I’m a GP who spent 6 months of junior doctor training on an Obstetric and Gynaecology rotation. I had watched baby’s been born, delivered a few myself and assisted in caesarean sections. I had also sadly supported women who had miscarried or had pregnancy or birth complications. It’s safe to say that by the time I got pregnant, I felt pretty well informed about the highs and lows of pregnancy and birth. All that knowledge and experience can be empowering but it can also be difficult suddenly being in the patient role.
When I got pregnant, I tried hard to de-medicalise my experience and go with the flow, and fortunately I had a relatively uncomplicated pregnancy. I felt relaxed and prepared in my third trimester.
My birth story started like many others – labouring at home for 12 hours until I was contacting 3 times in 10. That part I remember fondly – I felt in control. I had done a hypnobirthing course and we had the candles and essential oils on the go, I was in the shower and the bath for a lot of it and felt relatively calm.
Unfortunately, what followed was less peaceful. I had a long labour with intense contractions. I failed to progress due to an occipito-posterior position of the baby. My pain relief was inadequate – when I felt I needed an epidural, no anaesthetists were free and I had to wait 7 hours.
Ultimately, I ended up having a Synctocinon drip, fetal distress and a forceps delivery. I needed an episiotomy but also had a second-degree tear. We had a lot of people in the room at the end and it was far from the relaxing, hypnobirthing environment that I had hoped for.
My son was born 40 hours after my labour had started. The initial gratitude for it all being over and holding a healthy baby boy in my arms carried me through those first few days. It was only later that I started to digest what had happened and feel distressed and saddened by my experience and was getting a lot of flashbacks. I ultimately ended up getting Post Natal Depression and took an antidepressant for 6 months. For me, the trauma of my experience came from three things:
- Feeling unable to self-advocate. Unable to have an epidural for pain relief, I was given pethidine which made me very foggy and unable to communicate properly. My husband was trying his best to advocate for me but this was not in our birth plan so he found it difficult to navigate. I felt out of control.
- Fearing something was wrong with the baby but not being able to adequately voice that fear.
- An instrumental delivery and postnatal episiotomy infection which I had been so keen to avoid.
Recovery from birth
My recovery from birth and subsequent post-natal depression was hugely supported by my amazing network of family and friends. I definitely needed that army around me.
When being treated for Post Natal Depression, I saw a wonderful therapist who encouraged me to ask the hospital to speak to the Birth Trauma Midwife for a debrief appointment. A birth debrief, sometimes called “birth reflections” or “birth afterthoughts” is a one-to-one session in which a midwife or obstetrician will look at your birth notes, talk you through the events of your baby’s birth and answer any questions you may have. Not all units have this service but I highly recommend it for women that have had a difficult experience. I continued CBT for several months as well as taking antidepressants and slowly everything felt lighter. I also found the Birth Trauma Association a hugely useful resource.
Planning another Birth
It took me a long time to feel ready to try for another baby. Planning for a new birth can be very triggering, so here are some steps myself and my antenatal team have taken to try and plan for a better experience next time round.
Telling someone early
At my first booking appointment, I made sure I told my midwife about my previous experience. Sharing your experience early will allow the professionals involved in your care to ensure you get the support you need. This may include a referral to psychology to help you process the memories of your traumatic birth and any fears you might have about giving birth next time round. It might also include a referral to the Perinatal mental health team or specialist midwife team for further support.
Making a birth plan
Spend time talking through your birth plan with your team and partner. Whilst it’s difficult to plan for every eventuality, writing down your wishes around you care, pain relief, environment and type of birth can help reduce anxiety and support you in feeling in control. For me, this included planning for c-section next time round and talking this through with the Birth Options Clinic.
Visit the delivery suite
Seeing where you might labour and/or give birth can help familiarise the environment and reduce anxiety.
Some women may choose to try hypnobirthing antenatal classes to learn more about labour and methods to keep calm throughout their labour. I did this the with my first baby and found this very helpful.
A final word on Birth trauma
Birth can be traumatic for all sorts of reasons – it’s about the woman’s experience rather than the specifics of the events. It might be that you needed an emergency c-section, had a difficult instrumental delivery or postpartum haemorrhage. It might be that you had inadequate pain relief or there were times in labour that you didn’t feel listened to and heard.
Research has shown that 4-5% of women who given birth can develop Post-Traumatic Stress disorder (PTSD). This can manifest with anxiety, flashbacks and nightmares and can make it difficult to function. Other women may still experience trauma symptoms, but not meet the criteria for a PTSD diagnosis. Birth trauma refers to anyone that feels their birth experiences are still continuing to affect them in some way. Partners can also experience birth trauma symptoms and may also need support.
If you have had a difficult birth and are experience trauma symptoms, please speak to your GP or midwife for support.
The Birth Trauma Association (https://www.birthtraumaassociation.org.uk/) is also a hugely valuable resource of information and support. They have a team of peer supporters: parents (one of whom is a dad) who have all experienced traumatic birth themselves and been through a process of recovery.
If you’d like to talk to them over email about your experience, please contact them at email@example.com or phone them on 0203 621 6338.
You can also join their Facebook group for parents with birth trauma: www.facebook.com/groups/TheBta