Let’s Talk about Birth Trauma – Part Two

Healthcare Practitioners and Their Responsibilities

The importance of birth consent cannot be overstated. Healthcare practitioners must create an environment where women feel empowered to make informed decisions about their care. This involves clear communication, comprehensive information, and respecting a woman’s right to refuse or request specific treatments. Professional responsibility extends to ongoing development and self-care. Practitioners should prioritise continuous education, refine communication skills, and implement self-care strategies to maintain empathy and compassion. The complexity of medical and birth consent, especially when working with trauma survivors, is emphasised. Practitioners are encouraged to seek support if they struggle with the ‘grey areas’ of consent, recognising that many people have experienced trauma within these nuanced situations.

Empathetic and Supportive Trauma-Informed Birth Practices

Here, I outline several essential practices for providing trauma-informed care during childbirth:

1. 1. 1. Create a Trusting Environment: This involves listening to concerns, validating experiences, and ensuring patients feel safe and respected throughout childbirth (Sobel et al., 2018). “Trust is never granted; it is earned by a trauma survivor. A trauma survivor has earned the right not to trust you. They have the right to be cautious about you”.
      2. Offer Control and Choice: Empowering women by offering choices about their care can significantly reduce anxiety. This includes deciding who is present during labour, the preferred healthcare provider, and the birth plan (Sobel et al., 2018).
      3. Minimise Trauma Triggers: Healthcare providers should be aware of potential trauma triggers and strive to minimise them. This includes avoiding language or actions that could remind the patient of past abuse, explaining procedures thoroughly, and obtaining explicit consent before performing examinations (Sobel et al., 2018).
      4. Continuous Support: Continuous support from a known caregiver during labour has been shown to improve outcomes and reduce the likelihood of PTSD. This support can come from midwives, doulas, or trusted family members who provide emotional and physical comfort (Ayers et al., 2016).

The Role of Counselling and Postpartum Support

Counselling plays a crucial role in helping trauma survivors prepare for and cope with childbirth. The passage mentions that approaches like those based on Gamble’s method have proven effective in reducing psychological birth trauma by providing targeted psychological support before and after childbirth (Abhari et al., 2022). Postpartum support is equally important. Women should be offered psychotherapy and counselling to process their birth experiences and address any emerging psychological issues. Support groups and therapy can allow women to share their stories, validate their feelings, and find healing through community.

Final Thoughts

The passage concludes by emphasising that navigating childbirth after previous trauma requires genuine empathy and an informed approach. By creating a supportive environment, offering control and choice, minimising trauma triggers, and providing continuous and postpartum support, healthcare providers can help women transform a potentially re-traumatising experience into one of healing and empowerment. Understanding the unique challenges faced by trauma survivors during childbirth is crucial in delivering care that honours their resilience and supports their emotional well-being. This holistic approach not only leads to better psychological outcomes but can also contribute to improved physical health outcomes for both mother and baby.

References

Abhari, Z. H., Karimi, F. Z., Taghizdeh, Z., Mazloum, S. R., & Nekah, S. M. A. (2022). Effects of counseling based on Gamble’s approach on psychological birth trauma in primiparous women: A randomised clinical trial. The Journal of Maternal-Fetal & Neonatal Medicine, 35(4), 668-676. https://doi.org/10.1080/14767058.2020.1730799

ABC News. (2024, June 16). Physically injured and mentally traumatised, Australian women have been speaking up in what has become the ‘Me Too’ movement of birth. https://www.abc.net.au/news/2024-06-16/lgh-new-mothers-suffer-abuse-in-hospital/103878882

Ayers, S. (2017). Birth trauma and post-traumatic stress disorder: The importance of risk and resilience. Journal of Reproductive and Infant Psychology, 35(5), 427-430. https://doi.org/10.1080/02646838.2017.1386874

Ayers, S., Bond, R., Bertullies, S., & Wijma, K. (2016). The aetiology of post-traumatic stress following childbirth: A meta-analysis and theoretical framework. Psychological Medicine, 46(6), 1121-1134. https://doi.org/10.1017/S0033291715002706

Sobel, L., O’Rourke-Suchoff, D., Holland, E., Remis, K., Resnick, K., Perkins, R., & Bell, S. (2018). Pregnancy and childbirth after sexual trauma: Patient perspectives and care preferences. Obstetrics & Gynaecology, 132(6), 1461-1468. https://doi.org/10.1097/AOG.0000000000002956

Check out – part one here.