This is an important subject. As women we all know somebody who has experienced some form of trauma during pregnancy or birth and its something i see a lot of in clinic. So i wanted to dedicate a page to birth trauma and call in some expert help in the form of Dr Rebecca Moore.
Rebecca Moore is a perinatal psychiatrist working in London which means she works with women to support their mental health through pregnancy and after birth.
She is the Co-Founder of Make Birth Better, https://www.makebirthbetter.org. A collective of parents and professionals who campaign, train and support research around birth trauma to try to ensure rates of birth trauma for women lessen, ideally they want a maternity system where no woman would experience birth trauma.
She also runs an annual birth trauma conference in London, the next one will be January 2021 and She writes and podcasts all over the place!
Instagram @drrebeccamoore
Website https://www.doctorrebeccamoore.com
Q. Rebecca, how does a woman know she may have had a birth trauma?
I think your first birth delivers you into motherhood. It is literally the gateway to your mother self. I can pretty much spot the mothers who have had a hard time and those who have had a positive experience, one feels totally empowered and the other feels bereft. One feels empowered, the other feels bereft.
When a birth is traumatic we are left with many different feelings and emotions but in essence it feels like we cannot stop thinking about our birth and those feelings feel negative, we feel stuck and that we cannot move beyond our birth experience.
Birth trauma is common, it affects at least 20% of all births and it is totally unique to you, it is a subjective experience, how your birth felt to you, not what happened on paper. So you can have a vaginal birth and be traumatised, a caesarean and be traumatised or your trauma might occur just after birth on the postnatal ward.
Your story will be completely different to another woman but if you found some part of your birth distressing and frightening your feelings about that are totally valid.
1 in 25 women develop a formal clinical PTSD, Post Traumatic Stress Disorder, after birth.
So it may be that you felt out of control or helpless during birth, or you feared you or your baby might die, or it may be that your birth felt too fast.
Sometimes trauma comes from the way we are made to feel during birth so you may have felt alone, unheard, dismissed or that your pain was ignored or not managed well or that there was a lack of kindness and compassion.
Q. What are the common feelings/symptoms that can go along with birth trauma? 
After traumatic experiences before or during birth our brains try to process what has happened and this results in the symptoms we see after trauma. Sometimes these symptoms are there straightaway and sometimes they take time to show, so sometimes it might be six months till you start to have these feelings or in your second pregnancy or around the birthday of your child.
Commonly women describe constantly replaying their birth in their minds, talking about it all the time or dreaming about it with nightmares. This replaying and reliving takes over our thoughts to such a degree that we cannot focus on anything else or makes us feel preoccupied. Alongside that women can feel their mood is very up and down and that they are easily overwhelmed, tearful or anxious.
Or it might be that you totally avoid talking about your birth and if you think about it then you feel tearful or angry. This can mean that you want to avoid friends with new babies or pregnant friends because you just don’t want to talk about your own experience.
Women may feel more on edge and as if they are scanning for other bad things to happen or assuming the worst more, this might mean they don’t want to go out or are constantly checking on the baby at night perhaps or it may be that you feel disconnected from your baby and that you have no bond. Sometimes women can’t sleep or eat.
Q. What are good coping mechanisms for dealing with birth trauma ?
The best and hardest thing to do is to realise these feelings, this can take time as you are also a new mum and probably not sleeping much.
If you look at http://www.makebirthbetter.org we have some free downloadable crib sheets where you can check what symptoms and feelings you might be having. This can help to identify these and you can perhaps then use this crib sheet to take to your GP or Health Visitor to start a discussion about what might help support you.
If you can’t speak about what happened yet, sometimes its easier to write it down in a journal or diary.
Good coping mechanisms are being gentle with yourself, be kind to yourself, ask for help and support from friends and family and know you can get better with time and care. Other things which can gently support our mental health at any time are simple things like drinking enough water, eating when you can, trying to rest even if you can’t sleep and some fresh air outside with a slow daily walk.
Q. What are some of the not- so -good coping mechanisms for dealing with birth trauma?
Often our brains after trauma want us to avoid thinking about what has happened and we cope by avoiding reminders, avoiding another pregnancy or switching off anything on the News or TV about pregnancy, birth or hospitals. Or the trauma may be so in our mind all the time that sometimes we try to numb these thoughts and feelings with food, or alcohol.
Of course in the short term this may feel easier but then the trauma remains under the surface and isn’t really addressed.
Neither of these clearly are what we want long term, what we want is therapeutic support, usually with talking therapy to help safely explore and process these events. The aim is to be able to think and feel about these traumas without getting distressed and to move forward with them still part of you but in a way that feels more in your control.
It is really important to know that at least half of those who suffer from a birth trauma also report that there are positive changes in their lives afterwards, this is called post traumatic growth. This might mean seeing yourself as stronger afterwards, as having new strength and resilience or of using your story to help others by campaigning or offering peer support.
Q. What else is out there for a woman dealing with birth trauma?
There are many ways to seek help. The biggest hardest step for most women is to let someone know how you feel, this can feel really scary and often women fear being judged or seen as a bad mum, please can I be clear here, you can mourn the birth you had and still be an amazing mum.
The first thing is to find someone you can trust to talk to, it might be your partner, a friend, your mum, a GP or physiotherapist.
There are so many things that can heal trauma. Many of these can be accessed via the NHS but sometimes there are long waiting lists or services are not available so many women do end up sourcing some of their care privately which of course not everyone on maternity leave can afford.
For many women a good starting point is therapy and you can source a good trauma specialist therapist local to you. This usually uses CBT, Cognitive behavioural Therapy and sometimes a therapy called EMDR.
For birth trauma support online please see:
https://www.makebirthbetter.org
https://www.birthtraumaassociation.org.uk
There are some great helplines where you can be anonymous and speak freely, these include PANDAS which is staffed by women with their own experience of mental ill health and AIMS which gives support and is independent to the NHS. https://www.pandasfoundation.org.uk
Other ways to heal can include medication, exercise, diet, supplements, CBD or scar massage or physiotherapy. Trauma is often held in our bodies so movement of all kinds can really help, I wish every woman had a specialist women’s physiotherapist after birth as a routine part of her care.
You need to be able to safely tell someone your story and have them hear you, then discuss all the treatment choices so you can be informed to know what is available and what you feel would be the best mix for you to heal.
Q. What services are you involved with currently that can help women with birth trauma?
I am hugely involved with Make Birth Better and on my own instagram write and post about birth trauma all the time.
I am always open to anyone messaging me for advice or support, please don’t ever be afraid to contact me if I can help.
I also see women online or face to face in London to hear their birth stories and map out a treatment plan for them.
I also see a huge part of my role as trauma prevention, so for me this means teaching and training students of midwifery or obstetricians so that they learn how their actions with a woman in birth could cause trauma. So often it’s little things that make such a huge difference for women, kindness, warmth, touch, kind and positive words, we must get these right!