It’s a tricky question because we are so inclined to think that it is the circumstance of a situation that makes it traumatic. And this is often true, a car crash is traumatic, being attacked is traumatic, a warzone is traumatic. And we often can’t do anything about the situation so it seems correct that birth trauma cannot be avoided given how unpredictable birth can be.
However there are some critical factors that seem to always be in play when it comes to birth trauma. These are:
- The person perceives their life or the life of someone they love to be in danger.
- A loss of control of the situation and or an inability to escape.
- A threat to physical or emotional integrity. Boundaries of respect and dignity are crossed, a person’s humanity is ignored or disregarded.
- An experience of intense and prolonged fear, stress and anxiety.
At first glance it may seem that there is little to influence these factors but I believe there is a huge difference that can be made by midwives, doulas and birth partners that can negate the effects of a tough or difficult birth so that it does not leave a mark or have lasting effects on parents or babies.
The biggest asset we have in preventing a traumatic birth experience is all about effective communication with parents. Communication should aim to reassure, and not frighten and although this sounds obvious (I can imagine midwives reading this thinking ‘why would we ever want to frighten someone?’) Many routine procedures put fear into parent’s minds even though they are part of standard policy and everyday practice. For example post date inductions are often framed in the context of danger to the baby, rather than a presentation of facts, and choices to be made. This immediately seeds anxiety into parent’s minds so that they are vulnerable to experiencing higher levels of fear than necessary during birth. I would like to see an end to using fear as a tool for coercion and control during birth because it is likely to end as a traumatic birth experience costing parents and babies their future peace and happiness and costing the NHS trust and faith in the system.
Sometimes I see fear transferred from birth worker to parents. That their own previous experiences can bring fear into the birth room. Fear is contagious and spreads quickly causing any confidence in birth to quickly leave the room. It would be good to see some provision for birth workers to be able to safely process difficult births so they are able to work cleanly for each birth, approaching each one afresh. I feel that we expect our midwives to turn up to work day in day out, to be their best, compassionate selves for each and every birth but not provide any support for them to do this. Until we start treating birth workers with more compassion and the act of birth with more respect and reverence we can only expect production line care.
Loss of control during birth can be devastating to parents but as birth workers we can help soften this by offering more choices in care where possible. This approach takes time to explain what options might be available and it takes time to effectively support the choices once they have been made but the payoff for parents is huge. They feel like they had choices, and in making them it gives back some control.
One of the most lasting and deeply effecting aspects of birth trauma occurs when a person feels that they were not treated like a person during their birth. De-humanising treatment has a profound effect on us all. To not matter, to be transgressed, to be treated merely as a vessel carrying ‘precious’ cargo is the result of an over investment in technology, policy and protocol at the cost of listening and responding to someone’s human need.
Birth matters because it effects how we feel about ourselves, our partners and our babies for a long time afterwards. It’s always worth considering how we as individuals can prioritise a mother’s experience of birth above protocol, policy and institutional process because it is the mother, her partner and her baby that will have to live with the resulting feelings long afterwards.
To learn more about birth trauma, its’ effects and how to aid recovery go to www.traumaticbirthrecovery.com