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.
Picture: Netdoctor |
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."
Positive steps that can help
1. 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."
2. Post-birth counselling
can 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."
Physically
3.
A difficult birth can result in musculo-skeletal problems afterwards,
such as a misaligned pelvis or trauma to the pelvic floor. A physiotherapist
specialising in obstetrics and gynaecological issues can help – see the
Chartered Society of Physiotherapy's pelvic, obstetric and
gynaecological physiotherapy website for more.
Symbolically
4. 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
5.
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.
NETDOCTOR
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