After a difficult or traumatic birth experience women are often advised to have a birth debrief (sometimes this is offered as a listening or reflections service) with a Supervisor of Midwives (or SOM for short) or a Consultant Midwife at the hospital where they gave birth. Sometimes doulas and antenatal teachers offer debrief or listening sessions as part of their service.
Sometimes mums who attend these sessions are looking for answers to explain why what happened to them and their baby during birth. Sometimes they might want to off load and detox some of the more potent emotions that their birth has left them with. Sometimes they might be hoping for an apology for what happened, seeking some conclusion and peace about what happened.
For those offering the debrief service it can sometimes be a concern when answers don’t bring relief, when listening doesn’t help resolve unwanted feelings, when in fact it seems to intensify distressing feelings. It can feel awkward, unsatisfactory and worrying when at the end of a session the person is more distressed then when they arrived.
It for these reasons that I feel a debrief should be carefully considered and delivered because it can leave a person feeling worse. However I know that women do sometimes have a strong desire to find out what happened, to fill in blanks, to make sense of their feelings, to hold others to accounts, to seek peace and resolution to the feelings that dog them and so pursue a debrief for these (and many other) reasons.
From talking to midwives and doulas that I have worked with I have learnt that there are elements to a good debriefing or listening to a woman’s experience that can help a woman begin to resolve some of the feelings that arise from a difficult birth.
- Ask ahead of time what the woman (unfortunately it is rarely dads) would like to get out of the session. Make suggestions, for example you could say ‘would you like answers about what happened?’, ‘would you like your birth story to be heard?’, ‘would you like to discuss a personalized plan for your next birth?’ (if they are pregnant again). This builds confidence in what to expect from the session and can soothe anxiety about what will happen.
- Listen without an agenda, without interruption, without the need to explain (unless it has been asked for) to this woman’s story. Listen with compassion for what it must have been like to have experienced what she has been through.
- Apologise for what she has been through. This does not mean taking personal responsibility for what happened or taking responsibility on behalf of the organization that you work for. This is about connecting person to person and expressing regret for what they have been through. This is incredibly healing for many people and only requires ‘I am sorry you experienced that it sounds awful for you.’
- If she reports still feeling strong emotion about her birth even though it may have occurred some time ago reassure her that what she is feeling is normal given what she has been through. For example ‘I am not surprised you still feel anxious now given what you have been through’.
- Reassure her that even though what she is feeling is normal she doesn’t have to accept these feelings as permanent and that there are routes to recovery available.
And these are things I have found to be very unhelpful to women:
- Reframing what was a bad birth in her eyes into your perception of it being good. For example ‘at least it was a normal vaginal delivery’ or ‘at least your baby is healthy’. These can be more damaging for a person who may already be feeling guilty about their experience.
- Justifying procedures or interventions because this will rarely make someone feel better about what happened, it might even make them feel guilty for feeling bad about what happened.
- Excessively talking about the detail of what happened if it is clearly upsetting someone. The chances are that they are being re-traumatised by the re-telling of their story.
To learn more about techniques that can naturally ignite a healing response go to www.traumaticbirthrecovery.com to find out about courses for birth professional that teach these skills.