Why do I want to block out the memory of my baby’s birth?”
It’s been months since I gave birth but why do I feel panic when I think back to the experience?”
My baby’s first birthday is approaching, and it’s bittersweet….”
My baby is already 8 months old but I keep revisiting his birth and obsessing over the details and what-ifs..”
These may sound like vastly different post-birth experiences and reactions – but the common thread between them is that they’re all rooted in birth trauma. Birth trauma is a kind of complex trauma that occurs when a woman goes through a difficult experience in labour, birth, or immediate postpartum (the minutes and hours right after birth).
How does it occur?
Birth trauma may occur due to an explicit or tangible reason that may seem justified to an onlooker as the basis for trauma to occur. For example, care providers and/or family members may find it easier to offer initial support to mothers who suffer a physical injury, have a baby who needs monitoring or a prolonged NICU stay, or who go through a long or difficult labor.
What is often overlooked is that birth experiences may also turn out to be traumatic due to covert reasons, even though such factors may not be immediately obvious to an onlooker. These include an unexpected turn of events (even if the outcome is “positive”), feeling a loss of control of the process, being treated disrespectfully, feeling invalidated, abandoned, powerless, helpless, dismissed or feeling unheard, and feeling fearful or confused during or after the birth.
Why perception matters
Recent research suggests that the perception (how someone felt during their experience) is what matters most when determining whether a birth was traumatic. This is why, in many cases, the likelihood of the occurrence of birth trauma is often overlooked or disregarded when the birth process and outcome seem “successful” to those involved in the birth, such as the doctor, nursing staff, and even the partner or other family members. When there is an absence of an apparent or tangible reason, a woman may not receive the support, time, and resources she needs to heal from the trauma. Even worse, she may be told to “get over it” or to be grateful that she has a healthy baby, or that she is making a big deal out of nothing.
Birth is a very unique experience. It not only varies from woman to woman, but even for women with more than one child, each of her birth experiences may be significantly different from each other. Two women can have seemingly similar birth experiences (from the outside) and yet be impacted very differently by them.
For many years, trauma was used to describe the response to a “major” life event like an accident, assault or a natural disaster. In recent years however, the term has expanded to include any event that undermines a person’s sense of safety and control over a situation.
Faced with a stressful situation, our brain activates the sympathetic nervous system and releases stress hormones to defend us by activating our flight or fight responses. Once the stressful situation passes, the body typically activates the parasympathetic nervous system, which helps to re-regulate our body again to an optimal state.
However, after experiencing a traumatic event, like a difficult birth, the body feels like it has become stuck in a “survival mode”, due to a dysregulated nervous system. The body loses its ability to differentiate between a real and perceived danger and when re-triggered, it activates the same neurological pathway as the one between the original threat and accompanying response. Hence, there is a re-experience of the same bodily sensations felt in the original incident, every time a birth trauma-affected person is faced with a trigger.
The effects of re-triggering
Because of this, any stimulus in the environment that resembles the traumatic incident – sounds, smells, certain terms, the “look” of a certain place, visuals, and even anniversaries of the birth or other people experiencing a birth – can re-trigger the trauma. These are called flashbacks, and are common in trauma.
When a person experiences a flashback, it feels to them as though they are back in the birth space, reliving the traumatic experience. When this happens, the thinking or reasoning part of the brain is no longer in control. It can’t rationalise or help them logically do away with the panic. The body simply responds and reacts. A traumatised nervous system has a lower capacity for regulation and makes it harder for a person to bring their awareness back to the present moment and away from the traumatic incident.
Signs and symptoms of birth trauma
Symptoms of trauma may include one or more of the following:
- Re-experiencing – flashbacks, nightmares, recurrent thoughts related to the event
- Avoidance – numbing, disassociating from anything related to the event
- Negative beliefs, expectations and thoughts – seeing oneself and/or others as the cause, resulting in exaggerated and persistent negativity, blame, guilt and shame
- Arousal – reckless behaviours, anxiety, hyper-vigilance, disturbed sleep, problems with focus
For more information on symptoms, you can access the City Birth Trauma Scale, developed by City University to measure symptoms of birth trauma. Symptoms may vary in intensity and frequency between those who experience trauma – and not all trauma is experienced in the same way.
What happens if trauma is not dealt with?
When trauma is not addressed and a woman carries negative feelings from the birth experience, she is more likely to continue to suffer through her postpartum and mothering experiences, some of which include:
- Difficulty in building an attachment or bond with the baby
- Hyper-vigilance in the care of the baby and having a hard time trusting others with the baby
- Lack of confidence with taking care of the baby and in her mothering abilities
- Feelings of disappointment or betrayal with a significant other (usually a partner who was present at the birth) and who she didn’t feel supported by, or felt let down by
- May experience difficulty or challenges with breastfeeding, which further amplifies the feeling of disappointment
- Feeling guilty and blaming herself for the way the birth happened and any impact it may have had on the baby
How you can begin to heal
The healing process has many layers, and just like the origin of the trauma itself, it is unique and different for everyone.
- The first step is awareness, which is the purpose of this article. The affected person becomes aware of how the birth experience has impacted them and continues to impact them in the present day.
- Next, it is important for this person to have a safe space in which to talk about their experience, without the fear of judgment or dismissal, and to be listened to with compassion. It is equally important to feel acknowledged and validated.
- Finally, with the help of a skilful listener, the affected person can begin to reframe their experience, which helps them to process it in awareness, rather than be in a state of constant triggering from it.
Sometimes, in more severe cases, therapy and other modalities may be required such as the 3-Step Rewind, Eye Movement Desensitisation and Reprocessing (EMDR), and Emotional Freedom Tapping (EFT) or somatic therapy.
Helpful resources to note
Here are some resources you can take support from as you move through your healing:
- Birth Story Listening Sessions – The Nesting Heart offers Be Heard and Heal sessions – 1:1 private session with a trained listening mentor that allows you to process your birth story and begin your healing journey in a safe, supportive space.
- 3 Step Rewind Sessions – This service is usually offered over 3 sessions and session by session, step by step the process aims to lift trauma symptoms with the help of a trained practitioner.
- Birth Trauma Therapy – Perinatal clinical psychologists offer ongoing therapy sessions specifically aimed at helping you heal from birth trauma using different modalities.
- Online or in-person communities/support groups for debrief and support
- Facebook groups – These can be a free, easy to access resource, but please be intentional with where you spend your time, taking into consideration how and why the group exists and if its aligned and feels supportive to you.
- Books – How to Heal a Bad Birth by Melissa Bruijn and Debby Gould is an excellent resource
- Postpartum Support International – This worldwide organisation aims to promote awareness, prevention and treatment of mental health issues related to birth. They provide both online and in-person support groups.
How to lend support
If someone in your life has experienced birth trauma, here’s how you can help:
- Listen with compassion, not sympathy
- Don’t ask them to be grateful that they have a healthy baby
- Don’t try to explain or justify what happened to them
- Don’t try to criticise their choices, or be tempted to say “I told you so”
- Offer them a safe space to process their story
Healing is not a linear process and cannot be rushed. Give yourself time to grieve, make sense, make peace, heal and move on. You deserve it.
By Namrita Bendapudi
Namrita is a birth and parenting mentor and the founder of The Nesting Heart, an online coaching and consulting organisation, that is aimed at informing, empowering and supporting couples and families in their birth and parenting journeys.
She regularly conducts workshops, hosts circles, and offers 1:1 sessions to provide support with motherhood, parenting, postpartum mental wellbeing, breastfeeding, and labor and birth preparation, and healing from birth trauma.