Birth

Can childbirth ruin a woman’s mental state?

***** TRIGGER WARNING *****

(touches on babies born sleeping, infant loss, difficult births and obstetric violence/birth trauma)

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Without a doubt it can.  Sadly.

For the vast majority of women, around 2/3rds of women – childbirth and/or the arrival of a child will absolutely have no effect whatsoever on their mental state – thankfully.

Somewhere between 1 in 3 to 1 in 5 mums do develop a perinatal mental health illness (depression, anxiety, OCD, psychosis, PTSD) either in pregnancy, during or post birth. Some are very severe, others less so.

Around 5% of mums experience some sort of birth trauma – ranging from moderate to severe PTSD. The figure is really hard to determine – but around 1 in 20, quite high…. certainly much higher than it should be.  And many more experience birth grief/disappointment.

For some women, birth trauma occurs due to some unpreventable situation – maybe they’ve lost their baby before, during or after birth.  Maybe their baby has been taken away to the neonatal unit.  Maybe their baby has been born too early. Maybe mum has haemorrhaged at birth.  These awful things happen in a small minority of cases, thankfully.

However, for many, many, many more – over-medicalisation of birth has left women feeling unsafe, unloved, battered and bruised at a time when they feel MOST vulnerable. This ranges from unnecessary interventions, not giving access to pain relief (only today I had someone telling me this), being made to feel silly, being referred to in dis-empowering language, physical abuse including not discussed (never mind consented) episiotomy etc.

And then we wonder why women ‘fail to progress’ or can’t birth without intervention… And what this spreads is fear about horrific birth can be because women have been made to FEEL that their birth was a horrendous experience… And we know that women talk and women also don’t like to brag – so you’ll hear the difficult stories but will much less likely hear the “I FUCKING DID IT” stories.

Often women feel dis-empowered over their choices, they have no idea what they are signing up to when they are being given an intervention.  I’d say the VAST majority of women that come to to discuss birth trauma – THIS is the memory of their birth – the feeling of being vulnerable, the flashbacks of being unable to get out of a bed strapped to machines and monitors, the feeling of being unsafe…..

Michel Odent (I’m a teeny tiny bit obsessed with) who is a leading international birth expert has also summarised that women may disconnect from their baby when we interfere with the birth process.  Like other mammals, at a primal period in our lives, we may reject our babies when given artificial hormones or epidurals – something that also was reported in Sarah Buckley’s hormones of childbirth report.

This really is not researched or understood enough but his hypotheses is that other mammals immediately reject their baby when they have surgery or are given anaesthetics. We are mammals – we often forget, yet in this primal time of our lives we are expected to not be primal – to not birth with instinct. To birth with our brains and not our bodies.

As I’ve written before, in ‘Why Are Humans So Bad At Giving Birth‘, there are things we can do that support GOOD, non traumatic births.  We can make rooms dark, we can remove time limits, we can make it warm, we can let the women labour in peace, we can nurture her, we can feed her the right food, we can let her drink what she needs, we can encourage her to walk, rock, sway and move. We can stop speaking to her – minimising her neo-cortex interfering with her primal brain. In all low-risk births, we can encourage homebirths.  We can be positive about that choice.  When birth isn’t progressing or special circumstances start to appear, it is NORMALLY always possible to go through the options – see my other post about ‘What I wish I’d known about birth‘.

And I want to be clear, not all births needs to be silent waterbirths.  Not all births need to be about breathing the baby out.  Birth is a primal experience.  Many women become their most primal at birth.  Some are silent and glorious through birth, many are not – many are strong, fierce, beautiful primal women.

Call me a cynic, but I really blame the rise in the medicalisation on birth on big pharma companies.  Let’s consider for a moment what would happen to multinational pharmaceutical companies and medical equipment companies if we started to change birth – and make it low tech, reduce the use of procedures… Without a doubt, a c-section is a life saving operation, so is diagnostic equipment. I am not disputing this or ever will.

However, the over-medicalisation of the vast majority of births, including low-risk births is ensuring more and more women are subject to birth trauma/grief/disappointment leading to a very poor establishment of a positive relationship between mum and baby and really lining the pockets of multinational companies…. Not only through the birth process but also after…. (who is financially gaining from from antibiotics, the anti-blood clotting medication, the anti-depressants….). I’m sure there’s probably a book on Birth Politics/Economics somewhere – I haven’t read it… sure there will be….

Going back to the original question of this blog – before I get totally side tracked and my soap box gets bigger and bigger….

Can childbirth ruin a women’s mental state – YES IT CAN…

Birth trauma/grief/disappointment is a one of the MAJOR (not only – there are many others) contributing factor to a perinatal mental health illness – specifically birth-related PTSD for birth, but also the more widely recognised Postnatal Depression (PND).  This is awful when in many of these incidences it CAN be avoided.

The reason why this is such a big issue is that we now know that PND/PTSD can lead to poor bonding and attachment between mum and baby which can lead to developmental issues in the short term for the baby and consequences in later life around esteem and their own mental health.  A healthy baby is not all that matters. We know that suicide is the number one reason women die in the first year post birth.  We know that PND has a massive effect on not only the mum and the baby but also on the wider circle around her – family, friends, relationships.

PTSD from birth can also massively impact the Dad – something we rarely acknowledge but it can – leading to a very unstable start for any family. Dads often struggle to acknowledge their feelings and therefore their PTSD may manifest itself in ways that we don’t necessarily expect.

So here’s how YOU CAN REDUCE the chances of this happening to you (because you can!):

  1. Access a good antenatal education.  Now I’m going to be controversial here.  Not NCT or NHS – because both talk a lot about the mechanics of birth and all the pain relief measures etc – AND are a great place for meeting people, but they don’t provide the best antenatal education.  I know this as I went and so do the VAST majority of my clients – none of whom are ever prepared for their births or breastfeeding (they do have lovely friends though).  I’d suggest going to active birth classes (the Daisy Foundation provides classes across the whole of the UK and are a great starting point), pregnancy yoga (ie yogabellies or other local providers), look to see what online courses there are that talked about INFORMED and POSITIVE births and find your local positive birth movement group (here’s our Edinburgh one which I know is good because I co-facilitate it and it’s bloody brilliant).  I’ve also recently established the Birth and Baby Academy to bridge this gap with much better antenatal education to reduce the risk of birth trauma/mental health issues.
  2. GET A DOULA – time and time and time AGAIN, get a doula – why – because we navigate the systems for you ensuring that you can reflect positively on your birth.  We support all birth choices, all decisions are yours – we are there to ensure that you are totally looked after – and that we have your back.
  3. Consider a home birth – if you are at low risk – we know that home birth is a SAFE option for you.  Even if you are not immediately considered low risk – for example, VBAC – it still is something for you to consider (remember what the optimum conditions are for birth).
  4. Read this post – Things I wish I had known about birth.  Understand how to use BRAINS – maybe practice some scenarios. Take time for every decision.
  5. Be prepared! Get support to create the RIGHT birth “plan” for you – that includes mapping out all the different possible situations, how you’re going to manage any transitions and have every scenario covered.  What’s vital about this is that any birth partner must know and understand your plan inside out and be confident enough to be able to represent your wishes, even in challenging situations (one of the things I hear the most is that “my husband didn’t support me, he didn’t make me feel loved, he didn’t know what to do”).  Make a Dad’s plan.  Something I do with all my clients now.  It’s brilliant/easy/the way forward.  This is WHY having a doula there is so helpful.  But I appreciate a doula is not for everyone.
  6. Read this book.  If you’re are going to read ONE birth book.  Read it.  It’s slightly idealistic, however, it really helps you to understand the fundamentals of creating the right environment for birth and what the needs of a women are.  You can read it in less than an hour (32 pages long).  There are loads of lovely books.  I have about 5 million on my bookshelf that I love looking at.  But this is the one I give out every time. Because it’s ACE.

And look again, another mammoth post from me. Sorry.  I was told to write posts of about 300 words and this is definitely far more.

Basically because Perinatal Mental Health and Human Rights in Childbirth are both my biggest passions I can’t stop writing.  Informed consent – that is REAL informed consent is important to me.  How mums feel about birth is important to me.  How they prepare, how it changes them, how they recover, how they reflect, how they feel… I am obsessed.  This is my work and my passion.  Because it was NOT easy for me.  I have spent hours/days/weeks/months/years reflecting on my own experience on birth and as a parent and understanding how it affects us all.  And I want to share what I know and help others navigate it much more easily.

I believe by having a better birth experience, we can have a MUCH better parenting experience leading to a much kinder and loving society because we are starting from a place of love rather than mental recovery.

Much love, Tricia xxx

 

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