If labour was frightening and nothing like you’d planned, you may need help to get over it. Here’s where to start
Giving birth is a funny old thing. On the one hand, thousands of women do it all over the world, day after day. In that sense, it’s nothing out of the ordinary. On the other, it’s a life-changing event (particularly if this is your first child) and is one of the most physically and emotionally demanding experiences you’ll ever go through. You’re one of many and yet utterly unique.
And it’s these contrasting positions that so many women struggle with if their labour experience was traumatic (which the Birth Trauma Association estimates affects as many as 10,000 women in the UK). How can we justify making a fuss when so many women simply ‘get on with it’? Then again, why shouldn’t we? We’ve nurtured and birthed a whole other person! Surely it doesn’t get bigger than that?
Milli Hill, founder of the Positive Birth Movement and mum of three, agrees. “Giving birth is bigger than the holiday of a lifetime and arguably bigger than a wedding day so of course we’re entitled to have a vision of how we would like it to be and to feel a bit disenchanted if it’s nothing like how we imagined,” she says, in her book The Positive Birth Book: A new approach to pregnancy, birth and the early weeks (Pinter and Martin, £12.99).
“When a wedding day goes wrong we might be looking at a bit of rain or an embarrassing trip-up on the dance floor, but when birth doesn’t go to plan this often means we’ve had a experience that may have been frightening and traumatic. As well as crushing disappointment, many more difficult feelings can be added into the mix of postnatal emotions, not to mention physical scars that need time to heal.”
Libby Johnson, 38, is mum to Sam, now four. “Sam’s birth was hideous,” she says. “He was lying across my abdomen (what’s known as a transverse lie) which wasn’t picked up until I was actively in labour and the midwife felt his arm rather than his head. I was told I’d need an emergency caesarean as it’s not possible to give birth vaginally to a baby in that position. I appreciate the team had to work fast but it was such a shock that I could barely hold him when the doctors took him out. I cried for hours afterwards and felt so weak and silly for doing so but I couldn’t stop dwelling on what might have happened if I’d opted for a home birth, which was something I’d been considering. It’s taken me a long time to come to terms with it and Sam will be my only child.”
Like Libby, many women feel ashamed or embarrassed of how upset they feel after a traumatic birth, something that’s made worse by well-intentioned responses that focus on the positive outcome – that is, a healthy baby. “Of course they’re delighted that their child is OK but women are not just a passive vessel by which a new life enters the world,” says independent midwife Rebecca Tieken. “It’s not just about having a healthy baby – this completely overlooks how disempowering it is to have had a birth not go to plan, especially if it was very long and traumatic. Some women develop a fear of how other people will react to their feelings if they express themselves honestly, so stop talking about it, which can lead to postnatal depression (PND) and affect their feelings about subsequent pregnancies.”
- Surround yourself with people who understand. “Get in touch with the Birth Trauma Association, which has over 4000 members,” says Rebecca. “It’s a safe space to share how you feel without risk of judgement.”
- Post-birth counsellingcan help you to process your thoughts and feelings. “It’s normal to feel a range of negative feelings after you have had a baby, and this doesn’t mean there’s anything wrong with you or that you love your baby any less,” says the Positive Birth Movement founder Milli Hill. “However, if you feel desperate, out of control, traumatised or unable to cope, seek professional support. Remember you also have the right to make a formal complaint about the maternity care you received. If you think you want to do this, it is a good idea to write down as much as you can remember about your birth as soon as you can, and also to request a copy of your maternity notes. You may also want to report an individual practitioner to their professional body, or take legal action. For more information on this, visit the Birthrights website (birthrights.org), which was founded by lawyers.”
- A difficult birth can result in musculo-skeletal problems afterwards, such as a misaligned pelvis or trauma to the pelvic floor.A physiotherapistspecialising in obstetrics and gynaecological issues can help – see the Chartered Society of Physiotherapy’s pelvic, obstetric and gynaecological physiotherapy website for more.
- Hold a rebirth ceremony.“Create a calm, peaceful birth environment by setting the scene at home with candles, hypnobirthing recordings or music, an aromatherapy massage or a nice warm bath,” says midwife Rebecca Tieken. “When you’re ready, your partner will hold your baby in the optimal position down by your pelvis while you form a circle with your hands to represent the birth canal. Your partner will pass your baby through and into your arms. It’s an emotional process that involves letting go of the old memory and creating a new memory in its place – it can be a cleansing exercise, signifying a fresh beginning.”
Birth trauma and PTSD
- Post-birth trauma can take years to be expressed. “Women might find they’re unable to stop thinking about the birth (rumination), experience flashbacks, nightmares and mood swings,” says Rebecca.
“In this context, we refer to it as postnatal PTSD (PN PTSD) and as many as 200,000 more women in the UK may be affected,” says Kim Thomas of the Birth Trauma Association. PTSD occurs when the traumatic memory is stored in a part of our brain called the amygdala, our ‘primitive’ brain, which is primarily concerned with our survival and triggers our ‘flight or fight’ response. Unless we can process the experience and move it on to the part of the brain in which it’s supposed to be, the hippocampus, the debilitating symptoms will continue. Your first port of call is your GP, who will initially assess you. Current NHS guidelines recommend treating with trauma-focused cognitive behavioural therapy (CBT), which helps you to gain control over your feelings and reframe them in a more positive way – so that you no longer see the event a your fault, for instance. It can be combined with medication for very severe cases.