Sometimes I can not help but wonder if Postnatal Depression is really the epidemic that it seems to be, or is there something more than hormones that cause a new mum to fall apart? Birth itself can be traumatic, incredibly so, a woman is expected to be elated to have a safe and healthy baby, but what she goes through to deliver that baby into the world can be frightening and traumatising depending on how she experiences birth. Post Natal Depression is a very real, and very frightening illness – sometimes though it seems to be a catch-all for any new mum that admits that she is struggling emotionally. “It is just your hormones” – Medicate and move on!
If we can agree that birth itself is traumatic for many, how much more so for those who have survived abuse or assault(s)? There seems to be limited research into how birth could launch them into a full-scale emotional trauma and trigger terrifying feelings that they can then attach to their new baby on a subconscious level. I want to talk about this, we need to talk about this.
Quoting from a really great article I read on the blog Every Mum Should Know – “Many cases of birth trauma are preventable. It is as much how the experience is felt by the mother, as it is the circumstances around the birth, that can result in trauma. In what other situation do we expect a woman to lie in a submissive position, frightened and in pain, exposing her genitals to be inspected and touched by strangers for hours at a time? If intervention is required, unless proper care is taken to ensure the woman is respected throughout, this can at best result in feelings of failure, and at worst feel as violating as rape.”
Can I get a resounding “AMEN” to this? Especially the part about in what other situation would a woman be expected to lay in a submissive position while frightened and in pain, having her most intimate and private parts of her body inspected and examined? We wouldn’t – all respectable humans would be horrified at such a scenario. But when in labour it is expected of a woman, and she is expected to brush it aside afterwards and focus on the fact that she now has a baby.
It is obvious that due to the nature of labour and delivery that a womans genitals are going to be exposed and she will be physically uncomfortable afterwards – but the way a woman is treated in labour has a lot to do with the outcome of her emotional health and affects her mental health going forward as a mother.
Imagine starting a new job, and before you even get to your desk on that first day, someone has violently attacked you. You are left very traumatized from the attack, you have been hospitalised because of the severity of your injuries, but worst of all are actually the emotional scars of the attack. You felt powerless, violated, afraid, hopeless, and sickened, the feelings stay with you long after the actual experience, long after you have been released from hospital.
Each day when you go to work you are reminded of what happened and the feelings you experienced. These feelings make it incredibly hard to focus on your new job – previously you had been so excited about starting work and were looking forward too more than anything in the world, you had been sure that this experience was going to be the best thing you had ever done with your life. However instead you are faced with a painful new reality – the reminder of your trauma each time you see the hall you were attacked in causes feelings causes severe anxiety, depression, but you are constantly told that “At least you didn’t die, it could have been worse!” and “At least you still have your job!”
How do you feel? It is pretty confronting right? This is what birth can be like for some women. They start off their new job (motherhood) experiencing a vicious attack (labour) that leaves them feeling powerless, violated, afraid, hopeless and sickened (traumatized from feeling these emotions). These feelings stay with them long after the actial birth, long after they leave the hospital and return home with their precious baby. And each and every time they look at the beautiful face of their newborn child, they are transported back to the horrific feelings they experienced.
While many women may feel some of these feelings during birth, most women will be able to brush them aside once they see their baby, and move on. Yet for others, it brings up trauma from the past, it reminds them of being attacked, possibly raped, or abused in unspeakable ways. Such a beautiful new job that they had been looking forward to starting, becoming a mum, has bridged the gap between the past and the present!
No one can control how a labour will progress or not progress, but the most important part is to stop the “attack” before it started. For me, birth trauma was so very real. It triggered severe PND and made me relive horrible things.
My youngest son’s birth was actually the more dangerous of the two in some ways – physically anyway. I’d had pre labour for more than 4 weeks and then he was born blue and needed to be resuscitated. (He was all but dead, his initial score was 1 or 2). Yet the difference was that I had a very supportive midwife and OB-GYN who advocated for me during my labour and they allowed my husband to be right by my side the whole time, I was also given great care and kindness in the hours after his delivery. The experience although being fraught with danger was much better than that of our first son.
Why? During our first son’s labour the admitting midwife was rude and disrespectful, she tried to send my husband home and got angry when I panicked and said that if he had to go, I was leaving too. She was frustrated with me for coming in to the hospital, despite the fact that I had been labouring at home for around 20 hours and was fast approaching exhaustion, because I was not “in real labour”. When the midwife I was booked in with came and took me through to the Birth Center (which meant a private room where my husband could stay with me while I laboured) she came and removed our bags while I was being assessed and put me into a ward. She was horrible, I can’t express how incredibly frightened I was, I needed to have my husband with me and she was just as determined that I would not.
My lovely midwife was really upset at how I was being treated and could not understand it, she went and got my bags and put them back into the birth suite, and told the other nurse to guard it as I was booked through the Birth Center, and I WOULD be under their care. Thank goodness. The birth center took great care of us, but the labour was long and failed to progress – after 36 hours of laboring at the insistence of the second OB-GYN who I’d seen, I finally agreed to having an epidural and being given medication to assist. If things had stopped there it might have been okay, but difficulties happen and I ended up in theatre for an emergency C-Section.
Unfortunately even that would not work, while waiting for the pediatrician to arrive and my spinal block to work properly our son had moved and was now not in a position for a safe surgical delivery. What followed left me very battered and in a lot of pain for weeks afterwards, he was extracted via Ventose. But that was not what caused the severe trauma, it was the feelings of fear, helplessness, being exposed and violated. I went to a teaching hospital, and that meant students. I lay there, partially paralyzed, exposed, in agony (the spinal block did not work correctly at first), terrified, feeling totally helpless and violated while the room was filled with people. Orderlies, theatre staff, pediatrician, midwives, the OB-GYN and his assistant, the anesthetist and her assistant – all watching.
I know they were there for my safety and that of my baby, but there is little comfort offered to a woman when things are going wrong. I felt like a piece of meat, being inspected and hacked into, a bystander to my own trauma, de-personalised and simply seen as an object to be done with what was needed. I do not remember anyone except my husband and occasionally the anesthetist even talking to me. It was understandable that I would go into shock.
Birth trauma is a very real thing but we expect women to get over it and move on – afterwards I was told to be happy that I was alive, to be happy that my baby was healthy, to be thankful for what I had, and I was. But my underlying depression and the trauma of previous life experiences were now fully exposed and brought to the surface by the fresh trauma I had been through. I didn’t have Post Natal Depression, not in the truest sense.
I don’t really know where I am going with this, except to say that we need to focus less on diagnosing every sad woman as having post natal depression, medicating her, and moving on. How about we ask them about how they felt when they laboured, asking them if they have had previous mental health issues, have they experienced trauma? How about we are kind and sympathetic, and understanding – instead of telling them to be grateful for what they have!
Let’s be supportive of each other and care. Let’s ask doctors and nurses to remember that no matter how tense a situation is, to remember to treat their patient with respect and dignity, to be kind and gentle so that hopefully she does not feel as though she is being assaulted and causing trauma on one of the most important days of her life.