The stress of a difficult birth can take its toll both physically and on a parents mental health, and dealing with birth trauma and its after effects can be a lengthly process. About 30,000 women a year, according to the most recent research by the Birth Trauma Association, experience birth trauma in the UK. But even more – about 200,000 – feel traumatised by childbirth, and experience some PTSD symptoms.
Perhaps the baby’s heartrate dipped, leading to an emergency caesarean section. Maybe you or your baby suffered injuries as the result of the birth. Or maybe you felt that you weren’t well looked after in labour, or you weren’t told what to expect.
Having your birth not go to plan, feeling afraid harm may come to yourself or your newborn can lead to post-traumatic stress disorder (PTSD). Birth is completely unpredictable so you should never feel guilty about a traumatic birth but PTSD can make you feel that way.
Here we explain more about birth trauma, dealing with birth trauma and how to get the support you need.
What is birth trauma?
Birth is an experience that can leave us all wondering what just happened, but for some women they’re left with birth trauma, essentially post-traumatic stress disorder after the event.
It's not just the birth parent who can be effected either - some partners, and even midwives, experience PTSD after seeing a traumatic birth.
"Symptoms include flashbacks, depressive feelings, feelings of inadequacy and recurring negative thoughts about your experience," says Maureen Treadwell, co-founder of the Birth Trauma Association (BTA).
And you don’t necessarily have to have had a horrific time in the delivery suite to develop birth trauma. "Women who’ve had straightforward deliveries can also be affected," says Maureen. "If they felt as though they had control snatched away from them, for example."
Symptoms of birth trauma
Birth trauma can have a big effect on your day-to-day life. You might find it effects your relationship with your partner, or even friends and family. You might start to avoid triggers that remind you of the birth – other women with babies, television programmes about birth, hospital appointments. You might feel frightened about getting pregnant again and worry about having another traumatic birth.
Feelings of guilt, failure and anxiety are common issues after a traumatic birth.
Fears of giving birth again
If you’ve had a difficult labour, many women reason ‘why do it again?’ – even if they want more children. Before making a decision about future pregnancies, it’s helpful to talk to medical professionals about what took place when you gave birth, so you understand what happened.
"Most hospitals offer a Birth Afterthoughts service where you can talk through your experience with a specialist midwife," explains midwife counsellor Sue Frame.
Remember, too, that history rarely repeats itself. "Second labours are almost always quicker and easier," says consultant obstetrician Patrick O’Brien, spokesperson for the Royal College of Obstetricians and Gynaecologists.
Feeling like a failure after having a C-section
Many women who end up delivering in the operating theatre feel as though they’ve failed at motherhood before it’s even begun.
Sue Frame advises women in this situation to request a debriefing session with your hospital’s Birth Afterthoughts service. "Often, this helps you understand that a caesarean was the only option, and nothing you did could have changed it," she says.
Talking to other women who have had caesareans can be helpful, too. "Not everyone feels negatively about caesareans," explains Maureen Treadwell. "Speaking to these mums can rebuild your self-esteem and help you realise that it wasn’t your fault."
And while it’s important to be prepared for the possibility of a c-section in the future, don’t assume that a natural birth is unattainable. "Around 60 to 70 per cent of women who attempt a vaginal birth after a caesarean (VBAC) are successful," says Patrick O’Brien.
Scared of having sex since giving birth
It’s not unusual to feel strange, or too sore, to contemplate sex for months after giving birth. If you’re concerned, it can be worth seeing your GP before having sex to reassure you that you’ve properly healed. If the check-up gives you the all-clear, go slowly.
"Build up intimacy gradually until you’re ready for sex," says Sue Frame. "And if the thought of sex really upsets you, seek advice from your GP: a session of NHS psychosexual therapy can help."
Recovering from a traumatic birth
If you had a difficult birth experience, you cannot change that. There are, however, a number of positive steps that you can take to help you resolve your experience and heal from it, one of which is addressing your emotions surrounding your birth.
Honour your feelings
It’s so easy to dismiss or ignore those feelings of disappointment after your birth has not gone the way you wanted. This is partly because they can often immediately make you feel guilty or even ungrateful for the beautiful baby you hold in your arms. It can make you feel like a bad person.
It’s really important to know that this isn’t true. Birth is a hugely important life experience, and it’s ok to have had hopes and dreams about what it was going to be like, and to feel tearful or even angry that it wasn’t that way at all. Your feelings about this are normal, valid and important.
Talk about your birth
Try to find someone to talk about your birth with. You might like to talk to your partner, although they may be disappointed, upset or even traumatised too, and you might need someone with a bit more distance from the situation to be a balanced listener. This might be a close relative or friend, or you may like to seek out a counsellor or therapist.
Around 30 per cent of new mums experience some PTSD symptoms. If you think you may be suffering from post-natal depression (PND) or PTSD, then you should be referred for counselling by your GP.
Classic symptoms of Post-Traumatic Stress Disorder (PTSD) include flashbacks, nightmares and intrusive thoughts about your experience. Some women feel panicky when others discuss their birth stories, however happy.
Most maternity units will also offer to go over your birth and your notes with you, which might help answer some of your questions about what happened and why, and it can also help to talk to other mothers in online groups such as Positive Birthers.
Make a complaint
The key to a good birth is how it’s managed. "Two women can have almost the same experience, but the one who felt respected and well informed will look back on it more positively than the one who felt that decisions were taken away from her or that she was rudely spoken to," says Patrick O’Brien.
If you feel your labour was mismanaged, try writing an account of what happened. "Simply writing your birth story can be therapeutic," says Sue Frame.
You also have the right to make a formal complaint about the maternity care you received. If you think you want to do this, it is a good idea to write down as much as you can remember about your birth as soon as you can, and also to request a copy of your maternity notes. You may also want to report an individual practitioner to their professional body, or take legal action. For more information on this, see this factsheet from Birthrights on Making a Complaint.
Asking for a debrief can help you understand the care you received. If you’re still not happy, making an official complaint, by writing to the hospital’s Patient Advice and Liaison Service (PALS) is an option.
Remember that you matter
Your feelings about your birth don’t have to have any connection to your feelings about your baby. You can be totally connected to your little one and at the same time still be feeling low and upset about your birth. Likewise you can have a ‘dream birth’ and go on to really struggle with the emotions of new motherhood.
Give yourself permission to feel this complex range of feelings, and seek help if you need it. Your birth matters, your baby matters, and you matter too.