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Birth Trauma - Written by Jessica Pritchard
What is Birth Trauma? Wikipedea simply states: the physical or psychological trauma of childbirth.
A little inadequate I think.
When talking to my sister and mentioning the term “birth trauma” her response was - that’s just birth. To many, many women this is the case. Birth automatically equals Trauma.
If you look at the way birth is portrayed - on TV, in movies - its all the same. Women being rushed into emergency screaming, puffing, panting as though this is the worst thing in the world that could ever have happened to them. Its no wonder that birth is approached with such fear.
Through our ante-natal care we are reassured that we are in fact in the safest space available for birth (hospital). The days of loosing women and babies to birth are long gone and we are sold the collective lie that Obstetricians and hospitals are the saviours of birth. We are told to write out birth plans, to look into what sort of birth we want and encourage to talk to our care providers about it.
Recent surveys, and our own experiences, tell us that most of us want a drug-free spontaneous, physiological birth and yet we continue to go to the last places on earth this is likely to happen. ( Fraser, J. (2004) Stepping Outside the System to Birth - Embracing Woman’s Power and Rejecting Obstetric Control.)
Why?
Because we have been programmed to accept other people making our decisions for us, and desensitised to the violence that occurs during childbirth. From a very early age we are taught not to trust ourselves and are socialised to believe our bodies are defective and probably dangerous to the babies we birth.
We are so scared of birth, which is based on the lie that birth is innately dangerous and a woman is unable to do it without medical assistance. We are also conditioned to believe that hospitals are safe and appropriate places to birth and even when they brutalise us, many of us go back without knowing there is an alternative. (Fraser, J. (2004) Stepping Outside the System to Birth - Embracing Woman’s Power and Rejecting Obstetric Control.)
We place our bodies, our babies, our trust in these systems, in these people who are, after all, much better trained than we are. We are told that we can get the birth we want in hospital, as long as we go in prepared. THIS IS A LIE.
When this trust is violated, trauma occurs.
There was a recent Australian study that involved nine hundred and thirty three women. The results revealed that 45.5% of women experienced a traumatic birth and that 1.2% had PTSD at 4 to 6 weeks postpartum and 3.1% had PTSD at 3 and 6 months postpartum.
Characteristic symptoms of PTSD include flashbacks, avoidance of situations that may trigger memory of the traumatic event, nightmares, sleeplessness, anxiety, psychogenic amnesia, hyper-arousal, hyper-vigilance and intense psychological stress.
Specifically, the study investigated the predictors of perceiving childbirth to be traumatic, the development of PTSD and PTSD symptoms, and PTSD symptom change, and found that some of the most significant predictors include: persistent dissociation, environmental stressors, and peri traumatic affective responses such as the intensity of fear, helplessness, and horror. (Alcorn, K. (2006) Variations Among Women: An Investigation Into the Nature of Birth Trauma.)
HORROR. HELPLESSNESS. FEAR.
These seem to be prevalent emotions in women birthing in hospitals. Why? Maybe its because hospitals are predominately set up for sickness and so when a very normal physiological event occurs (like childbirth) the system automatically treats it as pathological until it can be proven otherwise. The problem with this is if something is looked for hard enough it can often be found.
People have stopped believing in birth. People have stopped believing in women. WOMEN have stopped believing. And that in itself is incredible disempowering.
Birth should be one of the pinnacles of a woman’s life. It is a sacred event that’s purpose is to prove her strength, her courage, her power. It is/should be an amazing, sometimes frightening, all-engaging journey from maiden to mother.
Non of this is acknowledged in our society. Not by Obstetricians, not by midwives and certainly not by other women.
The medicalisation of birth and infant feeding has stripped women of their intense power they have that is so totally different to our male counterparts. This has massive consequences when it comes to a woman’s journey through parenthood.
When you look at the forms that birth trauma takes it is sickening to realise that many, many people accept gross violations of a woman’s body simply because it is done by a care provider during childbirth.
A good friend of mine has just given birth to her first son. She was very well informed, had planned to birth in the local country hospital where the intervention rates were ‘low’ (because their definition of low risk was so narrow and they transferred anyone they thought may run into problems). At 39 weeks she was told she could not birth there and they were transferring her to a major Melbourne hospital. Because she had high blood pressure. The irony is that her blood pressure was still within normal range and that it was in fact her lowest reading in months.
She had a very clear birth plan - delayed cord cutting, skin to skin, no separation, no drugs. As soon as she arrived at the hospital she was confined to the bed with a monitor, the top band measuring contractions, the bottom measuring babies heart rate. After only 2 hours (with intermittent monitoring) all hell broke loose. Babies heart rate had dropped dangerously and a team was called in. The whole time mum knew her baby was fine and couldn’t understand what was going on.
Her vagina was cut and her baby was ripped out of her with a vacuum, cord was cut and baby was whisk over to the resus cart and suctioned. Vitamin K was given. A midwife later found out that the machine used was faulty and the heart rate they had pick up was actually the mothers. 47 minutes later - after extensive stitching she got to cuddle her child for the first time.
Her birth plan wasn’t worth the paper it was written on.
My sister was told that the anaesthetist had been called and was on his way up to prep her for surgery. If she didn’t push her baby out *now* she would be caesered. She ended up with a third degree tear from her anus to her clitoris. And she was thankful to the midwives for protecting her from abdominal surgery.
A friend was labouring beautiful, was feeling a little overwhelmed and so was jabbed with pethidine. Her baby was born 10 minutes later. He was so drugged up that she didn’t see his eyes open for 2 full days. She got a synto injection in her thigh as the baby was being born and ended up with a retained placenta. Massive cord traction, the Obstetrician attempted a manual removal with no drugs. 3 separate people “had a go”. She was then taken to surgery while her mother gave the baby a bottle. She has never bonded with him and has been diagnosed with PND.
A friend of mine was having a pph and the registrar decided a manual retrieval of her placenta was in order. Her husband was removed from the room because he was telling the reg. to stop what he was doing. What a shame the registrar never thought to look in the stainless bowl on the trolley next to him, which contained her full intact placenta.
Many, many women are labelled failure to progress and their labours augmented with Syntocinon. The Syntocinon causes contractions to become harder and faster than is natural, causing distress for the mother. She usually ends up with an epidural ( which is standard policy in some hospitals). Many babies get distressed from the contractions and are then ripped out with forceps or the ventrose. Many babies get cut out.
One woman’s account of her birth: When I woke the next day I was weak and sore. I turned over to see a tiny baby staring straight at me. My experience left me disconnected from her. [...]
I had terrible dreams, flashbacks and body memories from the birth ...with so many people involved, and such damage, I feel like I was pack raped with a sharp instrument. (Cross, J. (2008) Post Traumatic Stress Disorder in the Postnatal Period: Causes, Context Treatment and Prevention.)
Stories like these are not rare. Its not like I’ve had to sift through everything I hear, trying to find the bad birth stories. These are the closest women to me in my life.
And all of this is unnecessary trauma.
When a woman is belittled, infantilised or condescended to during one of the most important times of her life - that is traumatic.
When a woman is saying, yelling or screaming NO and no one is listening - that is traumatic.
When a procedure is carried out on a woman’s body without her consent or with clearly coerced consent - that is traumatic.
Birth trauma is real, it exists and it impacts on everything we do.
So why does birth trauma generally go unnoticed, ignored and avoided? Why do people find it so hard to believe that women suffer from ptsd?
Its complicated. Women are placated and manipulated with phrases like “healthy baby”, and “healthy mother”. Healthy is a term I would use loosely as it seems to apply to any baby or mother that’s not dead.
Many women truly believe they are lucky and their feelings towards the perpetrators of their trauma are confused and distorted.
On the one hand you have feelings of having been violated, abused and unheard.
On the other women can have feelings of gratitude - these people saved their lives and the life of their baby.
Just because the perpetrator uses gloves doesn’t make it any less abusive.
I believe the figures in the Australian study of PSTD would be much higher if we took out the mitigating and often complicated responses that are generally accepted. Many women are misdiagnosed with PND.
A diagnoses of PND is much easier to manage, it places responsibility squarely on the woman’s defective body. To make the PTSD diagnosis would involve revealing just how damaging our current maternity system is.
PTSD is defined as being caused by events that most people would find distressing; events that are outside normal human experience such as violence, rape, war, natural disasters.
And I guess this is why the initial claim of the PTSD diagnosis to symptoms women experience following birth was controversial, because birth is not outside of normal experience.
However, many of the procedures women endure through the medical system of childbirth can be interpreted as violence that is distressing and in no way “normal” and it has been noted that women experiencing post partum PTSD seem to have more in common with victims of torture rather than natural disasters. (Cross, J. (2008) Post Traumatic Stress Disorder in the Postnatal Period: Causes, Context Treatment and Prevention.)
There are also some cover-up symptoms associated with PTSD which could explain some of the misdiagnosis of PND because the longer the person has suffered from untreated PTSD, and the more severe the trauma, the more likely the PTSD will be hidden by one or more of these or other cover-up symptoms.
Alcohol and drug abuse
Eating disorders: bulimia nervosa, anorexia nervosa, compulsive eating
Compulsive gambling or compulsive spending
Psychosomatic problems
Homicidal, suicidal or self-mutilating behaviour
Phobias
Panic disorders
Depression or depressive symptoms
Dissociation symptoms
Fainting spells (Fraser, J. (2004) Birth and Post Traumatic Stress Disorder)
In depth de-briefing and counselling are routine for any type of major surgery except a caesarean section. Doctors, midwives, women, people seem to focus on the “healthy” baby and “healthy” mother (and I use this term loosely as it seems to apply to anything that’s not dead). This response creates a lot of confusion for the women who have gone through these traumatic experiences because the trauma itself is not acknowledged.
At the end of the day trauma is subjective and what was traumatic to some women may not be experienced that way for others. Comparing one woman’s trauma with another’s is not helpful and can be really detrimental.
So how do we move on from our traumatic births?
There are quite a few ways we can start healing and processing our trauma. Joining a support group (or starting your own) is a great place to be able to safely talk through the things that have happened to you with a bunch of people who understand and have similar feelings.
You can also get a medical debriefing from your care provider. Talking through things with the midwife or doctor if you had one can be a good way of working out exactly what happened and why it happened, getting your medical records can also be beneficial in filling in some of the gaps.
Writing out your birth story can also be a healing experience. Working through all the tough bits, having to really concentrate on each bit of your story can help get it out of your heart and your mind.
Be gentle with yourself. When you know better, you do better. There is no point beating yourself up over things that may have been out of your control at the time. Maybe use your feelings to work out what you would change for any subsequent births.
Read books and articles about birth trauma. And join Joyous Birth, which has an enormous amount of information on Birth Trauma, PTSD and healing.
Birth is dying and it is reflected in what is happening in our world today. We live in a world that places more value on stacking supermarket shelves than on raising children. Where millions of dollars are spent on institutionalising babies and children.
We are living in a disconnected world and it all starts with a disconnected birth.
People ask me why I’m so passionate about birth. I guess it is because I still think the world can be saved, but it is so huge where do you start? I say start at the beginning. With birth. Because you can’t save the world until you save birth.