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By Soraya Paterson-Byrne of Sage Birth
If this is you, you may be feeling pretty apprehensive about giving birth. You may be avoiding thinking about it altogether because it brings back too many difficult memories and post-traumatic stress. However, there are ways to heal, and you can move yourself from a place of fear, to a place of joy and excitement, once more, like you may have felt during your first pregnancy.
It’s not necessarily the details of what happened to you, or your baby, that have made you feel traumatised, but instead how you felt about the experience. People hold trauma after a significant event for various reasons. Sometimes this occurs when they have felt out of control, completely vulnerable, and helpless. Sometimes, when a person perceives that they, or a loved one, was at risk of severe harm, or they believed that there was a risk of death. At other times it could be because of the physical complications of an injury sustained.
Usually, when we experience a happy, or even mildly unpleasant event, the memory gets stored in a beautifully organised fashion, like a larder or closet organised by The Home Edit. However, a traumatic memory is like a documentary about someone who has been hoarding for 20 years; old magazines, mouldy food, and strange collections tumbling everywhere.
Having a disorganised traumatic memory of your childbirth experience can cause you to experience intrusive thoughts, such as fears about your baby’s health and wellbeing, nightmares of the event and flashbacks (reliving the event). Some people might want to avoid certain places, things, or people, such as a hospital, or watching birth scenes on TV, because they find themselves triggered into the fight, flight, or freeze mode.
You may find yourself feeling emotionally volatile; getting angry easily or, completely the opposite, feeling emotionally numb. You may find that your relationship with your partner, or other close family members or friends, becomes strained. You may tell yourself stories about how feeling or acting a certain way makes you a bad mum; please know, this is not true and you are doing the best job you can in the circumstances you are in.
If you experience birth trauma, it can really affect your quality and enjoyment of life, how you bond with your baby, and how you and your partner navigate parenthood. It’s not something you have to live with.
How do I plan for another birth after a traumatic birth experience?
A traumatic birth experience may leave you feeling that your body has failed you in some way, or that you have failed your baby. You may tell yourself stories about not being ‘good at giving birth’, that any poor outcomes are your fault, or that you, or your baby, would have died if you were not in hospital. This narrative may cause you to want to approach a second birth in a less optimistic, and more controlled way, than your first one.
You may be considering a planned caesarean, extra monitoring, an epidural, or birthing in an obstetric unit (labour ward) over a birth centre or home – these plans could be identified as safety seeking behaviours. With a negative narrative about birth, and your capabilities, you may find yourself lacking in confidence and empowerment.
The birth experience itself may also trigger a traumatic response where the familiar sensations of labour and birth may cause you to become distressed and go into fight, flight, or freeze mode. This would be frightening for you and disruptive to the process of labour, leading to an increased likelihood of a poor outcome, so it’s important to get help and support to heal from your birth trauma.
If you are able to approach the pregnancy, labour, and birth, of your subsequent baby, released from the trauma of your past experience, then you are more likely to have the best possible start to life with your next little one.
If you need someone to talk to, and expert guidance in releasing trauma, accessing a psychological therapist may be beneficial. The NICE Guidelines recommend either Trauma Focused Cognitive Behaviour Therapy (CBT) or Eye Movement Desensitisation and Reprocessing (EMDR).
You may be able to self-refer to your local Psychological Therapies or you could ask your health visitor or GP for a referral. Some Trusts also offer a Women’s Health Psychology service where a clinical psychologist may offer specialist support in birth trauma. There may also be a private therapist in your local area who specialises in birth trauma; please check what their qualifications are, what training they have in the recommended trauma interventions, and whether they have professional registration with a governing body like HCPC or the BABCP.
How can I best prepare for my next birth?
You may also find it helpful to book a Birth Reflections session. The NHS team or care provider that offered you maternity care last time should be able to provide this. A midwife will go through your birth notes and discuss the timeline of events, what decisions were made and why, and discuss the outcomes. You will also be able to have a chat about how you feel about the events that unfolded.
You may also find it helpful to book a Birth Reflections session with an independent midwife who will not be bound by NHS policies or regulations, and may be able to speak in a freer and more critical manner, about decisions that were made, due to not feeling a need to protect the organisation.
It can be helpful to look critically at whether you gave informed consent for any interventions or escalations in your care, and what decisions, made early on, had a negative impact on the outcomes of your labour. A common example is being encouraged to have an induction of labour for being “post-dates”; this increases a woman’s likelihood of experiencing an unplanned caesarean (Davey & King, 2016), or post-partum haemorrhage (Braund et al., 2023). Understanding the facts, and evidence behind interventions, may help you to have more confidence in yourself, your body, and your baby, to birth naturally.
Hypnobirthing is also an amazing way to arm yourself with techniques to support a positive birth experience. You will learn breathing strategies and relaxation techniques, to fill you with a calm confidence, in the lead up to your next baby’s birth. You will feel empowered in understanding policy, guidelines, research, and consent, and learn how to ask questions and take control of your care.
It is possible to heal from a previous trauma and you do not need to wait for “time heals all wounds” – and actually, when it comes to trauma, sometimes time doesn’t! I wish you all the best and hope that the next time you experience birth it is wonderful.
References
Braund, S., Deneux‐Tharaux, C., Sentilhes, L., Seco, A., Rozenberg, P., & Goffinet, F. (2023). Induction of labor and risk of postpartum hemorrhage in women with vaginal delivery: A propensity score analysis. International Journal of Gynecology & Obstetrics.
Davey, M. A., & King, J. (2016). Caesarean section following induction of labour in uncomplicated first births-a population-based cross-sectional analysis of 42,950 births. BMC pregnancy and childbirth, 16, 1-9.
NICE Guidelines on Post-traumatic Stress Disorder (NG116) published 5 December 2018 accessed on 31 January 2024 at
https://www.nice.org.uk/guidance/ng116/chapter/Recommendations#management-of-ptsd-in-children-young-people-and-adults
I’m Soraya from Sage Birth; a hypnobirthing expert, antenatal teacher, and clinical associate psychologist in Newcastle upon Tyne. I have a special interest in birth trauma, maternal mental health, informed consent, and the empowerment of women in their transition to motherhood. Please check out my website for more information on hypnobirthing www
You can also find me on Instagram for fun and helpful information.
