“Awareness is like the sun, when it shines on things they are transformed”
Emma Jane Sasaru
Despite maternal mental health being more in the news and on the national agenda perinatal mental health being addressed, when it comes to the impact birth experiences can have on the emotional wellbeing of families we still have some way to go.
Often when women or partners voice that they are struggling with anxiety, depression or feelings they don’t understand after the birth of their baby it isn’t explored whether this has been impacted by a difficult pregnancy or birth. Yet up to 34 % of women say they felt their birth to be traumatic, although the figures are thought to be much higher, so why when caring for families after birth are their experiences often left behind?
Often you will hear it said, ‘a healthy baby is all that matters’ or ‘don’t worry you will forget all about it in time’. Women are encouraged to move on, to be happy and concentrate on caring for their new baby. Speaking out about a difficult birth can be hard and many women fear the reaction they will receive if they do. This often leads them to having feelings of guilt, anger and disappointment.
Also if poor care has been the issue it can feel impossible to voice this to other healthcare professionals that a family maybe having contact with. Many women have voiced that have been worried to say they have experienced poor care for fear of how they will be treated or the impact this may have on care in future births.
So there can be a general view that if you have had a difficult birth you should try and forget it, move on and keep quiet.
There is also a lack of understanding around what ‘birth trauma’ is. On paper or to those around her a woman’s birth may not appear to have been traumatic at all. Others then can find it difficult to understand her feelings about her experience and dismiss them. For some the birth may have meant the loss of their baby or time in a neonatal unit. These families can find themselves as ‘nobody’s patient’ struggling to access support.
A difficult birth greatly impacts a woman, her baby, her partner and her family. If she feels traumatised it can seep into every aspect of her life eating away at her thoughts about herself, her ability to care for her baby, her relationships with those who love her and how she views the future. This can lead to postnatal depression, anxiety, or post traumatic stress disorder (PTSD) and also increase pre-existing mental health conditions such as OCD. For some women it can even lead to postpartum psychosis. The effect of these on families is massive in cost, both financially and emotionally.
Awareness Matters
Awareness of what birth trauma is and how it affects those who are suffering matters. Without awareness there can be a delay in women receiving support, often being misdiagnosed and thus not receiving the correct therapy or treatment.
When those caring for families during pregnancy and birth are aware and trained in birth trauma, they are able to evaluate what practices, cultures and situations can cause trauma. They are also able to look at the care they give and the services they provide to help reduce it.
When those caring for families after birth are aware of birth trauma they will know the signs to look for and feel able to ask families about their feelings. They will not dismiss or discount a woman or her partners feelings but instead be able to identify those who are distressed and thus provide the right support to reduce the damage and the risk of it progressing to a perinatal mental health condition such as PTSD.
When families are aware of what birth trauma is they can reach out for the right support instead of feeling alone. With awareness comes a reduction in stigma allowing them to not fear speaking out and voicing the need for help, which in turn reduces isolation, so they no longer feel alone.
Awareness too means maternity services working with families to learn how they can improve, including listening to their voices with openness and working with them as partners. This must not be tick box but co-production with families at the centre.
If when it comes to maternal mental health we are aware that women can be struggling with their mental health/wellbeing because of a difficult birth experience and if we explore this it can help families to get the right support quicker, which means lessening the impact on the whole family.
Awareness also means that when developing perinatal mental health services, commissioners and service providers, will recognise the need to provide provisions to support those who have suffered a traumatic birth. This would include providing counselling, therapies such as Cognitive Behavioural Therapy (CBT), Eye Movement Desensitisation and Reprocessing (EMDR) and birth reflections and/or debriefs. This would apply also to those who have suffered the loss of a baby or had a baby in a neonatal unit and the support they need.
Here is a quote from one woman called Shorny and shows why awareness matters.
“The negative impact of my maternity care experience far outweighs the good…but the impact of that one person who made a huge difference will one day have grown to far outweigh the negative when I’m stronger.
You cannot underestimate the importance of the care you provide in your roles. A quick decision or a quick flippant action can have consequences that lead to numerous physical and psychological problems that you have no idea about. We are the ones left dealing with it.”
Awareness How ?
So how can we raise awareness?
As families your voices, your stories matter. By sharing your experiences you help others to not feel alone. You also help those who provide care and services during pregnancy, birth and in the postnatal period to know what matters to you, what causes, but also reduces, trauma and what can make a difference even in the most difficult of circumstances.
Awareness can also be raised by the training of healthcare professions that enable them to review their practice, assess for birth trauma and signpost/refer to the correct treatment or services. The voice of lived experience can be so powerful to hear.
Awareness also means that we build services that support maternal/perinatal mental health in all its forms. This in turn impacts our families, our communities and society as a whole.
If you have been affected by birth trauma lift up your voice, if you care for families open your heart to hear their stories, listen so you can provide the services needed to support maternal wellbeing.
Together by raising awareness we can help to reduce and heal birth trauma, helping those who suffer to heal beyond birth trauma.