This week, July 15-21, 2024, is Birth Trauma Awareness Week in some parts of the world. I can’t find any information about whether the United States is participating, but I’m not surprised. The U.S. remains a consistent outlier in maternal care compared to other developed nations. Despite being one of the wealthiest countries in the world, we have some of the poorest outcomes for mothers and babies during delivery. Especially in the BIPOC and LGTBQ+ communities. Shameful.
The good news is that we are making progress on this problem! I am headed to Michigan this summer to provide an all-day workshop on preventing and healing birth trauma and childbirth post-traumatic stress disorder (CB-PTSD), sponsored by the Michigan Organization on Adolescent Sexual Health (MOASH). Wish me luck!
For those who are unfamiliar…
What is Childbirth Trauma?
Childbirth trauma is a complex and overwhelming experience that takes place during the delivery of a baby. It is most likely to manifest in women/pregnant people who have a history of physical, sexual, or psychological abuse before or during pregnancy. Partners/men are also impacted due to the lack of information provided to them during emergencies in the delivery room and low support for men’s mental health in the hospital setting.
The official definition of childbirth trauma from the American Psychiatric Association is “physical or psychological harm that occurs during the delivery process.” What is important to note is that childbirth trauma is subjective, meaning it’s the patient’s perception of the events that took place, not necessarily the events themselves, that can create symptoms of post-traumatic stress.
For example, a mother could go through a long and painful labor, ending in an emergency c-section, which was NOT what she hoped for, and NOT perceive her birthing process as traumatic.
Why would this be? Well, if she has no history of abuse/trauma and feels supported by compassionate professionals and family members, she might not develop symptoms of post-traumatic stress. It’s often when we feel alone in our experiences that trauma rears its ugly yet protective head.
On the other hand, a mother who has a similar birth experience but DOES have a history of childhood abuse/trauma and DOES NOT have adequate support in the delivery room may feel very traumatized by the c-section and the experiences that led up to that outcome.
Why would this be? Well, suppose the mother is disrespected, ignored, and uninformed about her options during this process or caught off guard by an invasive, immediate surgery with no time to process it. In that case, she may relive aspects of her original trauma, pushing her into a trauma response. Of course, these are only examples; every birth experience and response is unique.
Childbirth trauma is likely to arise in parents/babies if there are emergency interventions during delivery (c-section) or after delivery (NICU stays). As a pregnant woman, I endured both, and I did think it delayed the attachment process between us and resulted in post-partum depression and anxiety for me. On the bright(ish) side, most people who experience birth trauma do recover within six months of the onset of symptoms with resources and support.
Common Symptoms of Childbirth Trauma:
- Avoiding people, places, and things that remind us of the trauma (ex. the baby)
- Recurrent, disturbing, intrusive thoughts or memories about the events or the baby
- Sleep disturbances, nightmares
- Hypervigilance
- Panic attacks
- Depression and suicidal thoughts
Why is Childbirth Trauma an Area We Should Focus On?
- It can lead to long-lasting psychological impacts on parents and children, including anxiety, depression, and PTSD. Early identification and intervention can help mitigate these effects.
- If the child or parent is experiencing symptoms of birth trauma during the post-partum phase, it can interrupt the attachment process between them, which is critical for the long-term mental health of the child.
- Children who experience birth trauma may exhibit behavioral problems, such as difficulties in emotional regulation, increased aggression, or withdrawal. Addressing these early can improve outcomes.
- To adopt a “root cause” approach to children’s mental health. Let’s prevent avoidable trauma to increase overall well-being in society.
Preventing Childbirth Trauma
Not all childbirth trauma can be prevented. Some procedures and interventions are necessary for the safety of the parent and infant. Still, we have an opportunity to prevent significant stress if we train parents and providers on trauma-informed care and how to reduce trauma during birth.
Tips for Pregnant People:
- Choose a provider who is trauma-informed
- Change providers if they activate feelings of unsafety or won’t listen to you
- Know your rights. You have the right to informed consent for all medical interventions
- Have an A, B, and C version of your birth plan
- Ask providers for options and alternatives to invasive procedures
- Maintain as much control over your body as possible
- Ask questions if you don’t understand. It is ok to say, “Wait a minute, I need more information.”
- Have a support person present during delivery. A trauma-informed doula is highly recommended if you have a history of abuse or PTSD
- Say stop or no if you are uncomfortable with any behavior or decisions with your provider. You have a right to be heard
Tips for Healthcare Providers (when possible):
- Informed consent every. single. time.
- Offer alternatives and options to procedures/interventions
- Assume all patients have a history of trauma
- Learn about trauma-informed and responsive care
- Allow patients control and autonomy over their bodies
- Know your patient’s birth plan, and apologize if you aren’t/weren’t able to stick to it
- Ask the parents how they perceived the birth of their child
- Provide resources for those who endured trauma
A quote from the American Psychiatric Association:
“Systematic thorough collection of women’s life history of trauma during antenatal visits and implementation of the principles of trauma-informed, respectful maternity care can work towards mitigating the risks of childbirth complications, obstetric violence, re-traumatisation, and CB-PTSD for women with a history of physical, sexual, and/or child abuse, fostering a more compassionate and sensitive approach to childbirth, and ultimately promoting positive birth experiences and maternal well-being.”
I am passionate about this topic because I believe it is part of the root cause of the enormous mental health problems in the United States. Please join me in spreading awareness about birth trauma by sharing this newsletter with a friend or colleague who would benefit from this knowledge.
If you want to learn more about my virtual or in-person workshops on birth trauma, please contact me.
Free Event: Trauma in the Workplace
Hosted by Beth Tyson, Mark Feinberg, and Anup Sharma, MD MBA
Please join us for a vulnerable and open-hearted conversation about how trauma shows up in our workplaces and what we can do to create a work culture that supports each other instead of tearing one another down. Learn more and register here.
In Closing…
What is happening politically in our country and our world never ceases to shock me. It’s traumatic, and I don’t like using that word lightly. I’m focusing on sustaining hope that we will endure these ongoing tragedies as a country and take the steps needed to thrive again in peace, but I would be lying if I said I wasn’t afraid of what will come next. Hold your babies and children tight, and notice the flickers of joy that show up, even on the worst days.
One strategy that has helped me through the last several years of turmoil is getting comfortable with death and dying. I know that may sound morbid, but it’s actually not. Becoming comfortable with our mortality allows us to live more fearlessly and fully in the days we have left. As an eye-opening activity, I calculated how many Saturdays I have (on average) during the rest of my lifetime. The number is 1,768!
This puts my goals and priorities into perspective very quickly. How many do you have left, and what do you hope to do with them?
For those of you interested in confronting mortality, there’s a place you can go! They are called Death Cafes, and they are like support groups for people who want to get comfortable talking about death and dying.
This edition of my newsletter is short due to my current workload and social calendar. I will resume the full version of the Childhood Trauma Newsletter in the fall with a more consistent frequency.
Thank you for being a dedicated reader. I do this because of you. If you want to prevent unnecessary suffering in the world, I believe I have knowledge to help you do that.
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With hope, grief, and love,
Beth
