Changing the narrative

Giving birth is often conveyed as either a magical day or something to be feared. Neither is really true, but these beliefs can cause serious problems later on. In this honest account, Laura Bicknell explores the relationship between birth trauma and unmet expectations… 

My first birth was not something I especially want to repeat. Except for the obvious upside of having my daughter, it was an event filled with fear, disappointment, anger. Having planned to have a home birth, I ended up instead, three weeks overdue, in the main birthing unit at my local hospital. 

I desperately didn’t want to be there. Everything in my body was telling me to be afraid, and everything in my brain knew that being terrified was the worst state to be in. 

Fast-forward several chaotic, overwhelming hours and a catalogue of intervention later and my daughter was born by emergency c-section, less than nine hours after my waters had broken. I had tears in my eyes as she was pulled from me – and not happy tears. As I was wheeled into the operating theatre, I had looked at my husband and said: ‘How did we get here?’ He shook his head. 

Of course, moments later, my perfect little girl burst into the world, all 6lbs and 15ozs of her, fighting fit and crying her little lungs out. Everything else flooded away and she was here, and we were there, and it was now us three and that was enough.

Lasting damage

Days, weeks, months, years later, my feelings about this birth experience ebbed and flowed. I found new motherhood hard, and alienating, and I was scared a lot of the time. I was triggered by stories of other women’s homebirths or easy labours. I obsessed about the post-natal care that friends who lived abroad had experienced, and compared it to what had happened for me. 

I remained angry about how my daughter was born, how it had got so quickly out of control, how totally powerless I felt. In my darkest moments, I told myself that I hadn’t birthed ‘properly’ because my daughter had been born surgically, not ‘naturally’. I felt unworthy as a mother, a failed amateur surrounded by more powerful, all-woman birthing superheroes. 

As time went on, I settled into motherhood tempered my anger with gratitude, constantly reminded that sometimes birth can go horribly wrong. How lucky we were that this didn’t happen. I told myself that I could learn from this experience. Next time, would be different. 

Out of control

My experiences are not unique. The Birth Trauma Association (BTA) says that at least 30,000 women a year in the UK experience birth trauma; while in America at least 200,000 women have a birth story that they find hard to tell. In addition, between two and six per cent of women experience PTSD following childbirth and more than twice that number report feeling traumatised by their birth experience.

The reasons for experiencing trauma in birth can be from something as relatively common as a drop in heartrate (which happened to me) or an emergency c-section (also me); or something rarer, such as an injury to you or your baby.

However, when it comes to birth trauma, a lot of it can also be down to how you were made to feel, or what you expected to happen. ‘Birth can be beautiful and spiritual and joyous but there are also terrifying, emotionally raw, painful moments that can be difficult to move past,’ says psychologist and birth trauma expert Maureen Campion. Nowadays, birth trauma has been linked to needing intervention during labour; a baby needing medical attention after the birth; a previous birth trauma; birth not matching expectations; a difficult labour and complications; or inadequate care during and after birth. 

Birth misconceptions

In a digital age when information is so readily available, we are assailed with information about the ideal birth, the perfect birth, the natural birth, the drug-free birth, the easy birth, the home birth, the hypnobirth and so on. On social media birth announcements are peppered with references to a labour that lasted many days or a birth that was endured without any pain relief. Badges of honour and war wounds go hand in hand with the all-important names and dates and weights. 

‘Before names and onesies, there will be a birth. Women prepare for birth. Some spend hours on the internet. Some take classes and diet and do yoga and meditate. Some deny and ignore and bury their head in the sand… but they too are preparing,’ says Campion. ‘Women want their birth to be safe. They want their baby to be healthy. They want their experience to be uncomplicated and predictable. They don’t really expect it to be painless but they want to be brave and dignified as they face the pain. And for most women, if they could, they would have it be beautiful. Soft and serene and peaceful and loving and magical. That is how we picture birth. That is how they sell it.’

Looking back, I hadn’t realised how this narrative had weaved its way into my psyche. I hadn’t realised that part of my feelings of failure were because I was told that birth with no interventions was the only goal. I had spent so long reading about the theory of birth, that I spent virtually no time preparing for the physical challenges of birth. I hadn’t practised breathing, I didn’t know how to ‘go within’ to channel my own instinctive strength, I didn’t know to work with my body, so I fought against it.  

Better informed

‘Giving women the facts about different modes of delivery while they are pregnant isn’t scary, it’s empowering,’ says Rebecca Moore, a psychologist who founded the Make Births Better campaign. ‘Women are capable of making up their own minds, but rarely are they properly informed about risks and treatment when it comes to birth.’

The language we use around birth, and a stretched system that refuses to acknowledge female agency over their own bodies, creates an atmosphere in which we are doomed to ‘fail’. Paralysed by fear and expectation we are then thrust into a system that is under-resourced and over-stretched. In the absence of the kind of continuity of care needed to support and empower us with information, we enter the birthing process already on a considerable back foot. This then creates a situation where we feel a lack of control, and a sense that this birth was not something we participated in, but something which was done to us, leaving us at a higher risk of experience trauma, or even developing PTSD.

‘The whole system contributes to trauma,’ adds Moore. ‘Often women are being cared for by frontline staff, who are doing their job but not with much compassion, because they are burnt out,’ she recently told BBC Future.

It is common for women to report feeling fearful, helpless or unheard during their birth. Afterwards, shock, guilt or numbness can also be accompanied by panic attacks, and even a difficulty bonding with your baby. Midwife visits, along with family and friends, then force us to relive the trauma, in a way we wouldn’t expect any other trauma survivor to do. 

Changing the narrative

For me, resetting the long-held trauma I had from my first birth eventually came three and a half years later, with the birth of my twin boys. Determined that this experience would be different, I enrolled in a powerful hypnobirthing course run by working midwives whose goal was not to sell us a false dream, but to empower us with information, so we could make informed, confident decisions at every point in our labour. We discussed previous births, explored misconceptions and considered why, and how, things had turned out the way they did. 

In addition, we practised numerous breathing techniques, visualisations and relaxation triggers can help us deal with any situation in birth. We also talked about how to manage different types of pain relief; what we can ask for, how to speak to consultants and questions to ask. 

When my waters broke at 36 weeks, there was the very real possibility that history was to repeat itself. When we arrived at the delivery suite I remembered the cold, uninviting room, one big bed and one small uncomfortable chair, bright lights, lots of medical equipment, a cold, hard floor. It had shocked me last time, but this time was different.  I was expecting this and I was prepared for it. I used everything I knew to create a space I wanted to be in, I asked for what I needed, I controlled the situation and I was in charge. 

Later I had conversations with consultants where I felt fully engaged in decisions. At every stage, I felt informed and involved. When my twins were born, it was calmly, and with joy and anticipation in my heart. Two little souls, bursting into the world and into the arms of a mother who was peaceful, contented, expectant. 

 Simple steps for processing birth trauma

Write it down:
Use a journaling exercise to tell your story, at first, write it just for yourself.

Share your story: Read your story to a friend, trusted therapist, support group, partner or a family member. Re-storying your birth allows it to move safely into the past.

Seek Support:
Consider therapies such as Cognitive Behavioural Therapy (CBT) which works with changing the way you think about an event; and Eye Movement Desensitisation Reprogramming (EMDR) a relatively quick way to process past trauma, and especially effective with PTSD.  

Rewind Therapy:
Using visualisations to allow you to get to a place of deep relaxation, Rewind Therapy
takes memories which have
been created during trauma,
and allows you to process the trauma calmly, transferring it from short-term memory to long term memory.

Be Mindful on Birthdays:
Birthdays are an anniversary
of a trauma. Allow yourself
to acknowledge the pain of
this moment or day, and be
kind to yourself.