What is Birth Trauma?

Birth trauma is a term which is becoming increasingly familiar. And although many women through consecutive generations would know how birth trauma feels, there is now a name to describe the experience. Importantly, specific help is available to help women deal with its effects.

Birth trauma does not mean the same thing to every woman. Like many other life events, the impact of trauma is unique to every individual. Some women experience birth trauma as a result of their physical experience, others from the psychological effects of giving birth - each is equally important.

How does birth trauma feel?

Birth trauma can be difficult to describe in words. Many women who’ve experienced its psychological effects say they feel sad, disappointed, guilty and even robbed of the birth experience they wanted and planned.

The physical results of birth trauma can be more obvious e.g., pain, stitches, healing skin, walking awkwardly. Some women say that the physical effects are easier to deal with because they can be seen, whereas emotions are better hidden and often internalised.

Physical birth trauma

Physical birth trauma happens when the baby’s birth causes damage to the woman’s body. Sometimes the trauma is not immediately obvious after birth and only becomes clear in the days, weeks and even months after the baby’s birth. Without correct treatment, birth trauma can cause permanent physical changes. Generally, physical birth trauma relates to vaginal births, though caesarian section births can also cause trauma.

Common symptoms of physical birth trauma

1. Pain around the vagina, perineum, anus and pelvic area.
2. Incontinence e.g., difficulty ‘holding on’ to wee or poo.
3. A dragging or heavy sensation in the pelvis and sense that everything is lower than it should be.
4. Uncomfortable or painful sex.

Common symptoms of psychological birth trauma

1. Feeling depressed and/or anxious.
2. Feeling angry and/or guilty.
3. Experiencing post-traumatic stress disorder (PTSD).
4. Having flashbacks and ruminations about the birth and not being able to move on from the baby’s birth.
5. Obsessive thoughts and behaviours which impact on everyday life.

Risk factors for birth trauma

It can be helpful to understand what may increase the chances of experiencing birth trauma, but there is no guarantee of immunity. Every labour and birth are unique.  At some point, there needs to be a degree of acceptance of not having complete control. This can be hard for some women, particularly those who like an ordered, predictable life.

Women who have a tendency for anxiety are more at risk of birth trauma. Although it’s easy to say “just try and relax” it’s generally not that simple. Anxiety is almost always centred around future events and commonly felt when trying to plan for the ‘what if’ moments.

Having a baby is a huge life event and every woman and her partner want the labour and birth to be magical. The truth is that sometimes, this is not the reality.

Women are more likely to have birth trauma if they:

1. Lack support from their partner and/or family.
2. Are not satisfied with the support from their maternity care providers.
3. Experience fear and/or anxiety around the labour and birth.
4. Had a different labour and birth to what they hoped for.
5. Have a history of sexual abuse and/or trauma.
6. Have a previous history of traumatic or difficult birth.
7. Experienced a lack of control during labour and birth.

How can I reduce my risk of birth trauma?

There’s a limit to how much you can do to reduce your chances of experiencing birth trauma. Sometimes events happen during birth which may not have even been considered.  This can create a sense of shock and bewilderment, contributing to feelings of distress.

1. Talk with your partner and maternity care providers about the type of labour and birth you would like. Be open and honest about what is important to you.
2. Write up a birth plan but remember to be flexible. Include the possibility of things and situations not going as you would prefer them to.
3. Do as much research into labour and birth as you can. Join an antenatal and pregnancy class, either on-line or in person.
4. Speak with your GP about mental health support if you’re feeling anxious or at risk.

What can I do if I’m feeling traumatised about my baby’s birth?

Be kind to yourself.  it’s important you don’t feel you’re alone and that help is available. Try not to rationalise your feelings by applying logic to your baby’s birth. Even though you may remind yourself that what’s important is your baby and you are healthy, sometimes that may not seem to be enough.  

Speak with your partner, family and close friends. 

Talk with your maternity care provider about your baby’s birth. A ‘debrief’ session can be very helpful. Ideally, this happens soon after the baby’s birth.

Talk with your child health nurse who may refer you to a community-based counsellor.

Ask your GP for a referral to a counsellor who specialises in women’s health and birth trauma.  You may qualify for rebates from Medicare of a series of psychology sessions.   

References:

Childbirth trauma (panda.org.au)

Physical Birth Trauma

Post traumatic stress disorder following birth - COPE

Written for Nourish Baby by Jane Barry, Midwife and Child Health Nurse.