Traumatic labours and coming to terms with them

We have been focusing on labours recently and whilst some are fantastic experiences, like LAJ's homebirth, others are not. The aim of this post is NOT to scare pregnant moms, but to help moms who have had a terrible time and are struggling to deal with it.

From an early age, labour is generally portrayed in films and TV programmes in two different ways: the Waltons’ ‘ma, fetch the hot water and towels’ and the more graphic American TV ‘real life’ screaming labour programmes.

While some women will always find more traumatic than others, there will be women, who will experience events during childbirth that would traumatise any normal person. Such events can include:

• a lengthy labour
• a very painful labour
• induction
• poor pain relief
• high levels of medical intervention
• traumatic, emergency delivery

Some women who, for example, wished to have a normal labour with a low level of medical intervention, can find it very traumatic if they have to have an emergency caesarean or a high level of medical intervention. Afterwards, they can relive the delivery for days, weeks and even months at a time, failing like a complete failure for not having had a ‘natural’ delivery. If the baby’s life has been in danger during the delivery, these feelings of failure can be even more heightened.

For other women, it is not always the sensational or dramatic events that trigger childbirth trauma, but other factors such as loss of control, loss of dignity, the difficult attitudes of the people around them, the feelings of not being listened to, or the absence of informed consent to medical procedures.

These feelings of failure often can manifest themselves in actions such as constantly checking on baby while s/he is asleep or never allowing baby out of sight. Such women will suffer genuine and long-lasting distress and will often require medical help.

In other women, however, a traumatic labour and birth can lead to the more serious post traumatic stress disorder (PTSD). PTSD is the term for a set of normal reactions to a traumatic, scary or bad experience. It is a disorder that can usually occurs following the experience or the witnessing of life-threatening events.

While PTSD is generally associated with situations such as military combat, natural disasters, terrorist incidents, or violent personal assaults, the term ‘a traumatic experience’ can also include any experience, which involves the threat of death or serious injury to an individual or another person close to them. In the case of traumatic labour, it is a mother’s fear for her baby and, for this reason, it is now accepted that PTSD can be a consequence of a traumatic birth.

Characteristic features of PTSD include:

• An experience involving the threat of death or serious injury to an individual or another person close to them (eg, their baby)
• A response of intense fear, helplessness or horror to that experience.
• The persistent re-experiencing of the event by way of recurrent intrusive memories, flashbacks and nightmares. These memories and flashbacks will make women feel distressed, anxious or panicky when exposed to things that remind them of the event.

It is important to remember that PTSD is a normal response to a traumatic experience. The re-experiencing of the event with flashbacks accompanied by genuine anxiety and fear are beyond the sufferer's control and in most cases, medical intervention is required.

If you have suffered a traumatic labour, you may find this website on birth trauma ptsd helpful.