Birth Trauma: An Introduction
Birth trauma is an issue in desperate need of conscious raising, it is largely invisible to mainstream society and frequently misrepresented and misdiagnosed as postnatal depression. When birth trauma is misdiagnosed as postnatal depression women's bodies and hormones are made the scapegoats for a maternity system that is broken and harms the very people it should be caring for. Of course birth trauma can lead to depression, but depression is merely a symptom of the much bigger problem.
What is Birth Trauma?
The Birth Trauma Association of The United Kingdom defines birth trauma as post traumatic stress disorder that occurs after childbirth. They state:
"PTSD is the term for a set of normal reactions to a traumatic, scary or bad experience. It is a disorder that can occur following the experience or witnessing of life-threatening events. We usually recognize these as things like military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. However, a traumatic experience can be any experience involving the threat of death or serious injury to an individual or another person close to them (e.g. their baby) so it is now understood that Post Traumatic Stress Disorder can be a consequence of a traumatic birth." (BTA)
What Causes Birth Trauma?
There are a number of factors that can contribute to birth trauma and whether or not a woman's birth becomes traumatic depends heavily on who is present in her birth space. Some causes of birth trauma include (list inspired by the list from Birth Trauma Support Group Seattle):
* Care providers who do not listen to the mother.
* Care providers not considering the mother's emotional, psychological, spiritual and physical needs.
* Impersonal, insensitive or judgemental attitude of care providers.
* Care providers failing to adequately explain what they are doing and why.
* Care providers not giving mothers time or space to either consent or refuse procedures.
* Care providers not seeking consent before carrying out tasks.
* Care providers failing to pay attention to mothers dignity during birth.
* Staff changes, strangers in the birth space coming and going as they please.
* Care providers bullying mothers into consenting to procedures they would not otherwise consent to.
* Unfamiliar birth environment.
* Managed labour (eg drips, monitors, augmentation, induction) as opposed to undisturbed labour.
* Unwanted interventions.
* Multiple vaginal exams.
* Violation of birth plan/Care providers ignoring the preferences of the mother.
* Previous experiences of sexual abuse (flashbacks).
* Previous experience of birth trauma (flahsbacks).
* Unnecessary caesarean section performed for staff convenience.
* Separation from baby after birth.
* Unexpected outcomes and interventions.
* Inadquate emotional support.
The Birth Trauma Support Group of Seattle notes that:
"Until such time as child birth becomes recognized as a monumental event that impacts not just the physical body, but also the emotions and spiritual aspects of our humanity then [birth trauma] is likely sadly to continue."
Why is it Invisible to Most People?
By and large birth trauma goes unrecognised in our society and one of the major reasons for this is that Western culture blindly accepts that childbirth is meant to be a traumatic experience and that trauma is a natural part of giving birth. This of course, is not true. You only have to take a look at documentaries like Orgasmic Birth and websites like Positive Birth Stories, Joyous Birth and Born Free to know that birth is not by nature a traumatic event.
It is not birth itself which is traumatic, but what happens to the birthing woman during her labour that can cause the experience to become traumatic for her. Saying birth is traumatic is like saying sex is rape: one is a normal physiological function our bodies are designed to do and that we can derive pleasure from, and the other results from an abuse of our bodies and violation of trust.
This is not to say that you can have an easy or orgasmic birth simply by employing the right care provider (or none at all), it's not called labour for nothing. However, there is a vast difference between an experience being challenging and it being traumatic. For example, one mother who had a very long labour found that birth experience to be challenging, but after the birth she felt elated at having triumphed despite the challenge and walked away with new found respect for herself, and another mother who had a traumatic birth in which she was given repeated vaginal exams and an episiotomy which she did not consent to. The latter woman experienced nightmares and flashbacks of the birth and developed trust and body image issues that found their way into her marriage and sex life.
It is also worth considering that birth is a woman-specific experience and therefore birth trauma and violence against women are often one and the same in the birth space. In a world where violence against women is rife and yet few resources are allocated to erradicating this social problem it is little wonder that the violence comitted against women at birth goes unrecognised.
How to Avoid Birth Trauma
One of the simplest ways to avoid having a traumatic birth experience is to stay home. Home is a safe space, it is the mother's personal space. Unlike a hospital or birth centre the mother has great power in determining who enters her birth space, and what those present do whilst in her space. Hiring birth support people such as a birth servant or a birth specialist such as an independent midwife (regardless of where she chooses to give birth) is an excellent way of avoiding birth trauma. With a privately employed support team the mother can hand choose who provides her medical and/or emotional support during labour. Throughout pregnancy she can develop a rapport with the one (or however many she wishes) midwife or birth servant and develop a birth plan with them therefore dramatically decreasing the risk of having her trust violated during labour. Knowledge is power. Know your options, know what happens at normal undisturbed birth, know your body, know your care providers, know your birth space. This goes for the fathers, partners, aunts and grandmothers who might be invited into a mother's birth space. It is important that everyone at a birth is well informed about normal birth and about the mother's birth plan.
Birth trauma is real. Birth is not traumatic by nature. Birth can be made traumatic by care providers. Significantly decrease your risk of birth trauma by birthing at home with trusted care providers & loved ones!
For more posts about birth trauma click here
2009 The Year of Birth Trauma Awareness home page
Birth Trauma Association
Articles & Resources about Birth Trauma
Forms of Birth Rape, Birth Abuse and Birth Trauma (see this article for a comprehensive list of causes of birth trauma).
When a Bad Birth Haunts You
One Woman's battle with birth trauma
Birth Healing Forum
An Online Community for Supporting People Recovering From Birth Trauma
Birth Trauma Support Group
Original post from http://www.ilithyiainspired.com/2009/01/2009-year-of-birth-trauma-awareness.html