Sometimes women perceive their births as traumatic because of obstetric emergencies or physical injuries, but traumatic birth is frequently caused by how moms were treated by their providers during labor and childbirth.
Upon returning home from the hospital after the birth of my fourth child, I walked in the door and burst into tears. “It’s so good to be home,” I told my husband, but I couldn’t stop weeping. I thought my tearful entrance into our safe, sacred space was simply due to fluctuating hormones and fatigue — a normal postpartum response.
As the early days and weeks ticked by, however, my frequent tears turned to confusion, anger and flashbacks of the birth and the way the hospital staff treated me with curt indifference. Maybe they responded this way because I’d turned down an epidural, requested intermittent monitoring (versus continuous electronic fetal monitoring because studies show it’s ineffectual), shouted, “No!” to being placed in stirrups, or gave birth too quickly for them to place an IV.
I wondered why the nurses had forced me, an unmedicated mother, onto my back while crowning, resulting in excruciating, unnecessary pain? Why had they forced my legs back and open without my consent? The ob/gyn also quickly turned drill sergeant and barked out orders about when and how to push, leaving me unable to respond to my body’s natural cues.
The obstetrical team didn’t speak to me with encouragement or praise. One nurse left the room directly after the delivery without saying a word. The other shoved papers to sign under my nose as soon as she could, saying, “Next time, you should arrive on your first contraction.”
Without knowing at the time the extent of the damage they’d done, I thought silently, “There won’t ever be a next time at this hospital.”
A few months went by and my disappointment and confusion remained. Despite the exhaustion that accompanies newborn care, I had trouble sleeping, too. I shouted at my husband. “That hospital was the wrong place for me! The wrong place for our family! I’ve never felt like this after a birth before!”
We didn’t know what to do. The three prior births I’d had with midwives provided me with me positive, supportive care that resulted in feelings of contentment and accomplishment. We had made a mistake, I realized, upon moving to a new town and not understanding the culture of its women’s hospital.
I began to seek out answers to my sustained symptoms and typed “negative birth experience” or “disappointing birth” into search engines because I did not yet have the language for what I was actually experiencing: a traumatic childbirth.
I was shocked by what I discovered.
Renowned childbirth author and educator Penny Simkin dedicates an entire website, Prevention and Treatment of Traumatic Childbirth to the topic. There, she cites studies that an estimated 25 to 34 percent of mothers report having a traumatic birth. In the United States, this translates to over one million women suffering the impact of traumatic childbirth each year.
Though sometimes women perceive their births as traumatic due to obstetric emergencies or serious physical injury to themselves or their babies, it is frequently caused by their perception of the birth and how they are treated by providers.
According to Professor Cheryl Beck, “Women can perceive their birth as traumatic if they perceive they were stripped of their dignity during the birthing process.” Mothers can experience trauma even if it’s viewed as “routine” by clinicians.
The consequences of traumatic childbirth can be Post Traumatic Stress Disorder (PTSD) or Post Traumatic Stress Symptoms (PTSS), a less severe reaction to trauma. According to Kathleen Kendall-Tacket, Childbirth Connection’s Listening to Mothers’ Survey II found that “9 percent [of mothers] met full criteria for PTSD following their births, and an additional 18 percent had PTSS.”
Symptoms of these are what I was experiencing: intrusive recollections such as nightmares or flashbacks, avoidance/numbing reactions such as avoiding thoughts, feelings or people associated trauma or diminished interest in activities, hyper-arousal such as difficulty sleeping, irritability and angry outbursts or panic attacks, and functional impairment such as significant distress in social, occupational or other areas of functioning.
Risk factors for traumatic birth include but are not limited to:
- Real or perceived threat of death or physical injury.
- Care based solely on delivery outcomes.
- Unexpected change from care preferences.
- Unwanted routine interventions causing conflict with staff.
- Feeling coerced, powerless or discounted by staff.
- Feelings of loss of control.
- Poor, impersonal treatment and disrespect by staff.
- Lack of communication from staff.
- Lack of attention to dignity (ex. no coverings).
- Poor support from partner, doula or family.
If women suffer from a traumatic childbirth, it can also negatively impact mother-infant bonding, partner relationships, and breastfeeding, to name a few, and may consequently lead to depression.
It took me over a year to begin to heal from traumatic birth. Two and a half years later, I still feel anger, sadness and profound disappointment when I encounter reminders of the birth. I avoid images or videos of childbirth in a hospital setting, and immediately cringe when I see billboards advertising the hospital where I delivered my fourth baby.
Currently pregnant with my fifth child, I often struggle to find the joy of this pregnancy or the excitement of giving birth after trauma. I’m thrilled to welcome a new child to our family, but apprehensive about how his or her arrival will unfold.
Thankfully, I’ll be giving birth for a fifth time at a progressive birth center with a midwife who cares about the process of giving birth as much as outcomes.
In order to help ensure a positive experience this time, I’ve taken Simkin’s words to heart: “The birth of each baby has a long lasting impact on the physical and mental health of mother, baby and family.”