Day 18: "At Least You Have a Healthy Baby" -- The Hidden Pain of Birth Trauma

When someone says, "At least I have a healthy baby," how do you interpret she feels about her experience? Birth is a transformative experience, and women can be transformed for the better, or for the worse. How can we, as doulas, help support someone who has had a traumatic experience? Abby gives excellent ideas which remain within our scopes and roles as doulas. 

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When you look at the probability of trauma in the course of a woman’s life, the statistics are high. One in three will experience sexual abuse in her lifetime, one in four will perceive her birth as traumatic. So, if you’re a childbirth or postpartum professional, you are regularly working with women who have experienced trauma. And keep in mind: a woman who has previous trauma or a history of abuse has a much higher chance of being triggered in birth and experiencing trauma again.
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What is birth trauma? It’s all about perception. When a woman perceives her birth as traumatic, she has felt one or more of the following in an intense and damaging way:

• Complete loss of control
• Totally helpless in the face of defending herself or her baby
• Victimized by an authority figure; emotionally and/or physically
• Abandoned
• Disrespected

Birth trauma will have immediate effects on a woman and change her experience of birth, postpartum and motherhood. As birth professionals, our goals are to prevent birth trauma by providing support, information and guidance for laboring Mamas. Some of the things you can do during your time together are build trust, tune in to Mom’s behaviors to establish safety in the labor room, and speak to her in a calm, affirming voice. But unfortunately, we can’t always prevent birth trauma.
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Women who have experienced a traumatic birth can develop PTSD (posttraumatic stress disorder). It can be misdiagnosed as postpartum depression or anxiety but the symptoms are actually different. Some signs of PTSD in a new mother are:

• Lack of a strong bond to baby, not holding or responding to her baby
• Extreme irritability, anger and blame
• Obsessing over the events of the birth; may include flashbacks or nightmares
• Uncontrollable crying, intrusive thoughts and fear
• Avoiding doctor’s appointments, seeing family or scheduling to see you for follow up

There are some important things to keep in mind when dealing with a Mom who has birth trauma. Your support will be critical to establishing safety, support and eventually healing from this difficult time.

​Here are some things you can do to support a Mom with trauma

• Create a calm environment and speak in a calm, steady voice. Use her name when speaking to her as it will bring her attention to your voice. Give positive, truthful and affirming statements.
• Normalize her response to her birth. Confirm that her response is normal for someone experiencing an overwhelming amount of stress. Say things like, “That would be upsetting to anyone.” “You’re crying because that’s how people react when they feel angry or frightened.” Don’t place blame or contribute to her feelings by becoming angry yourself.
• Be a witness for her. This is the true gift of a doula. The human brain translates acknowledgement, support and connection as SAFETY. Help her establish safety in these important weeks after birth.
• Affirm that something bad has happened. In a loving way say things like, “I’m sorry this happened.” “You didn’t deserve that.” “It’s not your fault.” “You’re safe now.” Again, don’t fuel her anger or powerlessness by engaging in blaming, criticizing or attacking other parties who were involved. Restore a sense of control, power and self-efficacy. Continue to respect her choices, assure her that she is “in the driver’s seat” and she gets to determine her next steps. Let her make decisions and don’t tell her what she should do.

​The exciting and encouraging thing to hope for is what’s called post traumatic growth. With proper self-care, nutrition, sleep, and exercise she will begin to feel better. Suggest to her that some women find healing through yoga, body work, trauma therapy and groups. Post traumatic growth provides women the opportunity to heal from trauma and become stronger, wiser and more compassionate because of it. With adequate support, education and care, new Moms can fall in love with their babies and leave the shame and pain of trauma behind.

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Abby Bordner’s  background is in medical settings, community education and entrepreneurship. She currently has many online and in person projects for the non profit sector and her private business. She is a Cappa Doula Trainer, Labor Doula, and Lactation Educator. She is a certified ICEA Childbirth Educator, as well as an author and entrepenuer, creating such projects as Yoga Born, Birthing Tree Cooperative, Relationship Based Parenting, and Modern Motherhood. She travels around the US providing certification training for future Cappa doulas, and Yoga Born Childbirth Preparation classes – trainings for prenatal yoga instructors which integrate yoga and childbirth education.  

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