For many people, pregnancy and the arrival of a new baby is a joyful experience. However, for some, these experiences can be more challenging. Events can occur during pregnancy, labour and in the postnatal period that can be traumatic and overwhelming, leading to problems like Post-Traumatic Stress Disorder (PTSD), postnatal depression and anxiety.
What is Birth Trauma?
Birth trauma happens when we go through a frightening, stressful or distressing event which is related to giving birth. Witnessing a traumatic event can also be incredibly difficult, so partners can experience birth trauma too.
What Counts As a Traumatic Event?
What’s traumatic for one person might not be for another. It’s a very unique, individual experience shaped by things we’ve been through in the past, how we view ourselves and the world around us.
How we think about the event at the time is also a factor. For example, if someone is faced with a medical emergency and they believe they’re going to die or lose their baby, then it’s likely to feel very traumatic. If they believe there is an emergency, but they know what’s going on and feel the medical stuff have got it under control, they’ll experience the situation differently. We don’t have much control over these beliefs. They’re just responses automatically generated by our brains based on how we feel at the time.
This is why birth trauma can arise from a wide range of experiences. For example, someone might have a difficult pregnancy characterised by risk, illness or high levels of anxiety. Dealing with conditions like hyperemesis gravidarum, gestational diabetes or pre-eclampsia would fall into this category.
People often have a lot of expectations around birth and labour. When things don’t go to plan, and the arrival of their baby looks different to what they’ve envisaged, it can be difficult to accept. In some cases, simply feeling unsupported, disempowered or unheard during labour can be experienced as traumatic.
Complications during labour such as fetal distress can also be traumatic, as can the medical environment itself. Sometimes decision-making needs to be fast and reactive, so there isn’t always time to explain things fully which can feel very frightening for someone in labour. Medical emergencies can lead to interventions such as forceps or emergency caesarean. This can be traumatic for both the person giving birth and their partner looking on.
I have personal experience of this having had an emergency caesarean under general anaesthetic due to a placental abruption. While I was going through a scary medical procedure, my husband was left alone in a room, surrounded by the aftermath of a difficult birth. Obviously, this situation was traumatic for both of us.
Giving birth can be particularly difficult for somebody with a history of trauma. For example, someone who has experienced sexual assault or abuse may find the physical realities of labour and the vulnerability involved incredibly triggering.
Signs & Symptoms to Look Out For
When labour has been traumatic, it can impact how somebody feels in those initial hours and days after their baby has been born. They might feel detached, disconnected or numb. They may find it hard to bond with their newborn. People can also experience extreme emotions and high levels of distress amplified by the hormonal changes that occur post-labour. They may also be in pain, especially if they’ve been through a medical emergency. Certain medication can also heighten or numb the emotional state post-labour. Although unpleasant, all these things are to be expected.
However, it’s important to keep an eye out for symptoms of PTSD such as:
· Repeated intrusive memories, dreams or thoughts about the upsetting event
· Feeling more on edge and anxious
· Experiencing the urge to avoid things that remind them of the upsetting memory
· Unhelpful beliefs about the event such as blaming themselves
· Difficult emotions such as guilt, responsibility and shame
Birth trauma can also lead to other difficulties such as postnatal anxiety or depression. Symptoms to look out for include:
· Difficulty sleeping
· Changes to appetite
· Excessive worry
· Feeling irritable and on edge
· Excessive checking
· Feeling restless
· Racing thoughts
· Suicidal thoughts
Usually, after a traumatic event, things will settle down on their own without the need for therapy or any other intervention. Generally, we expect to see a gradual improvement in any symptoms in around four weeks. If things are getting worse or staying the same, it might be time to seek help.
What If It’s Just the Baby Blues?
When you’ve just had a baby, especially if it’s your first, it’s difficult to know what’s normal. You’re sleep deprived, your routines are up in the air, and everything can feel quite stressful. It’s easy to attribute certain thoughts and emotions to the upheaval of having a baby, but it’s so important that any changes in mood and wellbeing aren’t dismissed as ‘baby blues’ or ‘just hormones’. New parents, their friends and family, need to be really vigilant. It’s better to access help and find you don’t need it than sit with a problem for a long time and find it gets worse.
Finally…
Here are three things I wish more people understood in relation to birth trauma:
1. Just because having a baby is considered ‘natural’, doesn’t mean your birth wasn’t traumatic.
2. Just because somebody had it worse than you, doesn’t mean your birth wasn’t traumatic.
3. Just because you had a healthy baby at the end of it, doesn’t mean your birth wasn’t traumatic.
Please don’t judge yourself harshly. Birth trauma is still trauma, and if you're struggling you should seek support as soon as you can.
Get the Help You Need
At Fortitude, we’re lucky to have a member of the team who has a special interest in working with birth trauma and postnatal mental health problems. If you’re struggling with any of the things described in this article and you’d like support to help you heal and recover, please get in touch. I also share lots of tips and advice via Instagram.
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