinatal psychiatrist working in London, with experience spanning over twenty years.
Her role incorporates working with and supporting women who have new onset or pre-existing emotional issues through pregnancy and up to a year after birth in the NHS and privately. This includes infertility, pregnancy loss, anxiety, depression, OCD and trauma.
She is passionate about her job and has developed a particular interest in birth trauma.
Rebecca is also training to be an integrative practitioner and sees exercise, diet, movement and meditation and stress management as key parts of her treatment approach. She likes women to lead and own their care and works collaboratively with each woman to develop a bespoke plan for them.