THE VIEWS THAT Dr Svanberg EXPRESSES IN THIS PIECE ARE HER OWN, BASED ON HER PROFESSIONAL EXPERIENCE. This content is for general information purposes only and is in no way a substitute for medical advice or treatment. You can read our full disclaimer here.
It might seem like all of a sudden, we’re reading about birth trauma, hearing about it in the news, and seeing stories about parents being affected by their births for months or even years afterwards. But what is birth trauma? And if you’ve had a bad birth, how can you move on from it? ‘Birth trauma’ as a term has only really been around for the last 20 years or so. Before then, it wasn’t even recognised that people could have traumatic symptoms after birth. It’s interesting to think about the history of this. Women for generations have known that birth can be difficult – that story goes back as far as Eve eating the apple. But until incredibly recently, this was seen as just being part and parcel of the experience of becoming a mum. At least the baby is healthy, right?
It’s now widely recognised that birth can lead to symptoms of trauma, which are separate to postnatal depression. To find birth traumatic, there will usually have been a time when you were seriously worried about your safety or your baby’s safety. Whether or not you are traumatised by birth is down to a number of factors, including your experiences prior to becoming pregnant (for example if you have had previous traumatic experiences in your life), the experience of the birth itself (such as whether you had an operative birth, and how well supported you felt during birth) and factors after the birth (for example, the coping strategies you used or are using). We also know that other life experiences might contribute to how you feel after a difficult birth. If you are from an ethnic minority background or are LGTBQI+ you may encounter additional prejudice that impacts on your birth or your immediate postnatal experience (such as your experience on the postnatal ward or your feeding journey).
The key is that birth trauma is ‘in the eye of the beholder.’ What looks like a straightforward experience to one person might feel traumatic to another. You are the only one who can decide how you feel. Birth is a time when we are uniquely vulnerable.
Women for generations have known that birth can be difficult – that story goes back as far as Eve eating the apple.
How do you know if you are traumatised? You might have some symptoms of trauma, or you might meet a diagnosis for post-traumatic stress disorder (PTSD). (You can read about the symptoms of PTSD on the MIND website.)
What people usually notice as being the defining symptom of trauma is flashbacks – a feeling that you are suddenly ‘back there.’ Or you might have dreams or nightmares about your experience. Other symptoms include avoiding anything that reminds you of your birth, feeling on high alert, and noticing a negative impact on your thoughts and mood. Often people find that they also experience symptoms of depression, and you might be dealing with sleeplessness which can make everything feel that much harder. You might also have a physical injury that you are dealing with.
These symptoms occur because of what happens to our brains when we go through a traumatic event. Usually, when we experience something, our brain takes all of the information about that event and stores it with our other long-term memories. It includes what we can see, hear, smell, taste and feel, and it integrates it with other similar events and updates it as new information comes into our experience.
But traumatic events are different. Because we are fearful, the part of our brain that stores this information goes offline for a while. Instead, we go into fight-or-flight mode. We stop taking in the extra information that we don’t need (such as from our senses) and we become primed to fight or flee. In birth, as we can’t escape, we may also freeze and go elsewhere in our minds to cope with the experience. This is a really helpful strategy to get us through a horrifying time, but it means that those fragmented memories can pop up later and leave us feeling unable to fully remember what happened to us. Essentially, we can get stuck in that survival mode, feeling under threat and unable to move on.
It’s important to recognise that it’s not only the person who has given birth who can be traumatised. We know now that partners, other family members and staff can be affected too. I’d go so far as to say that many people are a little traumatised by birth. Birth is often presented as something to be feared, and we’re not very good as a society in supporting parents after the process. But by ensuring that people are well looked after through their maternity and parenting journeys, we can start to make that story a more hopeful one.
If you think you might be traumatised by your birth experience, or even by hearing other people’s birth stories, there are many ways you can begin to heal. Of all the different treatments out there, the only ones recommended by the NICE guidelines (which means they are backed up by scientific evidence) are trauma focused cognitive behavioural therapy and eye movement desensitisation and reprocessing. You can speak to your GP about accessing these; there are often waiting lists but if you are in the UK you are entitled to these therapies via the NHS. Other good approaches include activities that help you to reconnect with your body (eg yoga or ‘closing the bones’ ceremonies) and support your relationship with your baby (eg parent-infant psychotherapy). Talking to others who have been through similar experiences (such as the Birth Trauma Association Facebook group) can also be extremely helpful.
Many NHS services offer birth debrief sessions, but the evidence on these is mixed.
Most trauma-focused treatments work by integrating those fragmented memories and pulling them together into a whole. But if you have been through a number of other traumatic experiences, it may be that you need to feel a deeper sense of safety and stability before you even think about discussing your traumatic birth. It’s important to be aware that techniques that promise rapid results and practices involving mindfulness and visualisations may worsen the symptoms of trauma for some people.
One thing that may help you deal with symptoms of trauma is grounding. This is a really quick way of helping you come back to the present when you are experiencing traumatic symptoms such as flashbacks, or are feeling very anxious.
Here are three grounding techniques to try:
- When you are in fight or flight mode, a quick trick to let your body know you are safe is to lengthen your exhale. Notice that when you are running or exerting yourself, you begin to pant. In contrast, when you are relaxed, your breathing is slow. By consciously slowing your breathing, you ‘trick’ your body into thinking it is relaxed. You can do this by ensuring that your exhale is longer than your inhale. Or say the word ‘out’ in your mind as you exhale.
- Look around you and pick out all the shapes you can see.
- Use your senses to ground you in the here and now. Focus on what you can hear, see, taste, touch and smell. Consciously ground your feet on to the floor to remind yourself that you are here, and you are safe.
When you feel able to, do find someone to speak to about your experience. Often we can be left feeling that a bad birth was somehow our fault, or that we should have tried harder, or done things differently. Working with someone to think through your experience can be tremendously healing at the right time.