Birth Trauma
prevention & healing
In the United States, over 1/3 of people who have given birth describe their experience as traumatic. And 10% will go on to be diagnosed with post-traumatic stress disorder (PTSD) - a serious and long-term mental health condition. Read on for insight into birth trauma prevention and healing.
Prevention
Experiencing birth trauma is never your fault. And while many of the causes are outside of our control, here are some things you can do to help lower your risk.
Take a childbirth education class. Research has shown that taking a birthing class is one of the most effective ways to reduce your risk of experiencing birth trauma. Trauma can arise from a mismatch between our expectations of birth and the reality of it. Taking a class can help you to prepare for the birth you’d like to have, while also preparing you for the twist and turns that childbirth sometimes brings.
Build a stellar support team. Research shows that having an informed, supported, informed support person yield higher rates of satisfaction with the birth experience. So wether its your spouse, partner, sister, mom, or a friend - be thoughtful on who you’ll have by your side during one of the most powerful and vulnerable experiences of your life. Our course offers lots of content dedicated to your support person, so they feel confident in their role, and equipped to support you in the ways you need.
Make informed decisions. Some decisions might come easily to you, like what you want (or don’t want) to eat or what positions feels good to be in. Others require external information and come with risks and benefits that need to be weighed before making a decision. Whatever your choice, research shows that people experience lower rates of trauma when they get to make fully-informed decisions.
Have a care provider you trust. Giving birth is an incredibly vulnerable experience, and challenges us to place a lot of trust in our care providers. A good way to tell whether you’ll feel heard and understood by your care provider during labor is to ask yourself if you’re feeling heard and understood now, during your prenatal care. If you find that you aren’t, or if your answer to that changes at any point in your pregnancy or even during your birth, it is never too late to request a different provider.
Name your fears. Facing your fears around labor and birth head-on can help to take away the power they hold over you. Learn all you can about your fears, seek out accurate information, dispel myths, and make any changes you might need, within your power. Share those fears with your team so they can best support you.
Identify potential triggers. If you have experienced any previous trauma, consider whether these past experiences might have an impact on you during labor. Journal about it, talk to a trusted friend or family member, and/or find a qualified professional, and identify coping tools that might help. Also consider having a team who is trained in providing trauma informed care.
Hire a doula. Building a relationship with a trained professional who is experienced at supporting people through labor and birth can make a huge difference in your (and your partner’s!) experience. Choose a doula with whom you feel a sense of trust and connection, and whose style aligns with the kind of support you most envision yourself needing.
Let go. Paradoxically, one of the biggest sources of control you will have in labor is actually in your surrender to control. After you’ve informed and prepared yourself as best you can, identified your birth preferences and built a support team that has your back, let go and lean in to the process of birth and let your body lead the way.
Healing
The following was written in collaboration with our friend and colleague Libby Mukhi. She is a certified postpartum doula, and founder of Birth Story Processing.
When we hear the words “birth trauma,” many people envision scenes from an episode of E.R.: babies being whisked off to the NICU, birthing people rushed to the operating room, or worse. While those things could certainly cause birth trauma, the spectrum is so much wider than that.
Some common causes of birth trauma include:
Physical injury or distress to birthing person and/or baby
Emotional distress to birthing person and/or baby
Unwanted medical interventions
Lack of consent, privacy or dignity
Extreme length of labor (either very quick or very long)
Systemic racism
Not being heard
Misaligned expectations vs reality
Impersonal care, lack of compassion by support team
It is important to note that birth trauma does not only affect mothers and birthing people. Partners, birth doulas, and healthcare providers also experience secondary trauma, which requires the same amount of space and care to process.
Symptoms of birth trauma include:
vivid flashbacks
intrusive thoughts and images
nightmares
intense distress at real or symbolic reminders of the trauma
physical sensations such as pain, sweating, nausea or trembling
panicking when reminded of the trauma
finding it hard to sleep, even when you have the chance
self-destructive or reckless behavior
feeling emotionally numb or cut off from your feelings
feeling physically numb or detached from your body
feeling like you can't trust anyone
blaming yourself for what happened
overwhelming feelings of anger, sadness, guilt or shame
To make matters worse, women and birthing people are often told that “this is the most incredible day of their lives” leaving them to feel ashamed for feeling the way that they do. That shame often prohibits them from seeking the support that they need, because they feel like their trauma isn’t valid. Emma Svanberg, clinical psychologist and co-founder of Make Birth Better, said “There is a huge body of research on the disbelief of women’s pain, especially marginalized women, and often women’s voices are silenced.”
Tips for processing a traumatic birth:
Write it out: journaling is a powerful ritual, and can help integrate sticky thoughts
Ground yourself: notice how that trauma is showing up in your body, and provide signals to your body that it’s safe. Step outside onto the grass, barefoot, and feel yourself being held by the earth. Take a mindful moment: what 3 things can you see, hear, feel?
Talk it out: Simply talking to a supportive friend or family member can make a world of difference. If that isn’t cutting it, ask them if they have recommendations for a good therapist who specializes in perinatal mental health, or connect with someone who specializes in birth story processing. You can also refer to the Psychology Today database and filter by insurance and specialties. Organizations like PAATCh specialize in the prevention and treatment of birth trauma.
Get support: if you have the means, a postpartum doula can be a miracle-worker as you navigate life with a baby. They offer unbiased, evidence-based advice, as well as emotional support and education while you’re transitioning to life as a parent. And if you don’t have the means, many postpartum doulas offer sliding-scale pricing, so don’t be shy to ask around.