Healing from Pregnancy and Birth Trauma
By Sinead McGurrell BSSc
“You and your baby are healthy – that’s all that matters.”
How many parents have been haunted by these words? Their whole experience has been summed up by the end result (a healthy child) without acknowledgement of a traumatic journey and process.
Experiencing trauma during the pregnancy or birth of your child, throws expectations into disarray and instead replaces them with challenging memories and an unfamiliar path that was never envisaged.
Pregnancy and Birth Trauma – what qualifies?
It’s dangerous to oversimplify the meaning of trauma when it comes to bringing a child into the world. With any emotional status there is a continuum from mild to severe. From a professional perspective each and every level is significant and worthy of being addressed with appropriate support.
If low-level trauma is a person’s worst experience ever, then that is their benchmark. This trauma can feel as overwhelming for them as more serious trauma feels for another.
As most traumas are dealt with in medical settings it is often left to doctors and predominantly nurses to support the emotions of the parents. Occasionally parents are offered some support from social services. Generally it falls to the individual to realise they are not coping and to actively seek support.
It is worth noting that for some women, they take these unexpected changes without much impact psychologically, but for most the struggle is significant.
Definition of trauma
The definition of trauma as found in the dictionary is a deeply disturbing experience or emotional shock following a profound physical injury or stressful event
Wherever you look you will find varying descriptions and types of trauma, – this definition sums up the emotional and psychological aspect very succinctly.
Women and men often put a lot of thought and effort into planning to start or extend their family. There is a very clear and decided expectation of the joys that pregnancy will bring.
Despite much of it being expected, nausea and vomiting can literally halt some expectant mums in their tracks, some having to put life on hold for the early months. Some may struggle right throughout their pregnancy.
Significant medical conditions can require hospitalisation for some. Other conditions such as placenta previa (when the placenta is sitting over the cervix) mean there may be no choice regarding birthing options – i.e. a caesarian section is required for the safety of mum and child. For women who may have planned a vaginal delivery or homebirth the required medical intervention detracts from their rites of passage to labour with their child. There are many varied and complex situations that require close monitoring and these pregnancies become more like a medical condition than a natural process.
A key trauma of pregnancy is when the pregnancy is cut short and results in a premature delivery. There is the loss of that time with baby in utero and blossoming in the latter months of gestation. On top of that is the very serious nature of having a child preterm.
Having a preterm (born before 37 weeks) baby adds another usually unexpected chapter to the process of bringing your child into the outside world. Occasionally some parents will know in advance that an early delivery may become necessary. That may heighten the trauma, knowing that your child’s life may be in serious danger. Sometimes babies are born so early that the parents haven’t yet informed their family and friends of the pregnancy – so there’s a mixture of joyous and tragic news delivered at the same time.
Depending on gestation at birth a myriad of scenarios can transpire for the baby and parents, including weeks or months in hospital before the baby can finally go home. What that means is mum and dad go home without a babe in arms, the car seat is empty and the nursery is full but missing the key ingredient – a child. And while a child may be alive and relatively well in hospital, it’s another unexpected hurdle in what most people anticipate will be a treasured and joyous time.
Bear in mind that many of these angels born so early are tiny enough to fit snugly in the parent’s hand. Wedding rings often fits on the baby’s upper arm. Quite unimaginable but often a memorable keepsake photo for those who’ve travelled that journey.
Emergency during term delivery
The most tangible traumas are the ones where emergency medical intervention is required. Emergency caesarian section, postpartum hemorrhage or newborn needing help to breathe are but a few. Emergency caesarian can be vary between a scenario where it’s all hands on deck, doctors and nurses literally running to theatre and stripping mum clothes off en route or a labour that’s not progressing as expected.
Often little time is available to process what is actually happening, let alone coming to terms with the nature of delivery.
Process of delivery
For a large number of women their birthing experience falls short of their expectations. Depending on the difference between expectation and experience, those disappointments can have serious consequences. While hearing an account of a particular birth may not sound traumatic, a woman’s experience can be vastly different. The degree of trauma can vary too. It’s important to acknowledge any part of the experience that felt traumatic.
Dr Sarah Buckley discusses the need for birthing women to have privacy, feel safe and have people around who are familiar to them. For the most part women today rarely have access to these fundamental requirements for an undisturbed birth. Unfortunately many women enter labour unaware of what’s missing and usually unable to obtain the desired outcome, even if they are aware.
Medical intervention in the process of birth often interrupts how nature intended birth to be. As Dr Buckley puts it so beautifully, how would other mammals cope with birthing under bright lights, in a foreign environment with strangers in tow. With lack of continuity of care in most labour settings, this immediately sets a woman at a disadvantage when it comes to having the best labour possible.
Due to a myriad of these factors, some women struggle with the consequences which may include having an assisted birth (e.g. vacuum) or a medical intervention such as a caesarian section. Some women who plan to have a home birth and end up in hospital struggle with the huge disappointment of not achieving the desired birthing experience.
When term babies need help
For most struggling babies some suction and support to start breathing alone is sufficient, however others end up in neonatal intensive care units (ICU). These stays can be short-lived while others require transition via special care units prior to discharge.
The loss of holding and feeding a baby immediately after birth is excruciating for many women and men. On top of this trauma, is the obvious concern for the baby’s well-being.
Symptoms & Syndromes
As stated in Responses to extreme trauma may include but is not limited to
• “intense fear, helplessness, or horror
• re-experiencing of the traumatic event
• avoidance of stimuli associate with the trauma and numbing of general responsiveness
• increased arousal”
Posttraumatic Stress Disorder
In severe cases, if all of the above symptoms are present along with other key criteria, a person may be suffering from Posttraumatic Stress Disorder (PTSD). Immediate referral to a professional is required should any or all of the above be present.
Postnatal Depressive Syndrome
Postnatal Depressive Syndrome again includes a range of symptoms which might indicate someone is not coping with life. These may not transpire directly from a traumatic experience but often go hand in hand.
Depressive symptoms can include
• moodiness that is out of character
• increased irritability and frustration
• finding it hard to take minor personal criticisms
• spending less time with friends and family
• loss of interest in food, sex, exercise or other pleasurable activities
• being awake throughout the night
• increased alcohol and drug use
• staying home from work
• increased physical health complaints like fatigue or pain
• being reckless or taking unnecessary risks (e.g. driving fast or dangerously)
• slowing down of thoughts and actions.
Bonding with the newborn and wanting to engage may be very challenging during depressive times.
Given that some things such as waking at night, being fatigued and spending less time with friends and family may occur naturally due to the demands of parenting, these symptoms often mask themselves well in the disruptive time of having a newborn in a household.
Generally, if things don’t feel okay then they probably need addressing.
An important factor to remember is that all these struggles and symptoms can occur for both the mother and the father and often simultaneously. The onset of all or any symptoms can be gradual and may not start for several years after your experience.
The Healing Process
Self-help stepping stones and options to support Mum and Dad
a) Accept things aren’t going ok for you and/or your partner and be kind to each other in the process
b) Talk to your partner/supportive friend or family member (be clear that you know your baby is healthy – that it’s you that needs help to recover)
c) Release your emotions – journal writing, crying, talking.
d) Seek support from a suitable health practitioner (naturopath, homeopath, osteopath, masseur, GP)
e) Seek out support groups and/or counselling as an individual or as a couple. (see resources below)
f) Tell your friends you’re struggling and don’t carry the burden alone.
g) Seek your medical records from your birth place if you need to find out more information and ask questions if you need them answered.
h) Once the healing process begins, allow a reasonable timeframe (months) to see a noticeable change [seek professional support if no change occurs].
i) If you know someone who fits this description – reach out and offer support.
A natural starting point for many people is their GP. Some GPs have wonderful skills and use a range of resources. However many clients are offered anti-depressant medication at the initial consultation without other supports being offered or tried. These may be required, but for a variety of reasons (including breastfeeding and side effects) it may not be an option for many individuals. Be aware that there are a range of other options available to try if you are reluctant to use medication as a first option.
Self-help stepping stones and options for baby.
Babies who have experienced trauma often need time and support to heal. Dr. Aletha Solter, a Swiss/American psychologist has pioneered a way of assisting babies to heal through allowing them to cry whilst be held.
Other emotional and physical support may come through homeopathy whilst cranial osteopathic therapy (osteopathy) can be vital for realigning a baby’s body after the tight journey into the world.
As the baby becomes more content and parents begin to heal too, it offers more opportunity for a harmonious and content household.
Birthing a child is a precious and unique experience each time around. In most cases mum and baby physically recover within a relatively short timeframe and to the outside world any perceived trauma is well disguised. The psychological and emotional toll can extend far and beyond the birthing process. Acknowledgement, openness and support can lead those struggling into a clearer, happy world to engage fully in their new role.
American Psychiatric Association (1994) 4th Ed, Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington, DC.
www.awareparenting.com.au – Dr Aletha Solter’s website
Buckley, S (2005) Gentle Birth, Gentle Mothering, One Moon Press: Brisbane.
Gentle Birth, Gentle Mothering – The wisdom and science of gentle choices in pregnancy, birth and parenting, by Dr Sarah Buckley.
The Aware Baby, by Dr Aletha Solter
www.awareparenting.com.au – Author Dr Aletha J Solter – information on various resources.
www.birthrightnetwork.com – Brisbane based practitioners of various disciplines
www.birthtalk.org.au – Information and support – Brisbane based support group
www.bubhub.com.au – National resources for various forms of support
www.beyondblue.com.au – Information on depression
www.mindmassage.com.au – Australia-wide counselling available – telephone, internet or face to face in Brisbane (author’s website)
www.indigohouse.com.au – Holistic Health Centre in Brisbane
www.pipa.org.au – Information and support on preterm babies
www.sarahjbuckley.com – Information, articles and practical advice in pregnancy, labour and parenting.