What is Birth Trauma?
In this context Birth Trauma is Post Traumatic Stress Disorder (PTSD) that occurs after childbirth. The term birth trauma is also used to include those women who may not meet the clinical criteria for PTSD but who have some of the symptoms of the disorder. This is distinctly different form Post Partum Depression and PTSD is the term for a set of normal reactions to a traumatic, scary or bad experience. Symptoms are debilitating and can have long reaching consequences for women, their infants, and their families.
It is estimated that up to 30% or women are left feeling traumatized after the birthing experience and 2%-6% will have symptoms severe enough to be diagnosed with PTSD as a consequence. To put this into perspective, there are approximately 17,000 births per year in the Fraser Health Authority. That means that in the lower mainland, approximately 5000 women may be feeling traumatized after giving birth and between 340 and 1020 women may develop PTSD. PTSD is one of the most serious effects of trauma. Not all women who feel traumatized would qualify for the DSM Diagnosis of PTSD; however, many women are left with several of the symptoms after exposure to a terrifying event or ordeal where grave harm occurred or was threatened ( ie. to the woman herself or her infant). An Australian study found 1 out of 3 women reported a stressful birthing event with three or more trauma symptoms when interviewed 4-6 weeks after a vaginal delivery. (Creedy et al Childbirth and the Development of Acute Trauma Symptoms: Incidence & Contributing Factors, Birth 27 (2), 102-11).
Health care professionals are largely unaware of this problem and support is very limited. The symptoms are often misdiagnosed as Post Partum Depression. Women themselves may be unable or unwilling to discuss their trauma with medical professionals, given that it may have been the medical profession that contributed in the first place.
There are risk factors for Post Natal PTSD which include a very complicated mix of objective (eg. the type of delivery) and subjective (eg. feelins of loss of control) factors. They include:
- Lengthy labour or short and very painful labour
- Poor pain relief
- Feelings of loss of control
- High levels of medical intervention
- Traumatic or emergency deliveries, eg. emergency ceasarean section
- Impersonal treatment or problems with the staff attitudes
- Not beng listened to
- Lack of information or explanation
- Lack of privacy and dignity
- Fear for baby’s safety
- Baby’s stay in NICU
- Poor postnatal care
- Inability to sleep
- Delayed and/or reduced milk production
- Agitation and hyperarousal
- Emotional numbing and dissociation
- Intrusive, upsetting flashbacks of the birth
- Avoidance of all reminders of the birth
- Feeling sad, angry, or helpless about the birth
Social support is often lacking as well. Traumatized women are often told by well-meaning family and friends to “just get over it” and “be grateful you have a healthy baby”. This lack of understanding and denial of the trauma can actually re-traumatize women and worsen their symptoms.
The following symptoms may occur shortly after the birth and are highly suggestive of maternal psychological trauma;
Misconceptions About Birth Trauma
Often people believe that women who have been traumatized by birth must have prior history of trauma (e.g., childhood sexual abuse) or some other mental health problems (e.g., depression or anxiety). In some cases this may be true, however, more often than not this is not true. Research shows that the causes of maternal birth trauma are primarily situational, as are the causes of any trauma.
According to the official Diagnostic Statistical Manual DSM-IV-TR [9; p.466]:
The severity, duration, and proximity of an individual’s exposure to the tramatic event are the most important factors affecting the likelihood of developing PTSD. Although there is evidence that factors such as social support, family history and childhood experiences may influence its development, PTSD can develop in individuals without any predisposing conditions, particularly if the stressor is especially extreme.
Thus, the primary determinant of trauma and PTSD is the severity of the traumatic event, and not the history of prior trauma. Any person, even the strongest, healthiest individual, can be traumatized by a sufficiently strong traumatic event.
I am trained in several therapies specific to trauma and I am able to offer assistance in healing after a traumatic birth experience including EMDR.
If you would like to read about a female pediatrician’s personal birth experience and resulting trauma, please follow this link.
If you would like to read about how Birth Trauma affects fathers/partners, please follow this link.