Birth Trauma

It has huge consequences and is more common than you think

1 in 3 Australian women have stated that they had a traumatic birth experience (1). This trauma does not necessarily come from their life, or their baby’s life being in danger. The trauma these women experience is usually due to a feeling of loss of control. And the trauma isn’t only reserved for the labouring women. Partners also experience birth trauma from witnessing their partner in a vulnerable position, with scary things being done to her and them feeling like they are totally helpless.

Being in labour is one of the most vulnerable states a human can be in. You experience intense physical sensations and your emotions are running high. It is a momentous event in your life and you want it to go as smoothly as possible, with you and your baby happy and healthy. If the birth goes well (regardless of the mode of delivery), women feel invincible. They are empowered and proud and confident in their abilities. If the woman doesn’t feel like her birth went well, she can feel disempowered, guilty, ashamed, fearful and depressed.

The majority of women in Australia give birth at a hospital. The way our healthcare system is set up makes most people feel that the medical team caring for you are in charge of what happens to you. Being in a foreign space (a brightly lit hospital room), with strangers around you (obstetricians, midwives, nurses, other hospital staff) who are very comfortable in this space, while you are in this vulnerable state, increases that feeling of not being in charge of yourself.

So if a midwife or doctor tells you that you need to be on syntocinon, or have an episiotomy, or an emergency caesarean, most women and their partners would simply nod and go along with whatever they say. These procedures are often not fully explained and everyone seems to be in a rush (as hospitals are very understaffed), so they do what they have to and don’t spend much time walking you through everything that is happening and making sure you and your partner are ok. This lack of information, choice and respect removes the woman’s agency, and is a huge predictor of whether the woman feels as though she had a traumatic birth. Two women could have similar medical scenarios play out and they both need an emergency caesarean, but if one woman had a caregiver that took time to explain everything either before or while it was happening, and told her she would stay by her side and that she was doing an incredible job, while the other received none of that care and attention, they would come out of the situation with very different feelings about it.

Unfortunately, 1 in 10 women are victims of obstetric violence, which means; “any act by a healthcare worker that causes harm to someone who is pregnant, is giving birth or has recently given birth, such as performing examinations or treatments without consent, failing to respect dignity and confidentiality, threatening, blaming and discrimination” (2). And 1 in 25 women develop PTSD from their birthing experience (3).

Birth trauma can impact; how the woman recovers physically, the bond between mother and baby, the transition to motherhood and the mother’s self confidence, risk of postnatal depression, decreased breast milk, stress on intimate relationships, the partner’s mental health, lack of trust in the medical system…. basically it impacts every member of the family, and quite often long term.

None of this is good enough. Every woman and their partner (and support people) deserve to be treated with dignity, respect and care. The transition to parenthood should be a joyous one, helping women to enter motherhood with confidence and support. While there are many recommendations being given to our healthcare providers in Australia, we cannot count on these and leave our health and wellbeing up to the people caring for us. We need to take charge to ensure we have the best experience possible……..
 

So how do we do that???

We know that continuity of care really helps. This means you have your pre-natal, labour and postnatal care with one care provider (such as a private obstetrician or midwife), or sometimes there is a small group of midwives who will rotate, so you get to know each of them and one of them will attend the birth. Having this continuity allows you to build a relationship with the person/people and they are a lot more likely to know you, listen to you, and respect your wishes. It also allows you to decide if that person is right for you. You need to feel 100% comfortable with, and totally trust your care provider so you can enter labour with confidence that they will have your back and listen to you and your partner. You need to make sure they understand your preferences and that their policies, procedures and preferred lines of action are in line with your preferences.

If continuity of care is not an option for you, ask your provider questions about the hospital’s policies on consulting women and their partners before any interventions are implemented. Ask about episiotomies, caesarean rates, epidural rates, forceps, ventouse, reasons for induction, if the labouring woman is allowed to be mobile, get in the shower or bath, how often monitoring is performed, delayed cord clamping….. the more questions you ask, the better informed you are to make decisions about where you give birth and who cares for you.

Really good childbirth education sessions where you, your partner and support person fully understand; optimal positioning, the process of labour and birth, what affects the process, common problems, simple solutions, what all the medical jargon means, what the medical interventions are and what they do, how to write an effective birth plan, how to provide effective support, how to advocate for yourself/your partner/your baby, understanding your own views and fears about birth/parenthood, and taking into consideration any trauma that may already exist.

By being as knowledgable as possible, you and your partner enter labour calmly, armed with your preferences, easy solutions to lots of problems, and questions at the ready for when you are faced with any interventions. You know how to advocate for yourself or your partner and feel confident in your decisions. This alone decreases the risk of viewing the birth as traumatic.

A simple, but very effective birth plan which states that you and your partner are to be consulted before any decision is made, or any interventions are implemented is of vital importance. This birth plan should be discussed with your care provider in ante-natal appointments well before you go into labour. A copy should be given to your care giver when you arrive at the hospital, and have at least 2 spare copies. Ensure it gets placed in your file so if there is a change of shift, the next midwife can view it. When you meet the new midwife or doctor, please ask if they have read the birth plan. Click here to gain access to a free sample birth plan. It is advisable to have a plan for both vaginal and caesarean births, just in case.

So, please get the best childbirth education you can, write a short, to the point, effective birth plan, and discuss and question everything with your care provider so you have the best chance of having a joyful birth experience.

(1) Royal Australian College of General Practioners (2024)

(2) Hazel Keedle Warren Keedle, and Hannah G. Dahlen (2022)

(3) Alysha-leigh Fameli, Daniel S.J. Costa, Rebecca Coddington, David J. Hawes (2023)