Breaking the silence on birth trauma

An estimated 30% of women who give birth are likely to end up on the spectrum of birth trauma - whether they recognise and report it or not. And it isn’t just after extreme cases where the mother or baby was at risk of dying. Birth Trauma Awareness Week is an opportunity to acknowledge and support women who have experienced it. Mum and blogger Sarah shares her story with us.

I had an awful birth experience. But I didn’t die. My baby didn’t die. In fact, she is thriving – the brightest, happiest little ray of sunshine you ever did meet. And, almost two years on, here I am, getting the help I need. We all lived to tell the tale. So why does that tale even need to be told any more?

1. Because birth is not always a positive experience. And being honest about that should not be something that women are made to feel shame or guilt over. Expressing natural feelings of sadness or angry about a difficult birth doesn’t mean that a new mother is ungrateful for a healthy baby, the opportunity for motherhood, or anything else.
2. Because silencing anyone who has lived through trauma is not okay. I was utterly shellshocked by my experience, but I didn’t feel able to talk to anyone about it without downplaying it, because I didn’t want to be ‘too negative’. With a new baby, you are expected to give smiling introductions to eager friends and family. Not be a tearful wreck. I self-silenced on my feelings, because I felt the implicit judgement and silent comparisons of friends, family and strangers when I gave the basic stats and details everyone asks for. “Ooh, it sounds like my birth…” (…but I’m fine so…?). “My labour was much longer/shorter…” (…you’re lucky).”Well at least you have a healthy baby…” (…get over yourself and stop whining). If someone has been in a car crash, or escaped their burning house in the middle of the night, they are received with open ears and arms. We are horrified and want to help. But birth is such a commonplace event, and one which evokes so much for others, there simply isn’t the same space for a new mother to express what she’s been through with honesty, and not feel judgement or comparison. And when a traumatic experience is compounded by feelings of shame and guilt, because there is no space for open discussion, it only leads to isolation.
3. Because it affects more women than we think. An estimated 30% of women who give birth are likely to end up on the spectrum of birth trauma, whether they recognise and report it or not. And it isn’t just after extreme cases where the mother or baby was at risk of dying. It is also happens for those who have experienced intervention which felt violating, and those who were not treated with appropriate levels of care, dignity and respect by the medical staff. Sadly, because women are shamed into silence over experiencing anything less than a perfect birth, or don’t know enough about birth trauma, they often feel the impact of a traumatic birth silently. Going without treatment, they feel the negative impacts of their experience way longer than is necessary. But knowledge is power. If you know about it, and you end up as the one in three on the spectrum of birth trauma, you will know you are not alone. You will not experience the isolation of being shamed into silence, because ‘a healthy baby’ was not enough for you.
4. Because sadly, many cases of birth trauma are preventable. It is as much how the experience is felt by the mother, as it is the circumstances around the birth, that can result in trauma. This means two births which are both regarded as ‘normal’ in the hospital notes might have different impacts on the women experiencing them. Why? Because dignity, respect and empathy are critical to birth being an empowering transition into motherhood, as opposed to a frightening and threatening one. In what other situation do we expect a woman to lie in a submissive position, frightened and in pain, exposing her genitals to be inspected and touched by strangers for hours at a time? Why are labouring women empowered in their antenatal classes, but expected to ‘leave their dignity at the door’? If intervention is required, unless proper care is taken to ensure the woman is respected throughout, this can at best result in feelings of failure, and at worst feel as violating as rape. It doesn’t have to be this way though. Of course, no doctor can control the twists and turns of a birth. But everyone present can make the birthing room a place of dignity and respect. Perfectly put by a fellow mother, “the only things that could have given me a positive experience were free: eye contact, a hand to hold, warm words of support”.
5. Because the ripples of trauma go further than you imagine. PTSD following birth trauma can deeply impact vulnerable new mothers and their families for years. This includes the impact on newborn babies, our next generation, whose most critical period of development is under the care of a primary caregiver who is debilitated under the stress of mental illness. Try making organic pear puree when there is a bear growling in the room. That’s what hypervigilance feels like. The threat feels so real, how could you possibly do anything other than feel fear and panic, and succomb to the body’s fight, flight or freeze responses? The triggers are many and they are everywhere. A letter for a smear test, a shadow flickering past the window when you’re alone in the house at night. Shouting. The baby crying. It can all trigger symptoms – feelings of fear and threat – reducing a mother’s ability to parent well. And with such limited attention given to the impact of birth trauma on mothers, the long term effects on the baby are, of course, largely unknown.
6. Because if you know what the symptoms of birth trauma are, you can advocate for the right help. The after effects of trauma are really treatable, but they require a totally different set of solutions to post-natal depression or anxiety. Worse, some treatment options for depression can further damage a person who actually has trauma symptoms. Many of the symptoms of PTSD are similar to those seen in more familiar post-natal mental health issues, so it is easy for doctors to misdiagnose. I was the perfect example of that. I was told at my six week check, by a very empathetic and kind doctor, that I “could well be displaying symptoms of anxiety”. But it just didn’t feel like that to me. I knew something wasn’t right, I couldn’t sleep, I was constantly in fear that my new baby would die if I stopped watching her sleep or listening for her breathing, I had pins and needles in my hands and feet, sometimes stretching up my arms and down my legs. I couldn’t get enough air into my body when I tried to breath, even sitting ‘at rest’ on my bed. It wasn’t just the iron deficiency I was diagnosed with. But without knowing what else it could be, I just went away and struggled on quietly, thinking this must just be what being a new mother feels like. It wasn’t. It was hypervigilance, a common symptom seen with post traumatic stress where the body feels like it is constantly in danger and under attack. If I had known to question the misdiagnosis of anxiety, or if the doctor knew how prevalent birth trauma was and what appropriate treatment looked like, we both might have been quicker to recognise hypervigilance for what it was and seek appropriate treatment in the form of EMDR. Sadly, it took my symptoms to build up to a full breakdown six months later for me to get signposted to the right place for help.

So here I am, still talking about this. Because if I could change anything for mothers-to-be, it would be for more people to know about birth trauma. Hospital professionals, like doctors and midwives, so that it is less likely to even happen in the first place. Parents-to-be, so that they are more prepared for it, and can seek appropriate treatment quicker. GPs and post-natal support people, so they can be on the look out for it and support new families to get the help they need. And everyone who is the friend or family of a new parent, so they can better listen, empathise and understand.

Please, let’s break the taboo, stop the shaming and new mothers having to suffer in silence. It has gone on too long, and the impacts are too far reaching for us to ignore it any longer.

Sarah is a fundraiser, charity director and new mum. She shares her personal journey of birth trauma and PTSD on her blog everymumshouldknow@wordpress, in the hope that it helps others. You can find her on twitter @mummy_truths and on Facebook @everymumshouldknow