I find myself writing this blog during Birth Trauma week, from my bed, as I recover from a very different birth to the one I had planned. For those of you who do not know me well, and even those who do, but haven’t seen me or spoken to me much in the past year, it is worth noting that this was a surrogacy pregnancy. My own pregnancies and births had been very smooth, and my daughter’s homebirth could not have been more idyllic, so I fully anticipated that my body would behave in much the same way this time.
As the pregnancy had been entirely complication-free, I had planned to birth the baby at home, with my husband supporting me and the parents of the baby there to receive him gloriously into the world. I prepared, getting the birth space ready, surrounding myself with the home comforts that I hoped would provide a good flow of oxytocin; the birthing pool and shower curtains were at the ready!
However, despite all of the above, this birth ended in emergency caesarean birth, following an attempt at induction, surrounded by a team of doctors, a surgeon, an anaesthetist, midwives and nurses. But the most important person in the room, throughout the whole situation, was my husband, who despite being full of nerves and concern, maintained a sense of humour and calm demeanour that fooled me into feeling entirely safe. In fact, I had lovely conversations with the team in the operating theatre. Every single one made me relaxed and fear-free. The baby was born and quickly I could hear his first cries, and he was brought around for me to say a quick hello before he was taken for his golden-hour with his parents, who were desperately awaiting his safe arrival.
The post-surgery recovery hasn’t been easy, in fact, I have never felt so fragile, but I know that I will soon be past this phase and I continue to be supported by my loving family and wonderful friends. I am taking it as easy as I can. (Aside: I am also absolutely over the moon to see the family that I have helped to complete and I loved my cuddles before he was discharged from hospital).
All of the above serves as a context to my message about birth trauma. Interestingly, I do not consider what happened to be a traumatic experience. Why? Because every step of the way I was given all of the options, my views were respected and I had the loving support of my husband and the expecting parents. I felt safe and I felt in control.
I often hear health care providers suggesting that doulas and hypnobirthing teachers create birth trauma because we encourage a view of birth that is unrealistic, and then when birth doesn’t meet this expectation, this creates trauma. But this isn’t what I see. One person can have a birth that from the outside looks like a positive experience, but during the birth they felt coerced into a decision or felt they weren’t listened to, and as a result, they are left with a sense of fear and trauma that lasts long after the birth. Another can have a highly complicated birth, where baby and parent were in significant danger, and yet the way in which communication continued throughout the birth, made them feel empowered and listened to. Birth trauma appears to be more significantly correlated with the person’s sense of autonomy and control and far less associated with the actual events occurring in the birth, and certainly not about how different it was to the birth plan.
So how can health professionals and doulas help reduce birth trauma? We need to listen, avoid coercive language, respect everyone, give people all the information and trust them to make an informed decision. We need to encourage the asking of questions and asking for second opinions from colleagues, and not see this as someone being ‘difficult’; instead regarding it as someone making sure they have a full picture. We need to avoid over-medicalisation of births that didn’t need intervention, whilst also listening when people feel something is wrong and their intuition is telling them that they need more help to safely birth their baby. Finally, we need to ensure that everyone has the support of any birthing partners that they wish to be present. The pandemic brought restrictions that have made birthing without much needed support even more likely, and we really must make sure that these restrictions are not unnecessarily continued. All of this, for ALL women and birthing people, and I am convinced that we would see far less trauma in the birthing world and far better long-term outcomes for parents and babies.