Psychological Injury Following a Traumatic Birth
We asked consultant psychiatrist, Dr Rebecca Moore, co-founder of Make Birth Better and expert in birth trauma for her advice following a traumatic birth:
What types of psychological injuries can be sustained after a traumatic birth?
Birth trauma occurs when women and birthing people find some part of their birth traumatic, distressing and overwhelmingly fearful. It might have been a physically difficult birth, or it wasn’t the birth you hoped or planned for during pregnancy. It’s often a birth experience that feels stuck in your mind constantly or you cannot think or talk about it all.
Perinatal trauma does not always mean a life-threatening medical emergency such an emergency caesarean or bleed. This might be the trauma, but just as often it’s about the care given to women and birthing people in labour, it’s about the interpersonal care they receive from the team around them, feeling safe, issues around consent and/or feeling your pain was managed and feeling that you were cared for with compassion and kindness. It can also be something that happened before or after birth so , for example, the feeding of your baby might be part of your trauma.
It may also be witnessing your baby born in a poor condition, needing resuscitation, or being separated from you to be admitted to the neonatal unit.
How to recognise a psychological injury following a traumatic birth?
It’s important to let things settle following a traumatic birth as it can take a while for trauma symptoms to emerge. classical signs of trauma that you might feel include:
Your mood feels changeable and you may experience feelings of anxiety
Feeling angry or on edge, expecting something else bad to happen
Feeling unable to think about or talk about your birth, avoiding pregnant friends or the hospital or avoiding sex because you don’t want to get pregnant
Finding memories of your birth pop up in your mind out of the blue and then feel stuck there
Feeling it’s hard to go to sleep and having new nightmares all about birth
Vivid images of things that happened at the birth
Feeling physically tense and jumpy
- Feeling guilty and to blame about what happened at birth
You might have one or all of the above experiences and different parts of your maternity experience may have been your trauma, it might be things that happened antenatally or postnatally and not just the birth itself.
Equally, you may feel entirely focused on your child and the injury he or she has sustained at birth and providing and nurturing their recovery, rather than thinking about your own. Trauma can often go unnoticed or untreated for many years, leaving many mothers suffering needlessly. However, maternal mental health is an important factor that influences the whole family’s well-being.
What is the process of getting assessed for a psychological injury?
For most people this will involve speaking with their GP, Midwife, or Health Visitor. You can also self-refer to NHS Talking Therapies.
Another route is to speak to someone at PaNDAs (an organisation who offer support for women and families affected by perinatal illness) or Make Birth Better (an organisation that supports parents and professionals impacted by birth trauma) or even just starting that conversation with a friend or family member to explore how you might be feeling. If you can’t say it yet, perhaps write it down.
What help/support is available following a psychological injury?
There are lots of ways to talk about and think about trauma, this will differ based on where you live in the UK but there are lots of ways in which you can address your trauma. This might be a debrief at the hospital, making a complaint, speaking with your friends, seeing your GP, therapy, exercise, breathing, tapping, physiotherapy, journalling. All of these can help.
Consulting a solicitor who specialises in birth injury claims may also help you to discover whether there has been any negligent medical care around your delivery which may give rise to a compensation claim, and be a way to get answers about what went wrong.
Another option for women is to access therapy, such as CBT (cognitive behavioural therapy), NET (narrative exposure therapy) or EMDR (eye movement desensitisation and reprocessing therapy) and/or medication. Some medications can be taken whilst breastfeeding and are used to treat PTSD. Some, but not all, NHS areas night offer couples therapy and some areas might offer parent-infant work for you to bond with your baby.
Is full recovery possible following a maternal psychological injury?
Yes, recovery is possible. It can take time and women need the right care and support and this work needs to be done at their pace. You can have a traumatic birth and love your baby at the same time, you can mourn your birth experience whilst loving being a new mum.
There is a risk of birth trauma symptoms reoccurring in a next pregnancy as of course its anxiety provoking to have another a pregnancy and birth and to trust staff to care for you. This can be helped with continuity of care from a midwife, making a trauma-informed birth plan, or choosing where you give birth, for example at a different hospital, or how you give birth, with a planned caesarean birth perhaps.
Make Birth Better was founded by Dr Rebecca Moore and Dr Emma Svanberg in 2018 with the aim of making labour and birth as safe as possible for every mother. They run key training courses and campaign for more awareness surrounding birth trauma, advocating for change on a national scale.
“Together we must be loud and bold. Birth can, and must, be better. No second best. No excuses.”