Recovering from a traumatic birth

We’ll say it – birth is no walk in the park. And for some, the experience (or what comes after) can even lead to posttraumatic stress disorder. Here’s how you can cope, writes Robyn Lawrenson

WHAT IS PTSD?

Posttraumatic stress disorder (PTSD) is a mental health problem that develops after a person has experienced a traumatic event. This could be a car accident, hijacking, near-death experience, or in this case, a traumatic birth. Somatic psychologist Susanne Babble says, “PTSD is very different from postnatal depression (PND). The former occurs as a result of trauma (or perceived trauma) during delivery, while the latter happens because of hormonal changes in a woman’s body as a natural result of giving birth. Nevertheless, these two conditions are linked together in some cases, and can certainly exacerbate one another. It’s important to distinguish between the two so that you can seek the most effective means of treatment.”

WHAT COULD MAKE BIRTH (AND BEYOND) TRAUMATIC?

If you went through distress while giving birth, it’s referred to as a traumatic, or difficult, birth. You might have wanted a natural water birth, but landed up having an emergency caesarean section. You may have suffered immense pain, experienced a tear, or needed an assisted birth. And that’s the thing with birth: it often doesn’t go exactly according to plan. Psychologist Karin Steyn says, “A woman may experience her birth as traumatic if she or her baby experienced real or threatened injury or death. This could occur if the mother went into premature labour, or if the labour and birth were very long and painful and might have resulted in unplanned medical interventions. This could also occur if the mother was unprepared for what to experience during the birth (what happens in her body and what happens to the baby) and if she did not have adequate coping skills and support to deal with the pain of birthing.” Social worker in private practice Sally Baker, says, “Birth could be perceived as physically traumatic (overwhelming pain, surgery and interventions) or as emotionally traumatic (perception of a life-threatening situation to mother or baby, or experiences that result in feelings of helplessness, abandonment, abuse, bullying and neglect).”

KNOW THE SYMPTOMS

The effects of a traumatic birth vary from woman to woman. The way you feel

about, and cope with, what happened will be unique to you. Symptoms of PTSD after birth include revisiting images of labour and birth, fear of giving birth in the future, poor self-image and feeling inadequate, relationship difficulties, difficulty with bonding with your baby, and feeling guilty as a result, and feeling isolated. Karin says, “After a traumatic birth, a woman’s body recoils from the pain, fear and trauma; on a cellular level she might store the memory of the birth. Triggering in any of the physical areas of birth (her pelvis, vagina, abdomen, breasts) could stimulate recall of the trauma. She might avoid thinking or talking about the birth, and even avoid returning to her doctor or midwife for check-ups. She could be haunted by flashbacks of the birth. She might experience difficulty bonding with her baby when she’s emotionally taxed and unavailable and this can also affect her relationship with her partner. She could develop mistrust in her body, and the medical system. The loss of her ideal birth is something she might suffer and need to mourn. She would have to receive support to talk about and process her difficult birth.”

DEALING WITH PTSD EFFECTIVELY

If you think you might be suffering from PTSD, it’s important that you seek treatment. Sally advises, “Most women will benefit from non-judgemental and respectful support and guidance from other women. As the saying goes, ‘It takes a village to raise a child.’” But, she warns, don’t go looking for that support in “groups”. She says, “The concern for me is that traumatised women go into groups that have a certain purpose, like a moms group or baby massage, and use the group for a birth debriefing. This is not an appropriate use of the group and will result in the spreading of ‘scary stories’ and will not be helpful for the traumatised woman. I would suggest that women who have experienced traumatic starts to motherhood seek out a professional and qualified birth story listener and receive any treatment they need.” Karin says, “While PND responds well to a combination of counselling and psychotherapy and medication management, PTSD requires a unique treatment, and the sooner it can be diagnosed the better. PND might resolve without treatment, but PTSD could get even worse without the right treatment. It’s important to talk about your birth, understand what happened, and process the birth properly. Treatment options include talk therapy and medication.”