In this article:
- What is Birth Trauma?
- Physical Birth Trauma
- Psychological Birth Trauma
- Postpartum PTSD
- Postpartum PTSD – Risk Factors
- Postpartum PTSD – Symptoms
- How to Support Someone with Birth Trauma and/or Postpartum PTSD
- Support Services
What is Birth Trauma?
Birth trauma happens when a wound, serious injury or damage occurs during the child birthing experience. It can be physical or psychological (deeply upsetting and distressing) or a combination of both. Both mother and the father/non-birthing parent can be affected by birth-related trauma.
Physical Birth Trauma
Physical birth trauma injuries can include:
- Perineal tears
- Bladder damage
- Pelvic floor muscle damage
- Pelvic organ prolapse (POP)
- Infected stitches
- Urinary or faecal incontinence
- Pelvic fractures (public bone, coccyx, sacrum)
- Pudendal neuralgia (nerve pain/damage)
- Cesarean wounds
- Wound dehiscence (wound breakdown / separation)
- Hysterectomy (removal of womb / uterus)
- Postpartum haemorrhage (PPH / secondary PPH)
- Sweating, shaking, headaches, dizziness, gastro intestinal upsets and chest pains not connected with medical conditions
Psychological Birth Trauma
A child birthing experience that felt frightening or emotionally distressing is defined as psychological birth trauma. It can continue long after birth and can exist without physical trauma.
Psychological Birth Trauma can present as:
- Postpartum post-traumatic stress disorder (PTSD)
- Postnatal depression and/or anxiety (PNDA)
- Obsessive Compulsive Disorder (OCD) (for example, obsessive thoughts that can affect your behaviour, such as checking on your baby constantly or recurring thoughts that impact your enjoyment of daily life).
Physical birth trauma may or may not be identified immediately. You may be the first to notice that something isn’t right. If your birth experience felt traumatic and distressing to you, then it is ok to use these words or other similar terms to describe it. Some people find the word ‘trauma’ confronting, however it is important to not minimise your birth experience and recognise how it has impacted you. If you have experienced birth trauma, talk to a trusted doctor, health practitioner and/or mental health professional. Book in for an assessment, ask questions and get support.
What is Postpartum Post-Traumatic Stress Disorder?
Postpartum Post Traumatic Stress Disorder (PP PTSD) can occur after experiencing birth-related trauma – (physical and/or psychological).
Postpartum PTSD remains largely unknown and mis/underdiagnosed despite it impacting 1 in 10 Australian women and occurring in up to 15% of parents* in the first six months post-birth.
This means that women and parents are likely to be falling through the gaps in relation to their healthcare and as a result, may not be receiving adequate treatment and support.
Postpartum PTSD Risk Factors
You may be at increased risk of Postpartum PTSD if you feel:
- Fear for yourself, your baby or your partner
- You felt out of control or forced into decisions
- You had procedures without informed consent
- That you were not listened to or respected
- That you experienced distressing pain
- Socially isolated
- Unsupported by your partner
- Unsupported by your health professional
- Pre-existing or current mental health issues
- Complications affecting you or your baby during pregnancy, childbirth or soon after
- Prior mental health conditions
- A history of trauma such as sexual assault and/or abuse
- Previous perinatal loss, such as stillbirth or miscarriage
- Low levels of emotional or practical support during childbirth or after the baby is born
Postpartum PTSD Key Symptoms
There are four groups of Postpartum PTSD symptoms:
- Re-experiencing the traumatic event(s)
- Distressing flashbacks
- Intrusive and fearful memories
- Avoidance behaviours
- Not talking or thinking about the birth
- Distracting yourself
- Feeling unattached to your baby
- Avoiding people or places that remind you of the birth
- Negative thoughts and feelings
- About yourself, others or the world
- Anger towards those in the birth room
- Guilt or shame, particularly about yourself, the birth or parenting abilities
- Lack of positive emotion
- Feeling a heightened sense of threat
- Being on high alert or on guard
- Being startled easily
- Impulsive or reckless behaviour
- Feeling irritable
- Difficulty with sleeping or concentration
People who are important in the birthing process, such as health professionals and those closest to us, have the capacity to alleviate or exacerbate psychological distress. Sometimes, a lack of understanding, awareness or support from significant people contributes to the development and perpetuation of birth trauma symptoms.
How to support someone with Birth Trauma and/or Postpartum PTSD
How to support as a Husband or Partner
Talk so that you can better understand the physical and/or psychological symptoms. Seek solutions together. Expert counselling for both of you may be beneficial.
Attend appointments and assessments.
To fully understand diagnoses, treatment options and support plans – both for your partner and for yourself.
Encouragement to seek support.
Let your partner know that it is okay to get the help they need. It is also common for many fathers/non-birthing parents to experience anxiety and depression as new parents.
Give your partner time to rest.
Share the responsibility of caregiving as much as possible. Give your partner regular breaks so that they can sleep or have much needed alone time.
Talk to family and friends.
They may have had similar experiences and provide ways to cope or manage symptoms. The important thing to remember is that you are not alone in your experiences.
How to support as a Friend or Family Member
Check in Regularly.
Ask how they are going and what they need. Give them time and space to talk. Listen and observe. Learn and understand what they may find emotionally triggering or overwhelming, and help identify how these factors can be managed.
To talk to a doctor, health practitioner and/or mental health professional for support.
With strenuous activities such as cooking, cleaning and heavy lifting that may not be possible due to physical trauma or lack of energy. This is often more helpful than flowers or presents.
Attend check ups and doctor appointments.
Providing company can make the process feel less daunting. This may be especially helpful if the mother or birthing parent is feeling alone, unsupported, confused or socially isolated.
If you need support:
Always call 000 in an emergency.
Mental health support and suicide prevention
Centre of Perinatal Excellence
24/7 Support for Anxiety and Depression
Perinatal Anxiety & Depression Australia – supports the mental health of parents and families during pregnancy and in their first year of parenthood
Australian Charity solely dedicated to supporting women, partners and families after birth-related trauma. ABTA develop and release resources for mothers/birthing parents, fathers/non-birthing parents, families, doctors and healthcare professionals to educate and raise awareness about birth trauma.
Source: Australasian Birth Trauma Association (ABTA)