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What is Birth Trauma? - Birth Trauma Association

Birth trauma is a shorthand phrase for post-traumatic stress disorder (PTSD) after childbirth. We also use it for women who have some symptoms of PTSD, but not enough for a full diagnosis.

PTSD was first identified amongst soldiers returning from the Vietnam War, and most people still think of it as a condition experienced by soldiers. In fact, PTSD can follow any traumatic event – such as being in a car accident, being sexually abused or having a very difficult birth. It can also happen to people who have witnessed a traumatic event, so people who have seen someone else violently killed, for example, often experience PTSD. This is why some partners, and even midwives, experience PTSD after seeing a traumatic birth.

In most cases, what makes birth traumatic is the fear that you or your baby are going to die. We very often see birth trauma in women who have lost a lot of blood, for example, or who had to have an emergency caesarean because their baby’s heartrate suddenly dipped.

You can download our leaflet on coping with a difficult birth here.

Symptoms of birth trauma (postnatal PTSD)

There are four main symptoms:

• Re-experiencing the traumatic event through flashbacks, nightmares or intrusive memories. These make you feel distressed and panicky.
• Avoiding anything that reminds you of the trauma. This can mean refusing to walk past the hospital where you gave birth, or avoiding meeting other women with new babies.
• Feeling hypervigilant: this means that you are constantly alert, irritable and jumpy. You worry that something terrible is going to happen to your baby.
• Feeling low and unhappy (“negative cognition” in the medical jargon). You may feel guilty and blame yourself for your traumatic birth. You may have difficulty remembering parts of your birth experience.

Not everyone who has had a traumatic experience suffers from PTSD, but many do. It’s a completely normal response, and not a sign of weakness. It’s also involuntary: brain scans show a difference between the brains of people with PTSD and those without. PTSD is not something that can be cured by “pulling yourself together” or “focusing on the positive,” despite what other people tell you.

Who gets birth trauma?

Some women experience events during childbirth (as well as in pregnancy or immediately after birth) that would traumatise any normal person.

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 hostile attitudes of the people around them, feelings of not being heard or the absence of informed consent to medical procedures.

There is still a lot of research to be done, but some of the factors that make birth trauma more likely are:

• Lengthy labour or short and very painful labour
• Induction
• Poor pain relief
• Feelings of loss of control
• High levels of medical intervention
• Forceps births
• Emergency caesarean section
• Impersonal treatment or problems with staff attitudes
• Not being listened to
• Lack of information or explanation
• Lack of privacy and dignity
• Fear for baby's safety
• Stillbirth
• Birth of a baby with a disability resulting from a traumatic birth
• Baby’s stay in the special care baby unit or neonatal intensive care unit
• Poor postnatal care
• Previous trauma (for example, in childhood, with a previous birth or domestic violence)

Finally, people who witness their partner’s traumatic childbirth experience may also feel traumatised as a result. See our partners page for more information.

What is different about birth trauma?

Women affected by birth trauma often find that there is nowhere to turn for support because even other mothers who have not had traumatising births can find it hard to understand the impact of a traumatic birth. This can make sufferers lonely and depressed as they often feel they are somehow weaker than other women because they are unable to forget their birth experience. They may feel incredibly guilty as a result.

This is a terrible burden to shoulder. The nature of PTSD means it’s impossible to stop constantly thinking about the birth experience, but very few people are aware of this. Even health care professionals don't always understand.

Unfortunately, this lack of support can mean that relationships with friends and family may deteriorate. Many women end up feeling torn between their desire for more children and their determination to avoid another pregnancy. They may also lose interest in sex and these problems can place a great strain on relationships.

Some women also avoid any medical intervention that reminds them of their birth experience, such as smear tests.

For many women, their greatest concern is the day-to-day difficulties they encounter bonding with their baby who they see as a constant reminder of the trauma they have experienced.

The BTA aims to tackle this isolation by offering women much needed support and showing them that they are far from alone. By working together and providing women with a voice, we hope that we can help change those practices that contribute to birth trauma

What’s the difference between birth trauma and postnatal depression?

Birth trauma can overlap with postnatal depression (PND) as some of the symptoms are the same, but the two illnesses are distinct and need to be treated individually.

Unfortunately, many women are wrongly diagnosed with PND and are prescribed medication that may do little, or nothing, to help their situation. Women tell us that they are frequently told by their health care professionals that they should try and move on with their lives or that they should just be grateful that they have a healthy baby. This can exacerbate the feelings of guilt and isolation that women already feel. Women may then end up with prescriptions for anti-depressants, simply because doctors do not understand the disorder.

Sometimes PND can go hand in hand with birth trauma, however, and in those cases anti-depressants may be appropriate. If you are concerned that you have been misdiagnosed, do speak to your GP or health visitor. Please show them a copy of our leaflet if they appear to be unaware of birth trauma or the fact that it requires specialised treatment.
 

Birth trauma - mom, dad, doctor...?

Natalya Petrovna Kovalenko, participant of the First Scientific and Practical Conference of the CTA "Home Childbirth", May 20-21, PMC) - St. Petersburg perinatal psychologist, professor, organizer and head of the International Family Academy project, has been engaged in psychocorrection of pregnant women for a quarter of a century: " my approach to preparing for childbirth, grew up in the hospital. In the delivery room, I directly observed the cause-and-effect relationships of pregnancy - childbirth - family. There was a lot of psychology in this."

Pain and our attitude towards it? How does birth pain affect everyone - a woman, a man, specialists who are nearby ...

CTA: What is birth trauma for a mother, child, doctor ..?

Natalya Petrovna Kovalenko: "This topic is close and understandable to me, although my first and second births were wonderful. And in my youth, I thought that everyone gave birth like that. But when fate brought me to maternity hospital 12, and the manager asked me to come up with a program that would facilitate the work of doctors and the worries of pregnant women, I realized how difficult everything can be. that if it is right to provide assistance to her, that is, to psychologically join the birth, to understand and accept it as a human being, to coincide with her in condition, then, I saw it myself (!), - a woman who recently screamed and almost lost consciousness, maybe turn pink, and stand up, and walk around. That is, childbirth immediately passes into the zone of a normal - not traumatic - process. "

CTA: What determines how a woman will give birth? Not only from the level of the pain threshold?

N.P. K .: "Everything depends on the woman, on her nature, but also on who prepared her for childbirth, in what hands she falls into childbirth, and whether she is ready for them at all. When I started, in 1992 year, the health committee did not even have such an idea that a woman should be prepared for childbirth.It was clear that childbirth is childbirth, contractions began, which means that you have to go to the maternity hospital and that's it.But in the middle of 9In the 1900s, paid childbirth began to gain popularity, women could openly choose doctors. And this doctor she chose paid attention to the woman. It became obvious that in such a situation, a woman gives birth better than the one who was brought, as usual, by ambulance. Doctors themselves have also noticed this. Then the head physician of maternity hospital No. 12, Evgenia Leopoldovna Lukina, thought about psychological support, counseling. She set me the task of working with the staff: separately with midwives, separately with doctors. And, of course, with pregnant women. As a result, I gave her three different programs. So interesting and pronounced results were obtained that, having developed the topic, expanding my experience to three maternity hospitals in St. Petersburg, I defended two dissertations, a candidate's, and after 5-7 years - a doctor's. The central line of all these studies of mine was the question - how to reduce birth trauma, what to do with traumatic experiences that everyone has during pregnancy, during childbirth and after childbirth.0003

CTA: What causes birth trauma? How does it manifest itself?

N.P.K. .: "All traumas, one way or another, are connected with the family, with relationships within the family. For some, the pain is pronounced, and unpreparedness for it turns into a trauma. This painful shock is remembered all my life. For others, the pain threshold works differently, and childbirth also goes differently. Zharkin Nikolai Alexandrovich, a famous obstetrician-gynecologist, said that there are women who enter the delivery room with a smile, and leave with a smile. They are! But they are every year less and less. It's like some kind of talent, thanks to which some women do not receive any birth trauma in childbirth. I have a test that examines the dominant of motherhood. If a woman has a pronounced dominant of motherhood, everything goes better for her - both childbirth and breastfeeding and postpartum recovery... It is easy for her to be with the child around the clock, and no depression. If this dominant is not present, then difficulties and suffering can lie in wait for a young mother at all stages. And the level of traumatism from these sufferings She will be higher than the others."

CTA: What is birth trauma for a child?

N. P.C. : "A traumatic birth for a child is also a trauma, since the mother-child system is inseparable. For several years in a row I argued with our chief city pediatrician, he did not accept perinatal psychology for a long time, he laughed. But now he himself lectures on perinatal psychology for pediatricians. He realized that for pediatricians this part of the "child's life" (the perinatal period) turned out to be important. For example, in his lecture there is a block devoted specifically to the birth trauma of the child, there are studies that show the level of traumatic experiences of the newborn: it also includes the pressure experienced by the child, and difficulty in turning on the respiratory process, etc. "

CTA: What about a caesarean section? Formally, there is no trauma for a child…

N.P.K. : "There seems to be no injury, but there is a deviation from the natural course of events. A kind of lack is formed in the formation of the child's primary experience, and the woman is deprived of natural experiences, natural experience. Natural childbirth is also important because it marks the transition of a woman to a qualitatively new level - motherhood. And it should be somehow marked. During childbirth, a huge energy flows through a woman and her experiences. This is the accumulation of all mental, reflex, instinctive energy. For some, this is a trauma, but for women adequately included in the process, these are such positive experiences comparable to an orgasm. And this change from minus to plus occurs exclusively within a woman. Inside her personality, attitudes to pain, to childbirth, readiness for childbirth and motherhood change. This happens only with careful work on oneself in the process of training. We are preparing so that a woman during the period of pregnancy would surely develop the properties, skills necessary for motherhood, learn how to to control oneself, emotions, behavior, formed adult positions and attitudes towards oneself and the child. This will be what we call maternal dominance. If the mother's dominant in a woman is mature, then there will be no injury. And reflexively everything will happen better, physiology adjusts to the dominant and all processes (pulsations and circulations) will go better.

And so, caesarean section is not a natural birth process, but you have to resort to it if a woman is not in the mood for childbirth, could not open up, did not form a maternal dominant. This is not always her problem, it can be hormonal immaturity and other reasons that lead to surgery. But the task of specialists is to prepare in such a way as to avoid this operation. At least 60% of women after a caesarean section experience complex psychological problems: they experience depressive states, blame themselves for imperfection, worry about the child, and experience a feeling of inferiority. I often have to work with this, after childbirth I have to help more often than before childbirth. "

CTA: How does epidural anesthesia affect a woman?

N.P.K.: "Epidural anesthesia is also an unnatural intervention in childbirth, not provided for by nature. Indeed, in the body of a woman during childbirth, appropriate substances should be produced that reduce pain (if she behaves correctly). Anesthetics are serious drugs and are excreted not so quickly from the body of a woman, but to feed her.According to our observations and our foreign colleagues, women who have received anesthesia are more likely to show emotional alienation from the child, more often show selfish forms of behavior in those moments when circumstances and the nature of motherhood requires them to behave more altruistically for the sake of the child. Fear of pain gives rise to a tendency to fear any trials and stresses. And the mother will still have to meet them, feeding and caring for the child. "

CTA: And for dad?

N.P.C. : "I have a block in my program called "meeting with pain": how to cope with it, the psychological, physiological nature of pain, a reflex model, including labor pain. And when a woman has gone through this knowledge, she is no longer afraid of pain. But By the way, only women can do this. Men, even male doctors, have a completely different idea and perception of pain. If a man himself was born as a result of a difficult birth (asphyxia or something else), then this is fixed on the subconscious. Naturally, he he does not remember and does not realize this, but when he himself becomes a father, goes to the delivery room, then this manifests itself (difficult experiences for men).If he has a trauma associated with female nature (childbirth, mother, and the woman herself can be an aggressor for him ), then all this can manifest itself during childbirth.

CTA: How?

N.P.C. : "Men faint, they begin to vomit, diarrhea happens to them. Or ... the man just passes out. He starts to fall asleep and cannot be woken up. The woman wants to cooperate with him, he wants to, but ... cannot. And he lies - sleeps, and we give birth. When this began to happen during childbirth, we began to deal with this, pay closer attention to male dads in the courses. If I see that a man eschews the process, I either hint to a woman that she should not take it for childbirth (this may increase his birth trauma), or I suggest talking separately, conducting psychotherapeutic work.0003

When we started a partner birth in the 12th maternity hospital, we had the main thesis - "joint birth, husband's participation." A beautiful film was made specifically for a man to see. So we were inspired! And when we looked at the results, the inspiration diminished. Although I, of course, not against partner childbirth! There are men who are the best escorts. But there are also those who are injured, they are few, but now I am very cautious about their participation.0008

N.P.K. .: “All the 25 years that I have been conducting training courses on the topics “Perinatal Psychology and Psychotherapy”, “Resource Psychotherapy”, there are always doctors or midwives in groups. And why do they come to me? Because they received this or that injury. Still, childbirth is a process where complications are not excluded, and tragedies happen. And no one is safe from professional mistakes. Sometimes such an emotional trauma can be recorded by a doctor for many decades. For example, antenatal fetal death or any other death

For example, one doctor, after a difficult case when a child died in childbirth, quit her job, lived outside the city for five years: “I feel guilty, and I can’t even come close to the birth chair.” And, meanwhile, this is an excellent doctor, with excellent experience. She listened to my entire psychological course, worked off her injuries and looked at childbirth in a new way. And now she is delightfully working with women, delivering them in our projects (Gloria program)". ?

N.P.C. : "No, the sympathy and inner connection of the doctor is very good. But to a certain extent. There are doctors who are so compassionate, so involved in the woman in labor, that any negativity in her is a big personal trauma. This is an extreme. All doctors, and especially those who take birth should be trained to be able to slow down this emotional inclusion in time. This is professional self-control. I teach this at resource trainings created specifically for doctors and midwives. "

Birth trauma - an article at the LOTOS MC

All articles 11.04.2017

Perinatal damage (from 28 weeks of pregnancy to 7 days of life) of the nervous system in children is one of the leading problems. According to statistics, up to 10% of newborns have serious injuries received either before or during childbirth and they are visible to the naked eye, and up to 90% of newborns have a cranial osteopathic disorder (“cranium” - from Latin “skull”), which can only be detected with manual (manual) examination. In addition to traumatic damage to the head and body of the fetus, the osteopathic concept of birth trauma includes manifestations that are detected during manual osteopathic examination, namely: tissue stress, mobility restrictions, the relative positions of various structures of the head and body, which reduce the plasticity of tissues, their adaptive capabilities and lead to functional impairment as the child grows and develops.

The cervical segment of the spine is most often affected , during childbirth a functional block occurs in C0-C1.

In the process of childbirth, the expelling forces of the uterus and the birth canal, the resistance forces of the fetus itself and the forces of predisposing factors act on the fetus. Factors that contribute to the development of birth trauma include: fast and rapid labor, prolonged labor, discrepancy between the size of the head of the newborn and the pelvis of the mother, extensor insertion of the head, obstetric rotation, application of forceps and vacuum extraction of the fetus, as well as acceleration and stimulation of labor , breech presentation of the fetus, prematurity.

Osteopathic lesions as a result of birth trauma are diverse: at the level of the head and neck, these are compression and impairment of the global mobility of the skull, tension of the membranes of the mutual tension of the skull, impairment of the mobility of the cranial sutures, impairment of venous outflow and liquorodynamics, limitation of mobility of the upper cervical spine.

Signs of this pathology in newborns:
• Torticollis
• Regurgitation
• Poor sleep
• Hydrocephalic syndrome
• Instability of cervical vertebrae
• Reduced or increased reflexes
• Dysbacteriosis
• Head tilt
• Delay of mental and physical development.

Older children:
• Violation of posture
• Reduced memory
• Headaches
• Motion sickness in transport
• Scoliosis
• Impaired vision and hearing
• Increased fatigue
• Allergy
• Dermatitis

In adults, untreated birth trauma also has its consequences:
• Headaches
• Osteochondrosis
• Sciatica
• Migraine
• Weather sensitivity
• "Heavy" head in the morning
• Alcohol intolerance
• Varicose disease
• Allergy
• Fatigue
• Snoring
• Insomnia
• Shortness of breath.

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