Childbirth trauma

For most people, childbirth is a life-changing event which involves many emotions ranging from fear, pain, uncertainty and exhaustion through to excitement and joy.

However it is common for women who call PANDA’s National Perinatal Anxiety & Depression Helpline, and their partners, to tell us they had a complicated or even traumatic birthing experience. In fact, we know up to 1 in 3 mums experience the birth of their baby as traumatic.

This trauma can result from not only what happens during labour and childbirth, but also how a mother feels as a result of her experience.

She might have experienced pain or physical distress while giving birth. Or her labour or childbirth may have required medical intervention (this refers to actions taken by the attending medical professionals if the health of mother or baby is considered to be at risk) that she wasn’t prepared for. Sometimes women have ongoing physical complications from a traumatic birth. We also know that partners can feel traumatised following the birth of their baby and are often overlooked by medical and support teams.

Trauma is an individual experience and is not always connected to physical pain, medical interventions or injury. Many people who experience a traumatic birth experience a range of emotions during the process, for example feeling:

• powerless
• confused
• abandoned
• fearful
• unheard
• disregarded¹

Any of these feelings can be influenced or made more difficult by an individual’s personal history, as well as social factors like how much support the parents have around them.

Women who feel any of these things during the birth have a higher chance of experiencing:

• disappointment
• lack of confidence
• hypervigilance or intense preoccupation with the baby’s health
• feelings of failure
• Anger²

Perceptions of the birth

It is also common for women and their partners to describe their labour as ‘normal’, even if they are left with confusing, on-going symptoms such as anxiety – including for the health of the baby – or low mood. We know the emotional impact of the birth process can sometimes be overlooked within the medical system, and some health professionals who work with expecting and new parents do not focus strongly on the emotional wellbeing of the parents. So many parents end up pushing difficult feelings aside.

Risk factors

There are a number of factors related to labour and/or childbirth that can cause parents going through the birth process to experience difficult feelings and/or experience the birth as traumatic. These include

• ineffective or limited support from partner, family and/or health professionals during labour
• previous perinatal loss including stillbirth, miscarriage and death of a young baby, also known as neonatal death (we know that women with a history of perinatal loss can be at higher risk of being anxious about the next pregnancy)
• fear for the safety of herself of her baby at some time during the labour or birth.
• previous sexual abuse – some aspects of labour or giving birth might be traumatic for survivors
• previous trauma
• a tendency towards being anxious prior to the birth
• perceptions of not being in control during labour and not knowing what's going on
• inadequate pain relief.

There are also others that are not listed here.

A mother's fear for the well-being of her baby or herself following interventions or a life threatening situation can be very traumatic. If you are a new parent who has just gone through a birthing experience, the important thing to remember is that it is your perception of the birth that matters, and how you feel about the whole experience can affect your mental health and impact how you feel about being a parent.

Expectations of the birthing experience

Many people hope their birth will be calm and natural, or play out in a particular, planned way. If your birth experience does not match your hopes or expectations, it can be extremely disappointing. Sometimes you may even feel like you have failed as a parent or a person, on top of the emotional and physical scars that remain from the birth.

Post Traumatic Stress Disorder

A traumatic childbirth experience can sometimes trigger the development of Post Traumatic Stress Disorder (PTSD). If you find yourself experiencing high anxiety, stress or panic in response to triggers that remind you of the birth (for example, newborn babies, hospitals, doctors, face masks) you may be experiencing PTSD. Treating PTSD requires specific treatment, so if you find yourself experiencing these difficult feelings, it is important to seek advice from PANDA or a trusted health professional as soon as possible.

Having someone help you to debrief your birth can be a helpful way to begin to process, and recover from birth trauma. If your own birth experience has caused you any distress or affected your thoughts or feelings, PANDA’s National Helpline provides a safe and confidential space for anyone struggling with the feelings caused by a difficult birth experience. Our highly trained and caring counsellors can help you work through these challenges by talking openly and honestly about your thoughts and feelings about the birth.

For more information about PTSD: cope.org.au

Further information: birthtrauma.org.au

The Australian Birth Trauma Association is a national charity committed to reducing the incidence and impact of birth-related trauma whilst supporting affected women, families and health professionals.

_{1 How to Heal a Bad Birth, Melissa Bruijn and Debby Gould
2 How to Heal a Bad Birth, Melissa Bruijn and Debby Gould}