A ticking time bomb, an invisible wall, a video on constant replay, a mechanical robot and a dangerous ocean — what could all of these things have in common? According to researchers, these are the common metaphors birthing people use to describe their birth trauma.
What is birth trauma?
The term birth trauma refers to the experience of a difficult birth during which a woman or the newborn experiences medical complications or injury; where the birthing mother does not feel respected or treated compassionately; or where the birthing process happens in a way very different from what the mother expected. Birth trauma can be difficult to diagnose because it is subjective — the levels and types of emotional distress resulting from a traumatic event vary greatly from person to person.
The three most frequently reported birth traumas are:
- Emergency cesarean
- Lack of respect and compassion (sometimes referred to as obstetric violence)
- An infant who requires time in the neonatal intensive care unit (NICU)
Birth trauma is very common, and up to 45 percent of new mothers have reported experiencing birth trauma. Birth trauma also impacts those who witness it, and birth partners can experience post-traumatic stress disorder (PTSD) after a traumatic birth.
How to cope with birth trauma
To increase the chances of post-traumatic growth and better coping with birth trauma, a birthing person should self-disclose their experience to trusted friends, family members and care providers.
Here are some ways to engage in self-disclosure and to process birth trauma:
- Discuss the experience with a trusted clinical care provider and ask for medication when/if necessary
- Find a therapist who specializes in perinatal mood disorders
- Hire a postpartum doula
- Journal or write down your birth story
- Utilize mindfulness and meditation, or eye movement desensitization and reprocessing (EMDR) therapy
- Connect through social media with parents who have children the same age as yours
- Call Perinatal Support Washington’s Warm Line or join a support group near you
Depending on your socio-economic status, some of these coping mechanisms will be more accessible than others. Birthing people can start by asking their primary care provider for referrals and resources.
Researchers refer to the impact of birth trauma beyond the event itself as “ripple effects.” Even if the trauma lasted only minutes, the effects can be profound and long-lasting. Birth trauma can impact infant feeding and the person’s subsequent births.
The good news: The ripple effects can also positively impact a birthing person’s life. Researchers in positive psychology have begun to look at the recovery process for those with PTSD as it relates to perinatal trauma. They discuss the possibility of “post-traumatic growth” in people who have experienced birth trauma. The distress of the trauma does not disappear but coexists with post-traumatic growth. It consists of five dimensions: appreciation of life, relating to others, personal strength, new possibilities and spiritual change. The study found that the most common post-traumatic growth dimension was the appreciation of life.
What are the risk factors?
Of those who reported birth trauma, people with prior mental health disorders, sexual abuse survivors and those with poor-quality care providers are at higher risk.
Some other contributing factors include:
- Difficult labor
- Medical interventions such as forceps used for delivery or emergency C-section
- Birth injuries
- An infant requiring NICU care
- First pregnancies (with poor prenatal education)
- A previous traumatic birth (for subsequent births)
- Fear of childbirth
- Poor health or health complications during pregnancy
The difficulty of measuring birth trauma cases
The current research has limitations: Its sample birthers were mostly white, college-educated, married and had C-section births. Black mothers in the United States, for example, experience a threefold to fourfold higher risk of pregnancy-related death, and a Black infant is more than twice as likely to die within the first year of life as a white infant. The identifiers listed above don’t have to apply to you for you or someone you know to have experienced birth trauma. The quality of medical treatment for all birthing people in our country’s for-profit healthcare system is often inequitable and lacking, due to overburdened staff and the effects of racism, classism and ableism.
Ways to prevent birth trauma
Some of the birth trauma risk factors, such as prior mental health disorders, are identifiable in the prenatal period and should be addressed with a clinical care provider as soon as possible.
Seeking out trustworthy childbirth educators and perinatal care providers who offer evidence-based education and present realistic expectations for childbirth can enable families to feel more prepared and less fearful of childbirth.
Just as postpartum doulas are a helpful resource for coping with birth trauma, birth doulas can potentially be a buffer against the risk factors for birth trauma.
And finally, building a support network before or during pregnancy will benefit a family well beyond the birth. Identifying friends, family and external resources to call on will ease the transition into parenthood.
All birthing people require support and assistance well into parenthood. The key to resilience and growth in parenting is connection and community.
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