We at Mothering have a long history of honoring and celebrating the beauty and joy that childbirth brings to mothers and has since the dawn of time. But we are also cognizant of the fact that many women may have a traumatic birth experience and feel alone or isolated in their experience. Women may have Post Traumatic Stress Disorder (PTSD) as a result of their birth trauma, and we need to be more open about all the facets of the birth experience. If you have had a traumatic birth experience and would like help, we’ll feature resources at the end of this piece.

A gentle heads-up: birth trauma can lead to infant death, and this piece addresses that. Consider your emotions as you continue to read.

My First Child: A Traumatic Birth Experience That Ended In His Death

I suffered from infertility for nearly 13 years. My husband and I went to doctor after doctor and I underwent procedure after procedure. We attempted two domestic adoptions that failed (one was a scam, one was a mom who changed her mind) and an international adoption that also failed (the country closed just a handful of weeks before we were to travel). We are a military family, so when we were stationed near Shady Grove Fertility, one of the largest IVF clinics in the country, we decided to pursue IVF.

We were astonished when we got pregnant on our first IVF attempt! After years of negative after negative, we felt like we’d finally beaten the beast! Infertility didn’t win, and I no longer would go to baby showers feeling like the very odd (and old) woman out.

My pregnancy was pretty normal, though because of my ‘advanced maternal age’ (36, GASP!), I saw a maternal-fetal specialist. He was amazing and monitored my son pretty closely because we learned he only had one kidney. Believe it or not, that’s actually pretty common. But, in utero, it can be an issue if the kidney isn’t functioning and helping to produce enough amniotic fluid.

It was, though, and I went to 41w5 days before my doctors were concerned about the swelling I had. They brought me in for an induction, and though I definitely had some initial signs of pre-eclampsia, still there wasn’t a big concern about anything because he was obviously only a few hours away from delivery.

Until he wasn’t. And after almost 24 hours of labor and little progression, fetal heartrates suggested to them that they just go ahead and perform a C-section. It was not considered emergent, yet, but good practice after so much labor and a few other signs of it being better for my son to be born than to hang out in Hotel Mommy.

As a last ditch effort to see if he’d still come on his own, though, my doctor said she’d try to break my water and see what happened. When she did that, her face immediately changed and the entire mood of the room flipped in less than a minute. I began bleeding profusely and they hauled me to the OR faster than I could really believe possible.

The surgery now WAS emergent and six minutes after getting on the OR table, my son was born. He didn’t cry. He wasn’t breathing. People were moving all over the room at a furious pace and I saw them take my precious boy away very quickly. All I saw was the back of his little head, sweet little brown swirls of curls, and they were gone.

I had to lay there on the table, not knowing what was happening, while my OB and another on-call were examining my placenta to see what the heck had just happened. We were waiting for an x-ray, as the emergency surgery left them no time to do an instrument count before. They also were working on getting blood for me, as I’d lost a tremendous amount.

The wait on that table was excruciating and I can still remember every.single.detail about that ceiling and those lights even though I passed in and out of consciousness.

What originally was thought to be a placental abruption turned out to be Vasa Previa. Vasa Previa is a rare condition, and I’d had a rare presentation. When it’s known before the baby is born? It’s managed with a 98.9% success and a planned c-section so no blood vessels are broken during labor. When it’s not known? It’s a race against time after a woman’s water breaks (or in my case, was broken) and the mortality rate is about the same—97% of the babies pass.

Mine was one of them. He died the day after he was born, life-flighted out to our nearest NICU, but too much blood and oxygen lost to survive. My world hasn’t been the same since.

What is a traumatic birth experience?

A traumatic birth experience is just as it sounds. It’s stress or trauma that a mother (or father, partner, etc.) undergoes/watches as she is giving birth, and in which the belief that there is danger to the mother or baby. The danger could be perceived or literal; the brain doesn’t differentiate in a traumatic birth experience and the non-profit Prevention and Treatment of Traumatic Childbirth (PATTCh) concurs that even if the woman’s caregivers do not agree there was danger, it is the perception of the person experiencing the trauma that defines a traumatic birth experience.

This means that though my son being torn out of me and then dying is obviously a birth trauma, the same could be said for a mother who had to have forceps in delivery, and her fear of postnatal damage as a result. It’s important to stress that we can’t compare the trauma’s ‘danger rate’ so-to-speak, and only give merit to situations where the baby is injured or died. Many mothers who believe they had birth trauma ended up taking home very healthy, happy babies—but they still suffered from the experience.

In fact, it’s estimated that up to 10% of women who experience a traumatic birth end up developing Posttraumatic Stress Disorder. Some research suggests that those having experienced posttraumatic stress symptoms after birth trauma that isn’t fully diagnosed or screened as PTSD may be as high as 18%.

Symptoms of PTSD After Birth Trauma

Dr. Charles Figley is a trauma psychologist and the author of Trauma and Its Wake. When looking at risk factors of developing PTSD after Birth Trauma, some characteristics are general in most traumatic birth experience situations.

For instance, was the traumatic experience:
  • Dangerous? Was the delivery a medical emergency? Was there a life-threatening complication to you or to the baby? Did you think you or your baby would die? Did you have pain you did not expect due to no/failed anesthesia? Did your baby die as a result of the situation?
  • Sudden? Did things go from fine to very not-fine quickly? Were you whisked away or had things happen to you with very little explanation of the process? Did you find yourself wondering what had just happened?
  • Overwhelming or Encompassing? Were you under restraints? Did you have a general anesthetic that numbed what was going on but made it seem like a bigger, blurry picture? Did you feel small in a flurry of happenings? Did you have questions that no one could or attempted to answer in the moment?

The answers to many of those questions are what clinicians look at when looking at the diagnoses of PTSD after birth trauma.

The symptoms of Posttraumatic Stress Disorder after traumatic birth are varied, and differ from woman to woman. In general, some symptoms include:

  • Intrusive remembering, thoughts and recollections; many coming unexpectedly and with no outlying reason. This includes flashbacks to the trauma, feeling the traumatic event is happening again or extremely intense physiological or psychological reactions when the trauma is brought up or remembered on purpose.
  • Hyperarousal of the brain. Difficulty sleeping, angry outbursts, irritability, concentration difficulty, hypervigilance (fight mode always on), panic attack symptoms or experiences and exaggerated startle responses are just some of the ways your brain will show it’s hyperaroused state.
  • Avoidance. Avoiding thoughts or feelings that remind you of the trauma. Avoiding people associated with it. Avoiding places that may make you recall what happened. Avoidance of activities you may have previously been interested in. Avoidance of people so you don’t have to talk about it. Blockout of some of the parts about what happened. No desire to plan future events.
  • Cognitive and functional dysfunction. Difficulty maintaining social norms or functioning in everyday life. Being overwhelmed in situations that may make you remember or that may trigger your thoughts to the experience.

How Parenting After Traumatic Birth May Be Different

When you experience a traumatic birth, you may have difficulty parenting and attaching to your baby. Or you may not, and you may find it difficult to be with anyone BUT your baby. The effects are hard to predict, but it’s important for you to know that your feelings are real and valid.

Breastfeeding may be difficult simply due to physiological issues that happened as a result of the birth trauma, or your own psychological condition. Be gentle with yourself, and seek support from those who have been there and want to help. Try and allow yourself as much skin-to-skin time as you can with your baby to promote your mental healing (oxytocin is amazing) and your bonding with your baby and be okay with knowing your birth story is different, but nevertheless one in which you are now in control.

You may also find that subsequent pregnancies may bring about traumatic birth experience feelings. It’s important that you pay attention to your feelings and turn to your support system, childbirth educators and clinicians for help so that you are able to participate in this subsequent pregnancy solely as it is—not with the emotions still attached from your previous traumatic birth.

There’s really no way to predict whether a birth will be traumatic or not, nor whether one woman’s traumatic birth may be another’s not-so-difficult. The most important thing to remember if you’ve suffered from birth trauma is to know you are not alone, and there are resources you can turn to for help in processing your thoughts and emotions.

Some are:

Prevention and Treatment of Traumatic Childbirth (PATTCh)

Australasian Birth Trauma Association

Solace for Mothers

Traumatic Childbirth by Beck, Driscoll, and Watson

The Birth Trauma Association

Image: Stefan Malloch