"No one ever told me it was going to be like this". "I felt completely helpless and out of control". "I felt like no one was taking my views or feelings into account". "Maybe this is what everyone experiences and I am a bad Mum for not coping like everyone else".
In an age when women are being empowered to be strong and authentic, I wish from the bottom of my heart that individually and as a society we could refrain from using the term "yummy mummy". It creates a status of "motherhood perfection" which is an unhealthy and toxic ideal which breeds amongst social media and baby and toddler groups. I wish women could truly and genuinely support each other more.
25-34% of all women find some aspect of their birth experience traumatic and it can lead to prolonged distress for everyone involved (Mum, Dad (including same sex couples) and baby). Key themes that are often part of birth trauma are feeling out of control, unheard, helpless or fearing they might die or their baby might die during labour. It can lead women to fear having another pregnancy or avoid/delay getting pregnant again.
When we talk of birth trauma, we mean Post Traumatic Stress Disorder (PTSD) that occurs after childbirth. We also include those women who may not meet the clinical criteria for PTSD but who have some of the symptoms of the disorder. Quite often this can be in the background of Postnatal Depression and/or Anxiety and identified at assessment.
Characteristic features of PTSD include:
An experience involving the threat of death or serious injury to an individual or another person close to them (e.g. their baby).
A response of intense fear, helplessness or horror to that experience.
The persistent re-experiencing of the event by way of recurrent intrusive memories, flashbacks and nightmares. The individual will usually feel distressed, anxious or panicky when exposed to things which remind them of the event.
Avoidance of anything that reminds them of the trauma. This can include talking about it, although sometimes women may go through a stage of talking of their traumatic experience a lot so that it obsesses them at times.
Bad memories and the need to avoid any reminders of the trauma, will often result in difficulties with sleeping and concentrating. Sufferers may also feel angry, irritable and be hyper vigilant (feel jumpy or on their guard all the time).
It is important to remember that PTSD is a normal response to a traumatic experience. The re-experiencing of the event with flashbacks accompanied by genuine anxiety and fear are beyond the sufferer's control. They are the mind's way of trying to make sense of an extremely scary experience and are not a sign individual 'weakness' or inability to cope.
There are risk factors for Post Natal PTSD which include a mix of objective (e.g. the type of delivery) and subjective (e.g. feelings of loss of control) factors. They include:
Lengthy labour or short and very painful labour
Poor pain relief
Feelings of loss of control
High levels of medical intervention
Traumatic or emergency deliveries, e.g. emergency caesarean section
Impersonal treatment or problems with the staff attitudes
Not being listened to
Lack of information or explanation
Lack of privacy and dignity
Fear for baby's safety
Birth of a damaged baby (a disability resulting from birth trauma)
Baby’s stay in SCBU/NICU
Poor postnatal care
Previous trauma (for example, in childhood, with a previous birth or domestic violence)
In addition, many women who do not have PTSD suffer from some of the symptoms of PTSD after undergoing difficult birth experiences and this can cause them genuine and long-lasting distress. If you or someone you know is suffering from any of these symptoms do tell them help is available.
Treatment: I offer both Trauma Focused CBT and EMDR which are the NICE Guidelines recommended treatments and are really effective. Compassion is an integral part of treatment and helping clients to develop a compassionate mind and heart towards themselves and the circumstances they find themselves experiencing.
A typical course of treatment ranges between 6-12 sessions. The initial phase is all about learning how to understand what is happening and bring a compassionate awareness to it. The middle is about processing and updating unhelpful thought or belief patterns linked to the experience. And the third is about enhancing inner qualities of compassion as part of resilience for the future and parental life. Relapse prevention may include revisiting the place of birth, speaking to staff involved or attending a hospital lead reflection group.
As part of my perinatal work, I will often involve partners. Father's access treatment too where the adjustment to change in role and increase in responsibility activates significant distress. Therapy considers the wider context and is here to help!
"Just wanted to say thank you for all your help so far, I know it’s your job, but really couldn’t have chosen a better therapist to reprogram my mind and help me become a more tolerant, relaxed person. For the first time at aged 29 I feel like I’m really starting to enjoy my life!
Your emphasis on kindness, compassion, mindfulness and self care has been particularly key for me in this, as combined with the CBT approach has been a perfect combination and I don’t think either would’ve worked without the other. In a way (at the moment) I’m feeling quite grateful for the way the birth panned out and that it’s allowed us to have this time to bond when he’s more aware of his surroundings rather than when he was born and didn’t really know what was going on!" - Juliet
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