Birth Trauma: Signs and Symptoms

Pregnancy and childbirth bring?uncertainty for many women?due to a lack of control and a feeling of helplessness. Many factors can impact labour and delivery such as the size of the baby, heart rate, progression of labour, obstetric complications and medical interventions. Every birth experience is unique but up to one in three women experience their birth as traumatic.?

Birth trauma is a broad term that encompasses not just the physical trauma experienced during birth but the emotional trauma too. What one woman experiences as traumatic may be different to another and this can sometimes be influenced by past experiences.

A 2017 study?of postpartum women reported birth trauma was caused by lack or loss of control, fear for their baby’s life or health, severe physical pain and not enough communication from their maternity provider.?

What’s more, women who experience traumatic birth?are less likely to have more children?or wait longer if they do. Research shows birth trauma can impact a?woman’s breastfeeding experience?and is?a predictor of postpartum depression. A traumatic birth can have serious ramifications for both mother and baby.

What is birth trauma?

So what do we mean by the term?birth trauma? Well, we know that when someone experiences trauma they will be in an initial state of shock or distress. When a woman experiences their birth as traumatic, and the trauma is not processed effectively or the woman is not provided with quality emotional support, it can lead to posttraumatic stress disorder (PTSD). Birth PTSD, although not an official diagnosable condition, is gaining more acceptance in the field of psychology as research validates what many professionals have known for some time, birth can be a traumatic event for mothers and their non-birthing partners.?

Birth trauma refers to both the physical and psychological trauma associated with a childbirth experience.

Physical trauma

This means any physical injury sustained during or immediately after childbirth. This may include medical procedures such as an emergency caesarean section or hysterectomy, blood loss or perineal tears. There may also be excessive bleeding or haemorrhaging. After birth, the physical trauma may persist beyond six weeks postpartum with some women reporting incontinence, pain during sex, sciatica pain and feeling as if “your insides are going to fall out.”?

Psychological trauma

For many women, their childbirth experience is not what they expected. It can be a confusing and scary experience. Some women fear they will die or that something awful will happen to their baby. They may experience intense fear, helplessness or distress. They may feel numb or disconnected too. Tragically, some women have to birth their deceased infants or their babies die soon after birth.?

Emergency medical procedures may delay breastfeeding or interrupt skin-to-skin contact and the chance to bond with the baby. It may not be until the woman goes home with her baby that the shock settles and she is left with the unsettling reality of what she and the baby have been through. What's more, the physical injuries sustained in childbirth can affect a woman's psychological wellbeing. She may feel embarrassed or confused about her injuries.?

Other emotions a birthing woman may experience are a sense of powerlessness or feeling confused, abandoned, frightened, disrespected, unheard or dismissed. Any of these feelings may be complicated by a personal history of trauma and limited postpartum support.?

What about dads and non-birthing partners?

According to a?UK research study, up to 5% of partners?develop trauma symptoms after being present for the birth of their baby. Often, partners see their partner or baby in distress, they may be told by a medical professional that one of their loved ones may not survive, or they may be rushed off to another room with their baby while their partner goes into surgery. The flurry of activity when something unexpected occurs can leave non-birthing partners in shock. It can be overwhelming, especially if they feel torn between their partner and their newborn baby.?

1 in 10 Australian dads and non-birthing partners will experience perinatal anxiety and depression, while?a recent study of Canadian dads?found this statistic to be closer to 2 in 10 dads.

Assessing birth trauma in mothers, dads and non-birthing partners

Women benefit greatly from having the opportunity to debrief about their experience and often need to talk about it repetitively until she can process and make sense of what happened to her and the baby. Some women may find it helpful to go back and talk to their maternity provider if they feel confused about what happened during or immediately after the birth.

The?Australasian Birth Trauma Association?recommends clinicians ask direct questions about trauma symptoms:

Since the delivery, have you:

Had nightmares about it, or found it coming into your mind when you didn’t want to think about it?

Tried hard not to think about it and avoided situations that reminded you of it?

Noticed that you were hypervigilant, on guard, jumpy, easily startled, irritable?

Felt numb, detached from your surroundings, activities or other people?

If the woman answers yes to any of the above, it requires further assessment. But clinical judgement goes a long way and if a woman seems to be preoccupied with the birth or hospital experience or appears “stuck” in that experience, it’s likely a sign of trauma.

A traumatic birth, without adequate psychological support, can trigger PTSD. Signs of this may include:?

• ?Sleep disturbances (unrelated to baby’s sleep)
• High anxiety, hypervigilance
• Flashbacks or intrusive thoughts about the birth
• Feeling low in mood, detached or numb
• Difficulties bonding with baby
• Irritability and angry outbursts

Long-term effects of untreated PTSD can lead to:

• Fear of having another baby
• Wanting another baby immediately to try for a “perfect” birth experience perfect the next time
• Poor body image
• Distress, pain or lack of interest in sex
• Avoidance of reminders of the birth, in particular, fear of Hospitals
• Postnatal depression and anxiety

If a woman experiences PTSD then specialised support is available. Healing from birth trauma can come from debriefing and talking about the birth experience with a trusted professional.

This article was first published @ Lauren Keegan Psychology. If this article speaks to you and you'd like to receive my writings on perinatal and infant mental health direct to your inbox, please?join my mailing list.