Make Birth Better Campaign | Theme 3
'Delivery Into Parenthood'
The impact of a difficult birth, of course, was not just physical. Psychological symptoms were outlined, as well as the wider ranging, long term impact of these symptoms. Women also described the ways in which their births had impacted upon their relationships with their children, both in the immediate aftermath of the birth and in the weeks and months afterwards. Birth also influenced their decisions about subsequent pregnancies, with many choosing not to have further children due to their experience of birth. Those who did often had healing experiences with a high level of support. Finally, women described the trauma their partners had been left with.
1. OUT OF MY MIND
Women described a range of symptoms which would fit with psychological diagnoses of PTSD, anxiety and depression. Flashbacks and reliving the birth memory were described ‘Months later the sight of that doctors grimace, the pain, fear, loss of control and the inhuman wail that rose from deep within me kept returning in suffocating waves - the crystalline clarity, colours sharpened, left me shaking my head trying to rid myself of them’, ‘nightmares’, ‘vivid memories’; complicated symptoms of anxiety were also reported about the birth itself ‘complex stress reaction’, ‘unbearably anxious and rage filled’, ‘scared’, ‘hypervigiliance’ but also a more general anxiety such as ‘worry about health’, ‘extremely anxious about [son’s] health. Women reported feeling low mood and more serious symptoms of depression including suicidal ideas ‘worsening my moods’, ‘I felt numb’, ‘contemplated suicide’. Women often blamed themselves for their experience ‘pathetic’, ‘a sense of failure’, ‘shame was ever present’.
2. SOMETHING TRULY TERRIBLE
Women described a dawning realisation in the days, weeks and months after the birth that it had fundamentally affected them ‘ I started to realise that something truly terrible had happened to me’, ‘I walked in one person and walked out another’, ‘lasting impact on my mental health’. . Feelings of guilt and shame were described ‘Incredible sense of guilt’, ‘I was inadequate as a woman’, ‘I must have done something wrong’, ‘if only I’d been stronger’. There was a sense that this was not the way they should be entering into motherhood ‘your first birth delivers you into motherhood…it is literally the gateway to your mother self’, ‘alongside the tiredness and bewilderment of new motherhood, there should have been moments of joy’.
3. MISSING OUT ON BABY
In the initial moments after the birth, women felt that they missed out on the chance to bond with their babies ‘missed out on those crucial first moments’, ‘didn’t feel immediate bond’, ‘I didn’t get the rush of love’, ‘I thought ‘I don’t know you, you’re not what I expected’. Sometimes this was because babies were taken for special care, and mothers were left without their baby ‘she was placed on my chest then whipped away’, ‘I didn’t even know what her beautiful face looked like’.
Women described a sense of detachment from their children in the period after birth, which sometimes has never left them ‘I felt a disconnect’, ‘I feel detached’, ‘the chance to build a connection was taken away’, ‘I remember making excuses not to go and see them’.
In situations where women or their children had physical problems following the birth, this had a further influence on their ability to parent as they would have liked, including difficulties breastfeeding ‘I was advised not to breastfeed’, ‘I wasn’t producing enough milk’, ’I waited 5 days to hold them’.
For some, there was a sense of conflict over the love for their child and their continued trauma over their arrival into the world ‘How do you explain to a child [their birth caused] your whole life [to be] turned upside down?’, ‘I feel like I had failed him’.
4. IMPACT ON PARTNER
Partners were most often described as bearing witness to the trauma of the birth, ‘most brutal thing he has witnessed’, ‘one of the worst things he’d ever seen’, ‘distressed by what he saw’.
They were described as being left alone or isolated during the birth, not knowing what was happening ‘poor husband left crying in the hall’, ‘it broke his heart to leave us’, ‘he thought that was going to be the last time he saw us’. This had led to their own symptoms of trauma and distress ‘husband is more traumatised’, ‘he felt useless’, ‘massive impact on my other half’.
This also had an impact on the marital relationship ‘sex was out of the question’, ‘I couldn’t cope with him and the baby’.
5. TAINTED PREGNANCIES
Many couples decided not to have further children as a result of their birth experience, even terminating subsequent pregnancies due to the fear of birth ‘I was so traumatised…I’m really not sure if I would be able to go through with having any more children’, ‘I absolutely wouldn’t do it again’, ‘husband is more traumatised…with a lot of reluctance to go back for another’.
For those who did have subsequent pregnancies, while they experienced anxiety during the pregnancy, often these experiences were very healing ‘wonderful supportive home birth…helping to heal some of those earlier wounds’, ‘good birth to make up for bad’, ‘healing second birth’. This seemed to be due to women galvanising support and making firm plans for their births, including the decision to have an elective C section in some cases ‘I got a second chance and I grabbed it with both hands and all my heart’, ‘I took everything I learned from my first birth into my second’, ‘I read, I reflected’, ‘I hired a doula and I realised it was ALL MY CHOICE’, ‘I learned things that made my second birth experience vastly different’.
Reflections - The women are describing symptoms relating not just to the birth itself but the meaning attributed, leading to low mood, anxiety, and depression. Of course, these experiences are all linked together, for example numbness could also reflect depression or actually reflect dissociation due to the trauma experienced. This could easily lead to misdiagnosis - although if support is there to understand what happened and resolve the feelings about it, then the diagnosis becomes less important.
There is a sense throughout of feeling cheated - in the birth that was not as anticipated, but also this leading to motherhood also not being as expected. Partly, this may reflect our idealistic expectations of parenthood, but it does also lead to the question of how a woman in a traumatised state can be expected to care for a newborn alone.
Evidently birth is not just about birth - it affects women, sometimes permanently (this could also be a positive impact if supported in the right way), it affects their relationships with their children and their marital relationships.