Yesterday I was asked to help at a lecture about birth trauma by the inspiring Dr Rebecca Moore, sharing my son’s birth story with MSc students of Womens Health. I’ve briefly touched on Caterpillar’s birth before in some of my postnatal depression posts but I’ve never actually posted a birth story as such, or more importantly, how traumatic birth affected me and countless other women.
Since it’s been brought to the forefront of my mind by my recent discussions at Kings College, I’ve decided to share for today’s post. Even though my son is now three years old I think it’s important to share our less-than-perfect birth experiences, firstly to help us heal and secondly to highlight that not everything in life is like One Born Every Minute – that these experiences do happen, often, and should be out in the open and freely discussed.
Truth be told, I never felt positive about giving birth, even years before we even considered trying for a baby. I wouldn’t go so far as to call it a fear (although it should be noted that tokophobia is a serious condition), more a general unease. As a woman who knows she’d like children, you tune in to horror stories from friends and family members, or at least I did. When I became pregnant with Caterpillar I was overjoyed but I can’t pretend the hurdle of giving birth didn’t play on my mind. I considered myself a fairly weak person, with a low tolerance for pain (I no longer believe either of these) and made peace in my mind pretty early on that I’d likely opt for an epidural.
Many people believe that going into childbirth with a more positive & relaxed outlook can lead to a more positive experience and I don’t disagree with that. I’ve heard amazing things about hypnobirthing and know many people who were very laid back about labour and ended up with lovely deliveries. I certainly believe that going into labour with fear and stress certainly doesn’t help – after all all we hear at NCT is how endorphins are what’s required and adrenaline should be avoided at all costs (because it’s really easy to just tell your anxious body to stop pumping out adrenaline, right?). But I also know that difficult births still happen to women who went into the experience positive and relaxed so I guess there’s no hard and fast rules. It should also be noted that birth trauma doesn’t have to be medically traumatic but can be any situation where the mother was negatively affected – perhaps she felt out of control or had her wishes ignored, or felt upset or threatened by the words or actions of a member of the medical team.
I went into labour when I was four days overdue and was shocked by how unbearable contractions were quite early on. I had expected mild contractions, spread very far apart, for a good few hours but mine were spaced only four minutes apart only from the get go. This confused me no end. I was managing the pain at home (just about) but because prior to birth much emphasis is put on time between contractions rather than severity of pain we felt that when the contractions were only three minutes apart we had better get to the hospital. Plus, I wanted there to be time for an epidural.
Fast forward a few hours and I was still managing the pain while we waited for the anesthetist. I remember being very surprised by how quiet I was. Another unexpected thing – the labour pains made me very nauseous so I didn’t want to touch the gas and air in case it made me more sick. The anesthetist eventually arrived and my epidural was put in, but 40 minutes later didn’t seem to be doing anything. The nurses then realised that the needle was in but no drug was going down the drip and therefore I wasn’t actually getting any epidural (helpful). When it finally kicked in it was a relief (although I could still feel the pain, just not as strongly – another surprise).
After an epidural, they put a probe inside to attach to the baby’s head for monitoring the heartbeat. When they began this procedure they realised my waters had broken and contained significant amounts of meconium. I knew from what I’d read this wasn’t great, so only increased my anxiety. Time went on and Caterpillar’s heartbeat continued to drop. They tried to make me move positions with increasing panic but this is pretty difficult when you’ve had an epidural and are unable to move normally.
Eventually when Caterpillar’s heartbeat dropped dangerously low they decided to go for an emergency c-section. Frankly, I was relieved. The constant rising and falling of his heartbeat was terrifying and I just wanted him safe. Everything after that is a little bit blurry (both figuratively and literally as I had removed my contact lenses!). All I could think about was getting him out as soon as possible. People had become a little frantic as his heartbeat was so low and a big part of me thought he was going to die at this point.
When he was born he was quickly whipped away as they had to suction mucus out of his throat so I didn’t get to see him for around 20 minutes. Nobody was really telling me much except my husband who is the only one who replied to my constant “Is he alright? Is he alright!” Stuck on that bed, with your stomach cut open, you do feel hugely powerless. The saddest part for me is when I did get to see him I couldn’t hold him as I was unable to move. When they were prepping me for surgery I could still feel a fair bit (I’m really not sure the first epidural had worked properly at all in hindsight) so in their rush they obviously gave me a bit too much to counter it so I was completely paralysed except my head, neck and a tiny part of one arm. This took eight hours to wear off.
I don’t harbor a lot of anger towards the staff and think they mostly did right by me, however why my son couldn’t be placed on my chest and held by my husband, or why my husband and son had to leave the room while I was stitched up is a mystery and brings with it a huge sense of sadness and frustration. Those early moments and experiences are vital for women and their newborns and should be prioritised by health care providers where possible. I will never get that chance back.
When I finally held Caterpillar that afternoon I sobbed. The midwife looked at me in surprise until I explained that I felt like I was meeting him for the first time. That eight hour period while I waited for the anesthetic to wear off is almost completely missing from my memory. I remember being sick several times, I guess I slept a little but I don’t remember my baby at all and this will always hurt.
- We are both alive and well
- The medical team acted quickly and efficiently in our best interests
- Hubs was able to be present and connect with Caterpillar straight away
- The first epidural being messed up
- Later being administered too much epidural and becoming “fully blocked”
- Not being kept informed of what was happening to my baby immediately after birth
- My medical notes being whipped off within hours before I even got a chance to see what had actually happened to us
- Not seeing Caterpillar and then not being able to hold him for so long – I personally believe this contributed substantially to my fears about bonding with him. I’ve mentioned in previous posts that my terror that I didn’t feel connected to my son or love him “enough” during those early weeks was the catalyst for the anxiety that led to PND for me. I also had a particularly heart-wrenching therapy session where we established that when I thought he was going to die I emotionally distanced myself as a form of self-preservation, which possible also contributed.
- Hubs & Caterpillar being forced to leave the room while I was being stitched up – this is the one that really upsets me as I don’t see any need for it. My husband says no checks were being done during that time, they just sat in recovery waiting for me, so why could they not sit in the room with me? While the surgeons were finishing with me I could have been looking at my baby boy and bonding, rather than lying there alone, cold and wondering where they were.
What could help
The deeper I look into all things perinatal the more I realise how much difference simple changes can make to so many parents. Sadly, these changes tend to cost money in many cases. But here is my wishlist for how to help women before and after birth:
- Realistic antenatal classes – in my small NCT group of four couples only one had what would be considered a “straightforward” birth. And yet our sessions primarily focused on natural delivery and natural pain management techniques. Believe me, I’m not knocking this. As mentioned above, whatever we can do to alleviate fear about birth is a good thing. However, we need balance. We need more than a fleeting paragraph on the multitude of assistance some women require to give birth safely. I’ve been lucky enough to meet two wonderful ladies who work as researchers for NCT and they have embraced our feedback and hope to make changes in the future.
- Access to my medical notes – I have no idea why my notes disappeared but all this did was made me think the hospital had something to hide
- More support immediately after birth – an empathetic ear and some general psychological checking-in during those few days in hospital and subsequent home visits could have gone a long way to processing Caterpillar’s birth (and helping with my anxiety and PND in general but that’s a whole other post)
- Better postnatal screening – this still isn’t perfect for PND but for PTSD it’s largely non-existent.
- Fast and free access to counselling for anyone who feels they may be experiencing the longer term affects of birth trauma – whether that be PND, PTSD etc. Therapy services are so overstretched and in desperate need of investment, which hopefully will trickle through eventually, given Cameron’s prior promises.
- A detailed reflection discussion with medical staff regarding your birth experience – at my local hospital there is an option to discuss your birth with a midwife but, for some reason, this only seems to be offered as part of your antenatal care during your next pregnancy (which, considering many women who aren’t successfully treated for perinatal mental health issues decide not to have another child, is largely irrelevant!)
Attending Dr Moore’s lecture taught me so much and only made me thirsty for more. I’m happy that lectures like hers are being taught to our future medical professionals but more needs to be done now too.
For me, Caterpillar’s birth was only one of many smaller factors which contributed to PND, I’ve not experienced flashbacks and my anxiety issues haven’t been only related to the birth. But for countless others a traumatic birth experience can be the primary cause of a perinatal mental health issue and should be addressed, further than the cliched “Oh well, you’re both healthy – that’s all that matters.” Of course, mum and child being alive and well is the primary concern but it isn’t the end of the road. Sometimes people are suffering from an illness that makes them unable to let go of what they went through, and hearing those words will only increase their feelings of guilt for not “getting over it” quicker.
If you have experienced birth trauma and feel it is impacting your emotional health and every day life The Birth Trauma Association can help. Visit their website at www.birthtraumaassociation.org.uk or join their Facebook support group.