Women, parents and families don’t have to walk the journey alone if they’ve been affected by birth trauma. That is the overarching message of Birth Trauma Awareness Week, run by the Australasian Birth Trauma Association (ABTA) from the 6-12th September. The week aims to raise awareness about physical and psychological birth trauma by encouraging people to share their stories through traditional and online media.
In this article we’ll explore what birth trauma is, look at some of the different types, and point you to some useful resources for more information and support. Our families are strongly encouraged to talk openly to us at Hatch Private Maternity so we can provide individualised advice based on your journey and circumstances.
What is birth trauma?
The ABTA defines birth trauma as a wound, serious injury or damage. It can be physical or psychological (deeply upsetting and distressing) or a combination. Both mother and father/partner or families can be affected by a traumatic birth event.
Physical birth trauma
Physical trauma covers birth injuries, and these injuries might not be known immediately. If you notice something isn’t right, it’s important to ask questions and know you may need to seek expert medical advice and assessment. Physical trauma can present as:
- Perineal tears: Tears in the skin, muscles or other soft tissues between the vaginal and anus. Often described in “degrees”, such as first, second, third, or fourth degree tears, with the third- and fourth-degree tears having more long-term concerns for the mother.
- Pelvic floor muscle damage: During a vaginal birth the baby passes through the ‘levator hiatus’ in the pelvic floor. Sometimes the muscles, connective tissues and nerves can be damaged in that process.
- Pelvic organ prolapse (POP): When an organ loses some of its support and moves downward through the vagina.
- Pelvic fractures: These affect the pubic bone, coccyx, and sacrum.
- Caesarean wounds: Following abdominal surgery to deliver baby, pain is common in the early months and needs to be managed with rest, pain relief and activity modifications. Additional concerns may include wound break down or infection.
Psychological birth trauma
Psychological birth trauma can come about for a range of reasons, including the result of unmet expectations of a birth plan. For example, if a mother is focussed on having a calm and natural birth, and interventions were needed or an emergency caesarean results, many new mothers can feel a sense of failure. This is made worse when not prepared for other outcomes. Combine this with the sleep deprivation that comes with being a new mum, may present and escalate depression, anxiety and other disorders such as post-partum post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD). An example of the latter may be when obsessive thoughts can affect your behaviour, such as checking on the baby constantly, or thoughts that affect your daily life.
According to the ABTA, some people can experience severe emotional distress after a traumatic birth even in the absence of physical trauma.
When preparing for birth, it’s important to be flexible with your birth plan knowing that although you may want your birth to be a certain way, sometimes emergencies happen and intervention is needed for your safety or your baby’s safety. There is no right or right way to feel about this, however understanding elements of the pregnancy and birthing process can help in terms of mental preparedness.
There are many organisations committed to bridging the information divide between what is taught at antenatal classes – where there is often a focus on natural, vaginal births – and the reality of covering many scenarios that may eventuate in the birthing process.
The ABTA is one of those such organisations and has committed to reducing the rate of birth trauma in Australia and New Zealand. They have developed THINKNATAL – a series of educational resources aimed at providing support and information about how a woman (or partner/family member) can best prepare for their first or next pregnancy and birth. The first module is on perineal tears and they will have more modules coming soon. Their philosophy is to encourage a multi-disciplinary and individualised approach to care that recognises each woman’s life experiences, values, wants, needs and physical health requirements.
The Centre of Perinatal Excellence (COPE) has some great tips too on preparing for birth and for when things don’t go to plan.
Birth after birth trauma
The prospect of having another baby after experiencing a birth trauma, can seem overwhelming. Spending time on your mental health and thinking/discussing how you feel can help immensely, as well as being prepared and knowing what your options are. It is important not to rush into having another child so you have time to cope with what has happened, and only you and your partner can ultimately decide what is right for you.
Some people choose not to have other children, and others go on to have many more children. Allow time to process your trauma, try to talk honestly and openly about your previous experience with your partner and loved ones. Seeking the support of a counsellor can also be of great benefit, as they are impartial and can help you work through any emotional difficulties you are experiencing.
Where can I find more support and resources?
- Australasian Birth Trauma Association for more information about this year’s Birth Trauma Awareness Week and to hear people’s stories follow the hashtags #yourstorymatters and #starttheconversation. There is also a donation page, to contribute to the cause.
- COPE (Centre of Perinatal Excellence) is an excellent resource for planning a family, preparing for birth and has many support resources.
- At Health Direct’s Pregnancy, Birth and Baby you can call 1800 882 436 and speak to a maternal child health nurse (7 days a week, 7am to midnight AET).
- Perinatal Anxiety & Depression Australia (PANDA). Call 1300 726 306 to speak with a counsellor (Monday to Friday, 9am to 7.30pm AET).