Preparing for Birth with PTSD
I want to be a responsible resource for my clients when they come to this section of the site, and so I am starting this post off with a very transparent notice: Although I have extensive experience with PTS(D) (Post Traumatic Stress) and PTG (Post Traumatic Growth), and have done outreach and been a caretaker for over ten years for those affected by trauma, I am not a trauma counselor, I do not have a license of social work or medical practice, and know that the research surrounding birth, trauma, and trauma recovery is a very vast web of (incomplete) information. I know that, and I know not talking about the shifts and changes that happen in birth are too significant to not discuss what I am witness to.
trau·ma: noun
A deeply distressing or disturbing experience.
emotional shock following a stressful event or a physical injury, which may be associated with physical shock and sometimes leads to long-term neurosis.
Wound
We have long recognized that through discomfort and adversity we are given the opportunity to transform and grow. Birth is classified as a normative crisis in a female's life and requires giving up their identity and assimilating another. Add to that the hard fact that there is "little professional or public literature which agrees on the psychological symptoms women experience" during childbirth. I would say all birth has some level of trauma. Whether that trauma is transformed into stress or growth has a lot to do with how supported you felt as a birthing individual.
First let me say, it is possible to have a great birth. It is possible for your ideas and reality to align, and for you to feel as beautiful as you hope to feel in the process before - and while - meeting your baby at birth. I recognize that when I talk about birth and trauma and the relationship between the two it may not resonate with you. However, for those who experience birth, not as a perfectly predicted series of milestones and check-boxes, it can lead to feelings of disappointment, shame, betrayal, separation, and failure. How can childbirth lead to such vastly different feelings? Where do these ideas of failure and shame come from?
As a doula, it is my job to notice the smallest details and shifts that happen during birth. It is my goal that your birth is as positive as possible and in order to do that I must be able to recognize what factors influence this.
What I notice as a birth doula is vast and important:
More and more people are separated from traditional support structures that give information and guidance for the variance of "normal" births. In many ways, the type of birth experience that is considered to be “good” has become narrow and ridged and the pressure to achieve this type of birth is overwhelming and at times very unrealistic.
More and more people are not subject to rituals surrounding birth and motherhood, making normal psychological changes seem even more radical and less understood. It also makes the physiological transition into motherhood confusing and often fearful.
The birth stories people share are usually negative. These negative birth stories are then carried by the pregnant individuals who receive them and have the power to impact their own birth experiences. Expecting individuals often must morph into a support person for the person sharing - often giving comfort for an experience they are still waiting to have.
Many doulas and birth workers describe laboring individuals as being in “the zone” or in “labor land” while coping with the discomfort of labor. For individuals who have experienced trauma in the past this feeling of dissociation can be triggering if you are not prepared (and sometimes even when you are prepared) for this common coping strategy.
I know that perceived pain, and actual pain are linked in birth, and the perceived belief in one's ability to overcome pain contributes to feelings of success.
I also know that feeling supported through birth directly impacts a person's belief of having satisfactory feelings about their birth experience, and when partners have positive feelings about birth it can decrease postpartum depression risk through recovery.
Your emotions impact hormone production. These hormones affect how your labor progresses as well as your feelings about your overall birth experience.
The type of birth you have (cesarean vs vaginal, medicated vs unmedicated, hospital vs home) is less important in regards to overall satisfaction than how you felt during your birth.
Individuals who experience fear, loneliness, abandonment, dismissal, invalidation, etc… during birth often have a more difficult time recovering from their birth.
One of the best indicators of recovery from birth, and to promote Post Traumatic Growth is the feeling of being well supported, well informed, and the ability to retain autonomy over themselves and their decisions throughout the birth process or traumatic event.
For all these reasons and more, doulas offer guidance through pregnancy, labor, and recovery.
Because birth is both a physical and psychological process or journey, we all have the ability to influence it. As a doula, it is my responsibility to affect birth in a gentle and responsible way, and not to impart my own ideas and beliefs about what a “good” birth experience is upon it.
With all of these observations and bits of insight, what am I here to say?
I am here to say that you are important.
Your birth is important.
Your story is important.
The experiences you have had, or will have, do not make you less worthy of having support.
Being a birth doula requires me to be present with the person in front of me. That means, I am skilled at helping you through a whole host of situations and emotions - the expected and the unexpected.
You deserve a voice, a choice, and support throughout your pregnancy, birth, and recovery.
I want you to say what you need. I want you to feel what you are feeling without shame or denial from those who "know better." And I want you to feel seen and heard at your birth.
Regardless of the decisions. Regardless of economics. Regardless of color. You matter, and your birth matters.