Picture this: you’re 30 weeks pregnant, and starting to think about the big day ahead. Your midwife, doula, friends, family, and the barista at your local coffee shop keep asking you if you’ve thought about the birth, and if you’ve jotted down any ideas yet. You have, but they aren’t exactly well-formed and you’re being a bit bombarded with information from a variety of sources.

One person tells you to write a plan and stick to it, don’t let the midwives or the doctors sway you from anything at all.

Another tells you to go with the flow, let nature take its course and baby will come one way or another.

So, to compromise, you decide to go for a good middle ground: a general idea of how you envisage the birth, but you’re open to things changing if they need to.

It’s important to say at this stage that there are only two main goals when it comes to childbirth: a living, healthy baby, and a living, healthy mother. Everything else can be dealt with in due course. And of course, that’s all anyone wants. Their precious baby, who they’ve lovingly carried for nine months to come out happy, in good health, and to cuddle them for the first time. 

The thing is, that even if you’re lucky enough to tick those boxes and both of you come out of the experience healthy, blissfully in love, and able to walk out of the hospital as a new family of three (or four, five, etc), women are still left with a lot of trauma following the birth which can be extremely hard to deal with and sometimes they can flounder without knowing where to go or who to talk to.

Birth trauma takes many forms but, at its core, it’s defined as lasting post-traumatic stress following childbirth. Many women experience birth trauma following an experience where the fear that they or their baby are going to die, whether that’s from blood loss, an emergency resuscitation, or a multitude of other factors. Most of the time it’s the mother who experiences birth trauma, but fathers, birth partners, and midwives can also feel the effects of it long after witnessing or being involved with a particularly difficult birth.

I decided early on in pregnancy that I wasn’t going to have a strict plan. I would write down some preferences, including a water birth and no medication if possible, but in general I just wanted a healthy baby. But slowly, over time, other things became important to me. I wanted to be the person to pull my baby out, I wanted my hands and my husband’s hands to be the first ones to touch her. I wanted to watch him cut the cord. I wanted to birth the placenta naturally and keep it. I wanted to use my hynobirthing techniques, and I didn’t want internal examinations.

I only had one thing on my list that I firmly did not want, to the point that I said I would refuse to consent to it during labour due to past trauma: foreceps.

We all expect that not everything on our birth preferences list will happen. We hope it will, but we resign ourselves to the fact that we may not have our perfect birth, that we might have to sacrifice some things on the list in order to have our child safely. But what happens when none of the things you planned for come to pass?

Backing up a bit, I was a bit of a worrier during pregnancy, but with reason. In 2018, we lost a baby at 11 weeks pregnant and I was hospitalised for blood loss and complications. This meant I was a little bit nervy during pregnancy, to say the least, but I approached the birth confidently, calmly, and with an open mind that it didn’t matter what happened as long as our baby girl arrived safe and well.

And she did, but following a lengthy, heavily medicated labour lasting fifty-six hours, with an epidural that didn’t quite work, and ending up in theatre with forceps delivery. That’s obviously the heavily shortened version of what was the most traumatic, frightening three days of my life, but you’ve got the gist.

The Birth Trauma Association lists the following as potential factors that make birth trauma more likely:

• Lengthy labour or short and very painful labour
• Induction
• Poor pain relief
• Feelings of loss of control
• High levels of medical intervention
• Forceps births
• Emergency caesarean section
• Impersonal treatment or problems with staff attitudes
• Not being listened to
• Lack of information or explanation
• Lack of privacy and dignity
• Fear for baby’s safety
• Stillbirth
• Birth of a baby with a disability resulting from a traumatic birth
• Baby’s stay in the special care baby unit or neonatal intensive care unit
• Poor postnatal care
• Previous trauma (for example, in childhood, with a previous birth or domestic violence)

Any single experience on this list, or a combination of them, can cause women to be left with lasting physical and mental trauma which, if not treated, can last for years and can seriously impact many aspects of life. It can cause problems bonding with your baby, problems with other relationships in your life, problems with your sense of self, and a myriad of other difficulties.

I was lucky that I didn’t struggle at all with bonding with my daughter. But that trauma manifests itself in other ways, which I will save for a later post. 

The point of writing this out is twofold: catharsis, and to let other women know that they aren’t alone in struggling after a traumatic birth. We expect childbirth to be difficult, painful, but ultimately a joyful experience and when that joy is ripped away it can leave us with a skewed sense of the world around us, the experience itself, and life going forward.

I’m now tackling the trauma I experienced at my daughter’s birth using EMDR therapy, but there are many other techniques out there that work well when it comes to treating trauma, particularly following birth. The Birth Trauma Association is a fantastic place to start. 

Just know you’re not alone. It’s okay to look back on your child’s birth and recognise that it didn’t go to plan and that it’s left you hurting. But also recognise that help is out there. You’ve got this.