"Everyone kept saying 'isn't it wonderful' and all I could think of was no"
What is Birth Trauma?
Trauma means a wound, serious injury or damage; it can be physical or psychological (deeply disturbing and distressing).
The delivery of a baby can be a positive experience for some women, but for others it can be very negative, resulting in physical and/or psychological injuries (trauma). The psychological trauma may be the result of an extreme disconnect between a woman’s expectations of what would happen and the shock of what actually occurred. It may also relate to feelings of loss of control and a sense of not having a ‘voice’ in the face of authority, and unexplained interventions, as well as to the physical damage. Thus it is important to note that some women may have severe emotional distress after a traumatic birth, although they did not have physical birth injuries. The list below includes both.
Psychological and Physical Symptoms of Birth Trauma
Trauma effects may continue long after the birth, with distinct psychological and physical symptoms.
Psychological symptoms may include:
- Feelings of intense fear, helplessness or horror in reaction to reminders of the experience, for example words, smells, rooms, clinicians
- Fear and anxiety about going outside
- Poor self-image
- Memories (flashbacks) of the traumatic vaginal delivery during sexual relations
- Trying to push feelings away and getting on with looking after your baby
- Difficulty sleeping due to bad memories or reminders of the birth
- Nightmares regarding the birth
- Feelings of isolation
- Irritability and guilt
- Anxiety or panic attacks
- Avoiding reminders of the traumatic birth such as the location where it occurred (avoidance reactions)
- Feeling emotionally numb or detached from others, activities, or your surroundings
- Alcohol and drug misuse
- Struggling to bond with your baby
Physical symptoms may include:
- Sweating, shaking, headaches, dizziness, gastro intestinal upsets and chest pains not connected with medical conditions
- Continuing pain around the site of the episiotomy or tear in the perineum (between vagina and anus) after birth
- Urinary or faecal incontinence
- Difficulty opening and emptying bowels
- Pain or difficulty having sex
- Constant lower back pain
- Awareness of a bulge or lump at the vaginal opening
- A dragging feeling in the pelvis or a sense that something is ‘falling out’ – this symptom may be increased by standing, lifting, tiredness or at period time
- Vaginal or pelvic floor muscle laxity
It is important to understand that physical injuries resulting from birth trauma may include damage to the pelvic floor or perineal area and require expert medical advice and assessment.
Some effects of a Traumatic Birth
- Effects may vary from woman to woman.
- The subsequent feelings and ability to cope with what has happened will be unique to each individual.
- Being believed about birth trauma and/or injuries is vital in dealing with emotional distress
- Distress can be exacerbated if you are not believed about physical pelvic floor and perineal injuries that have not been adequately assessed and treatment options given.
- Lack of interest in sex and relationship issues are fairly normal for most new parents, but these are prolonged in a trauma situation.
- Symptoms of pain, incontinence or prolapse may influence your relationship because often it is too embarrassing to explain physical damage to your partner.
- Coming to terms with the experience of childbirth may take longer than the mother, or those close to her, expected.
- If, as the months go by, the above signs and symptoms do not disappear, it is important to seek support from a health professional, for example a GP.
- Hoping that the feelings will go away, or assuming that they are not important will inevitably be unhelpful.
- There is support available.
- Sharing experiences with expert urogynaecologists or a specialist women’s health physiotherapist may help to make sense of what has happened.
- Correct diagnosis is important. These symptoms are not necessarily due to postnatal depression (PND) – although depression and anxiety are to be expected in these circumstances.
This broad term covers a range of difficulties usually including low mood, poor quality sleep, low energy, poor appetite, tearfulness, pessimism and anxiety symptoms (excessive and inappropriate worrying). Many women experience mood swings in the early days after the birth of a baby (“baby blues”); hormones play a significant part in this process. However, postnatal depression (PND) describes more severe and prolonged symptoms lasting more than 1-2 weeks and interfering with the mother’s ability to function on a daily basis with normal routines of caring for the baby and the relationship with her partner.
- Loss of enjoyment in most activities
- Loss of self-esteem and confidence
- Loss of appetite and weight
- Inability to sleep restfully (irrespective of the baby)
- Sense of hopelessness , guilt and being a failure or a ‘bad’ mother
- Suicidal thoughts or ideas
- Loss of libido
- Fears for the safety or wellbeing of the baby and/or the partner.
As with the psychological trauma symptoms, PND is a condition that will require counseling, and possibly medication, from appropriate mental health professionals.
Post-Traumatic Stress Disorders (PTSD)
PTSD is one of a group of Trauma and Stressor-related Disorders. People often associate these with war veterans, police officers, or paramedics, but trauma-related disorders are widespread in most communities and are more common in women than in men.
Not all trauma symptoms meet criteria for a formal diagnosis of PTSD, but that does not mean they involve less suffering. Although some women and partners may be relieved to hear there is a diagnostic label, such as PTSD, not everyone wants or requires a psychiatric diagnosis. In addition, co-morbidity is considerable, as it would hardly be surprising if the symptoms did not include or result in anxiety, depression, relationship problems, and many attempted strategies for self-treatment. When the symptoms interfere with the person’s life, professional help is likely to be needed.
Research linking birth trauma and PTSD is fairly limited at this stage; however, you can find some published articles on our research page.
Please seek help if you are experiencing these feelings – Your GP and mental health professionals are there to help!
We recommend the following websites:
- beyondblue – beyondblue.org.au
- PANDA: Perinatal Anxiety & Depression Australia – panda.org.au
- Gidget Foundation – gidgetfoundation.com.au
- The Black Dog Institute: - theblackdoginstitute.org.au
- COPE: Centre of Perinatal Excellence – cope.org.au