Let’s Talk about Birth Trauma – Part One
This blog post discusses sensitive topics, including childbirth, birth trauma, and sexual trauma. Some readers may find the content distressing or triggering. Please consider your emotional well-being and consider whether you feel comfortable proceeding. If you need support, consider contacting a trusted friend, family member, or someone like me to work through things.
As a former Paramedic, I’ve been honoured to assist women during childbirth. One particularly memorable experience was a 2 AM delivery on Christmas morning when a baby decided it was time to make its grand entrance. I’ve also encountered high-pressure situations where swift action was crucial—whether dealing with a breech birth or a baby with a dangerously low heart rate in the womb. In these intense moments, you can feel the palpable tension between Mother and the helping team trying to do their best.
The journey of childbirth is unique for each person. While some may find it empowering and joyous, it’s crucial to acknowledge that for individuals with trauma histories, particularly those who have experienced sexual violence, pregnancy and childbirth can evoke complex emotions, including fear and anxiety. Labour and delivery’s physical and emotional intensity may resurface past traumas, potentially impacting the birthing experience. The attitudes, language, and behaviours of healthcare professionals are equally influential. A provider who lacks an understanding of trauma’s effects or who adopts an authoritative approach may inadvertently recreate dynamics that echo past traumatic experiences.
Traumatic feelings are valid and deserve compassionate attention. This reality highlights the critical need for healthcare systems and providers to embrace trauma-informed care practices. Such an approach prioritises the emotional safety and autonomy of the birthing person, respecting their experiences and choices throughout the process. By fostering an environment of understanding, support, and empowerment, we can work towards ensuring that all individuals, regardless of their past experiences, feel safe, respected, and heard during this significant life event. This includes recognising the strength and resilience of those who navigate childbirth while carrying the weight of past traumas.
In the first part of this blog, I discuss the unique challenges that a birthing person with a history of trauma may face during childbirth. I’ll explore supportive practices, including addressing sexual trauma before conception when possible and emphasising the importance of consensual and embodied practices during birth. In the second part, I will focus on how healthcare practitioners can create a safe and supportive environment for women who have experienced trauma. I’ll also look at the vital role of counselling and postpartum support in helping people navigate their childbirth journey and recovery.
The Intersection of Past Trauma and Childbirth
For many women, the experience of childbirth is profoundly shaped by their past. Women with a history of sexual trauma often enter childbirth with heightened vulnerability. The intimate and physically invasive nature of many childbirth procedures can trigger memories of past abuse, leading to increased anxiety, fear, and even flashbacks. A study by Sobel et al. (2018) highlighted that women with a history of sexual trauma expressed a strong need for control over their bodies and their birthing environment. They desired clear communication and preferred having trusted individuals present during labour and delivery.
For women with unresolved trauma or those who have begun addressing their trauma but need additional support, engaging in counselling well before conception can be incredibly beneficial. As a trauma-informed counsellor, I recommend starting this work as early as possible, ideally in the pre-conception phase and continuing through the pre-natal and post-natal periods. A proactive approach like this allows us to work together to build coping strategies, process past experiences, and develop a strong foundation for a positive birthing experience. We can explore your fears, anxieties, and hopes in a safe, supportive environment, tailoring our sessions to your unique needs and experiences.
However, I understand that life doesn’t always follow an ideal timeline. Pregnancies can occur unexpectedly or under various circumstances. If you find yourself pregnant and feeling unprepared to deal with past trauma or current trauma, please know that it’s never too late to seek support. I encourage you to reach out for counselling as soon as possible.Whether you’re planning for a family or facing an unexpected pregnancy, my role is to meet you where you are without judgment. Together, we can work on building your resilience, processing your emotions, and preparing for the journey ahead. Remember, seeking help is a sign of strength, and you deserve support no matter your circumstances or where you are in your journey.
The Emotional Journey of Birth for Trauma Survivors
For people who have experienced trauma, particularly sexual trauma, the psychological impact of childbirth can be profound and complex. As a counsellor, it’s crucial to approach this topic with sensitivity and understanding. Some survivors may find that the childbirth experience triggers memories of past abuse, potentially leading to feelings of vulnerability, powerlessness, or violation. These intense emotions, especially violation, can be overwhelming and confusing, especially during a time that’s often expected to be life-altering.
In some cases, these experiences may lead to postpartum post-traumatic stress disorder (PTSD). As Ayers (2017) notes, this condition can manifest through symptoms such as intrusive memories, heightened alertness (hypervigilance), and avoidance of reminders of the birth experience. Validating these feelings and experiences is essential. It is vital to create a safe space where clients can express their fears, anxieties, and conflicting emotions without judgment. I work together to develop coping strategies tailored to everyone’s needs, always prioritising emotional safety and well-being.
The Importance of Informed Consent & feeling this in your body.
Consent is a fundamental aspect of trauma-informed pregnancy and birth care. The recent ABC investigation into allegations of mothers undergoing procedures and being medicated without consent inside a Tasmanian hospital underscores the critical need for healthcare providers to ensure informed consent at every stage of childbirth. Gino Pecoraro, the president of the National Association of Specialist Obstetricians and Gynaecologists (NASOG), emphasises the importance of teaching junior obstetricians about consent, highlighting that consent is not just a legal requirement but a crucial component of respectful and empathetic care.
One mother from the investigation shared her experience: “Like I knew I could have done it if they just left me alone, let me change positions, if they’d not sabotaged me from the moment I entered, I could have done it on my own”. This statement reflects the profound impact that lack of consent and autonomy can have on a woman’s birth experience. I am professionally appalled by reading about such experiences, especially within healthcare systems. It frustrates me immensely that our systems fail to be advocates for women during in these situations. Especially when there voices are dampened by others.
It is crucial to empower women to take control of their birthing experiences by providing them with comprehensive psychoeducation on informed medical consent and what consent feels like in there body (embodied). Ensuring women have the knowledge and confidence to say “no” or “stop” when necessary is vital in preventing traumatic experiences.
For many women who have experienced trauma, finding their voice again can be incredibly challenging. In these moments, they may feel powerless, allowing things to happen to them without feeling they have a choice. Their voices and bodies can freeze. This is never their fault, and unresolved trauma that hasn’t been worked through, or even worked through can still contribute to such situations. It’s essential to plan for how you might respond if you experience a freeze response or hypervigilance. Having these conversations with your midwife and doctors before birth is crucial. I understand that many women who have experienced trauma often don’t feel safe having these discussions and are understandably reluctant to re-live their traumatic experiences. The fatigue and emotional exhaustion from such conversations can be overwhelming. However, making trauma-informed care a priority is essential for ensuring your safety and care during childbirth.
A trauma-informed healthcare practitioner will recognise the importance of understanding your specific triggers and how to respond effectively. This doesn’t mean you need to share every detail of your past trauma but rather communicate what situations or actions might make you feel unsafe or distressed. Ideally, having a trauma-informed birth doula to support you during childbirth would be fantastic. In a perfect world, everyone would feel safe and supported and have all the necessary resources. However, we know that these conversations often don’t happen, and for many people, the birth experience is not trauma-informed and leads to activating a trauma response and additional trauma. And if you are in a partnership, this too can affect the other partner.
Another great way to support yourself is to work with someone like me before conception or afterwards if that’s impossible. I can guide you in embodied consensual practices and help you explore the Wheel of Consent®. I can help you work through past trauma. Together, we can practice having meaningful conversations and develop strategies for moments when you dissociate or experience a freeze or hyper vigilance response. By incorporating these practices and profoundly understanding the wheel of consent, you can become more consensually embodied. Additionally, we can create a comprehensive plan and prepare supportive letters for your birthing experience, particularly around a trauma management plan.
