We all want mothers and babies to come through birth feeling healthy and emotionally complete. But, when a birth is not a healthy or positive experience or a mother does not feel supported or safe, it can have devastating results. These births may be disappointing, negative, or even traumatic.
Birth trauma is a real condition. It affects many women every year. Birth trauma is often not talked about or not recognised. Mums are told to pull yourself together or look at your lovely healthy baby, that is all that matters. Women who experience birth trauma are often believed to be depressed, when in fact, it is something very different. Birth trauma if formally diagnosed can be labelled as Post Traumatic Stress Disorder following childbirth. It is estimated that 3% of all vaginal deliveries result in PTSD and 6% of all c births result in PTSD, but that up to a third of unplanned c-birth may result in birth trauma.
1.A full clinical diagnosis; or
2. Some or many of the symptoms of PTSD but do not meet the full criteria for clinical diagnosis.
•the woman felt threatened or in danger of injury
•the woman felt threatened or in danger of death
•the woman felt threatened or in danger that her baby was at risk of injury
•the woman felt threatened or in danger that her baby was at risk of death
•the woman felt helpless, out of control or alone
•the woman was not treated in a supported or kind manner
•the woman did not feel listened to
•lack of information – withholding of information
•not being part of the decision making process
•the type of labour – long, painful – short, sharp – inadequate pain relief, highly medicalised, or she feels she was left to suffer
Diagnosis of Birth Trauma is based on the woman’s feelings about her birth, whether the health care providers agree or not. Birth Trauma can occur with or without physical injury to the mother or baby; in all types of birth. As one research study concluded:
“Birth Trauma lies in the eye of the beholder” University of Connecticut School of Nursing 2004
Clinically diagnosed Post-traumatic Stress Disorder (PTSD) following childbirth has been shown to range from 5.6% (Creedy, Shochet, & Horsfall, 2000) to 9% (Beck, Gable, Sakala & Declercq, 2011). The rates of women who have symptoms of post-traumatic stress, but do not meet full diagnosis of PTSD, have been shown to be up to 18% (Beck, et al. 2011).
To care for me: Was that too much too ask?
To communicate with me: Why was this neglected?
To provide safe care: You betrayed my trust and I felt powerless, and
The end justifies the means: At whose expense? At what price? (1)
PTSD following childbirth is thought to be under-reported and misdiagnosed. Many women with PTSD are diagnosed as having Postnatal Depression (PND), and, therefore, they do not get the treatment they need. While women experiencing PTSD may also experience depression, the symptoms are very different.
“Trauma survivors have symptoms instead of memories” Harvey, 1990
Women experiencing birth trauma often experience strong symptoms. She will experience nightmares or flashbacks, often reliving the trauma over and over. These nightmares and flashbacks are often very vivid. Women contacting AIMS Ireland often find that they have ‘triggers’ which can bring them right back to the event – sounds, smells, images, places.
“Every night for over a year I would wake drenched in sweat after nightmares of my daughter’s birth. I could feel their hands on me, hear the machines, feel my heart racing in fear. I regularly awoke to my own crying out. There was no escaping it. The daytime was even worse, it was then I had to confront reality. A baby to care for that reminded me of my trauma. A husband who said he understood but didn’t want to talk about it. I felt so ashamed I let them do that to me. I should have been stronger, louder. It was my somehow my fault. I was so angry at my husband for not helping me. It wasn’t his fault but I hated him for it. I felt so much shame. I used to cry all the time. It consumed me. My anxiety was through the roof and I developed a fear of confined spaces and panic attacks. I finally sought help after I had to go into the hospital for something unrelated … I walked past the antenatal clinic and the sounds and smells hit me like a force I’ve never felt before. I ran to the toilets and threw up. Its been 5 years since my birth…. it never goes completely away but its no longer a trauma I relive. ” ~ A woman in contact with AIMS Ireland Birth Trauma Support
Women may also feel strong anxiety, panic, or feelings of fear. She may have difficulty coping and bonding with her baby. She may feel guilt, shame, or worthlessness.
•re-occurring flashbacks, nightmares, “play-by-play” reel of the birth playing over and over
•you may feel distressed, panicked, or anxious around things that remind you of your birth
•you may avoid things that remind you of your birth
•you may feel unattached or have a hard time bonding with your baby
•you may feel anger at those who were in the room with you (birth partner)
•you may feel violated
•you may feel grief, anger, or numb
•you may become obsessive with details of your birth
•you may avoid speaking of or thinking about your birth
•you may fear or make a decision to never give birth again
•you may want to get pregnant straight away – “make things different”
•you may experience problems in your relationship if your partner doesn’t understand or you have sexual problems
•you may experience sleep difficulties
If you are having a difficult time recovering from a difficult or traumatic birth, it is important to recognise how you are feeling. Don’t just hope that your feelings with go away or that how you are feeling is not valid or important.
Sharing your feelings with supportive people is important. You might not want to at first, but a lot of mums feel relieved once they do.
• your partner
•a close friend or relative
•a debriefing service through your maternity unit
•peer support, from other women who are healing from birth trauma. Some counselling services run support groups for birth trauma.
•AIMS Ireland support services
•AIMS Ireland closed online Birth Healing Support Group
•The Birth Trauma Association in the UK
Not everyone you speak to may understand birth related PTSD, may health care professionals are not very familiar with it yet. It may help to print this out and show it to your partner or GP. If you find a health care provider isn’t supporting you, there are other supports available through counselling and support groups, listed below.
There are many reasons why women, and, sometimes their partners, may benefit from counselling after the birth of a baby.
There are no ‘right’ or ‘wrong’ reasons for seeking counselling.
It is important that if you feel like you need to speak to someone, that you find the support you need to feel better.
The accredited list of counsellors can be found here: http://www.irish-counselling.ie/
AIMSI Birth Healing support group: A closed group for women whom have experienced a difficult or traumatic childbirth offering a safe place to share stories and provide peer support. If you are interested in this group, please contact AIMS Ireland. email@example.com or via messages. You will be required to provide an email address to be added.
Read one woman’s experience of birth trauma here
If you have had a difficult or traumatic birth, you may have many unanswered questions. Reviewing your birth notes can help provide answers, fill in gaps, and give the hospital’s account of your birth. You can find out how to request your notes here
If you have had a difficult experience you may also want to make a complaint. Find out more about making a complaint here
To contact AIMS Ireland Support Services or to be added to the Birth Healing Peer Support Group email: firstname.lastname@example.org
1) Beck, C. T. (2004a). Birth trauma: In the eye of the beholder. Nursing Research, 53(1), 28-35.
2) Creedy, D. K., Shochet, I. M., & Horsfall, J. (2000). Childbirth and the development of acute trauma symptoms: Incidence and contributing factors. Birth, 27, 104-111.
3.) Beck, C. T., Gable, R. K., Sakala, C. & Declercq, E. R. (2011). Posttraumatic stress disorder in new mothers: Results from a two-stage U.S. national survey. Birth, 38: 216–227.doi:10.1111/j.1523-536X.2011.00475.x