Childbirth and motherhood are one of the most miraculous occurrences in nature. Every culture and community worldwide celebrates and puts childbirth on a high pedestal. The experience of nurturing and birthing a child is nothing short of a marvel. And as essential as it is to care for the growing life inside the womb and after birth, the mother’s well-being is just as critical, as it plays a vital role in the child’s growth.
Motherhood also means venturing into a new phase of life filled with the anticipation of a fresh start and an underlying dread of unexpectedness. No two childbirth experiences are the same, and generalizing the sentiments and perceptions of childbirth would be wrong. Mothers must be cared for closely by their loved ones and provided medical assistance to ensure the well-being of both the child and themselves. However, life can be quite unpredictable.
Certain unexpected instances can happen where the health of the child or the expecting mother can be at risk, making it challenging for both the patient and the medical professional. While the advancements in medical science are constantly evolving to ensure a safe birthing experience and intensive care if necessary, it can still significantly affect the mother’s mental well-being.
Birth trauma or childbirth trauma is an umbrella term for distress, especially mental health issues experienced by the mother due to any unexpected events in pregnancy. It is a patient-centered condition, meaning that a particular incident might seem like a standard procedure for an individual, but at the same time, it can be the reason for someone’s despair. And while the word trauma indicates a physical injury primarily, it can also refer to the psychological distress a mother goes through throughout childbirth. The symptoms of this condition closely resemble those of traumatic mental disorders, such as PTSD, and require professional medical and psychological attention.
Being pregnant is already such a vulnerable state of life that any added complication can bring out extreme emotions of being at risk. This is not specific to what takes place during delivery but can still hold a significant impact much later in life. In many instances, women have reported feeling numb, shocked, and even guilty after going through a traumatic event.
Many aspects factor into unexpected distress related to the newborn’s health or childbirth. And hospitals are one of them. Therefore, any neglect or mistreatment from the medical staff can negatively affect the patient. While the Indian healthcare system is constantly transforming for the best, raising awareness about empathy and kindness toward the patient is crucial, especially for pregnancy cases. Expecters, especially new mothers, can experience discomfort and worry regarding their and their infant’s safety. In that case, offering them compassion and support can be the best way to help them. Therefore, healthcare institutes must include better obstetrics guidelines that align with the WHO list of recommendations to ensure a positive and respectful childbirth experience.
Experiencing any birth-related trauma can significantly harm the mother’s mental health and even affect their relationship with the newborn. And while the psychological trauma symptoms may get away after some time without any help, they can emerge later.
What are the Symptoms and Causes?
The signs and symptoms of psychological trauma due to birth are similar, if not the same, as PTSD after any traumatic event. And those symptoms can impair several areas in one’s life, from relationships, profession, and personal interests. A professional will observe different categories of signs and symptoms to understand the trauma’s severity and provide better treatment options. These categories might include intrusive symptoms (like flashbacks), cognition symptoms (memory, emotions), avoidance symptoms (avoidance of people or places), and arousal changes (disturbed sleep, lack of concentration). Some common signs and symptoms of birth trauma include:
- Intrusive thoughts towards self and the newborn
- Flashbacks of traumatic events, including delivery or related circumstances
- Recurring nightmares
- Unexplained fear of places or events/people associated with the trauma, leading to building an avoidance
- Heightened arousal senses (excessive response toward any startling incident, increased irritability, anger, hyper-vigilance)
- Disrupted sleep cycle
- Anxiety disorders or panic attacks
- Postnatal depression
Birth trauma can be due to either actual or perceived traumatic incidents that might have happened during the delivery of a child. One of the leading causes is a lack of information or consent, abusive behavior from an obstetrician, and provider neglect. Some other causes include:
- An unplanned or un-informed C-section (cesarean delivery) might be performed in case of a difficult delivery which might occur due to conditions such as breech delivery, where instead of the baby’s head, the bottom is the first to exit the birth canal.
- Unplanned hysterectomy: Partial or total surgical removal of the uterus in case of severe complications to the maternal health (One cannot get pregnant in the future once they undergo hysterectomy).
- Prolonged labor: If the labor lasts more than 14-20 hours, it might cause several complications, including fetal distress (health risk to the unborn child).
- Inadequate pain management: Neglect from the healthcare provider to administer the required pain management options, such as an epidural.
- Preeclampsia/eclampsia: Sudden and severe spike in blood pressure, which might even cause a seizure or coma.
- Forceps or vacuum-assisted birth: Unexplained use of forceps or vacuum extractors for delivery without informing the mother about the possible complications, such as intracranial or subdural hemorrhage, which can cause cerebral palsy due to brain injury in the baby.
- Postpartum Hemorrhage: Heavy bleeding during or after delivery.
- Perineal trauma: Third or fourth-degree vaginal tear during vaginal delivery or, in some cases, forceps-assisted delivery.
- Prolapsed cord: A rare but severe case when the umbilical cord prolapses (drops) from its natural position and comes out of the cervix before the baby.
- Injury to the baby: Any form of harm to the baby’s health due to complications during delivery, such as brachial plexus injury, intraventricular hemorrhage, or even spinal cord injury.
- NICU requirement: The newborn going to the neonatal intensive care unit for comprehensive care after birth might put the mother in distress, especially if it is without proper consent or information.
- Inability to breastfeed: In some cases, a mother might be unable to produce breastmilk due to health complications such as hormonal imbalance or high blood pressure.
- Lack of communication: Neglect or lack of empathy and proper communication from medical personnel during or after delivery can foster a sense of helplessness in the mother.
- Sudden changes in the birth plan: Un-informed changes in the birth plan due to any health risk.
Different variables can significantly affect the health of the mother and the newborn or unborn child. These factors can vary depending on the mother’s health and her environment. A healthy support system and surroundings ensure the woman feels safe during delivery. However, certain incidents and factors can lead to birth trauma, which includes:
- Previous birth trauma: If a woman has a history of complications or trauma related to the prior pregnancy, it can put her at risk of going through it again, as the past fears and anxiety can resurface.
- Changes in the birth plan: If by any means the childbirth experience doesn’t go according to the expectation, it might lead to significant distress.
- Difficult or prolonged labor: If the labor lasts longer than the average time and fails to progress, it might lead to fetal risk or infection, putting the mother and the child in danger.
- Assisted delivery: If any additional medical intervention is necessary during vaginal delivery, such as forceps or ventouse (vacuum), without proper information or consent, it can cause mental distress.
Emergency cesarean: If the mother expects a natural delivery but has to undergo a cesarean (C-section) due to any complication, it might leave the mother feeling anxious, leading to further distress.
- Birth injury: If the mother or child suffers from any injury during birth, it can affect their overall health and might cause future complications.
- NICU requirement: NICU requirement: If the newborn needs special medical attention after birth and is taken away from the mother, it can put the mother’s mental health at risk.
- Stillbirth or neonatal death: Losing a child at birth or a case of neonatal death (baby passing away in less than 28 days after birth) can be highly challenging for the mother’s mental and physical well-being.
- Lack of empathy and support: The absence of a sound support system among the family members and empathetic medical assistance can harm the mother’s mental health, especially during sensitive moments of pregnancy and childbirth.
- History of abuse/trauma: Any woman with a history of abuse is at a higher risk of birth trauma. Earlier incidents might include domestic violence, childhood abuse, or sexual abuse.
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Can It Be Prevented?
There is no fixed formula for childbirth, and different outcomes are possible based on circumstances. Many birth trauma cases are sometimes beyond control and unavoidable, making it difficult to stop them from happening. However, one can implement techniques and lifestyle changes to reduce the risk of birth trauma:
- Prepare before childbirth: Pregnancy/antenatal classes can be a great option as they can help you prepare for new changes such as labor, breastfeeding, and how to care for the newborn.
- Keep an open mind: Discuss possible outcomes and risks with your doctor based on your medical history. Although there is no right or wrong way to birth a new life, preparing yourself to manage adversity would be better.
- Talk to the professionals: Try contacting gynecologists, midwives, and obstetricians to understand your situation better.
- Build a support system: Ask your loved ones and trusted friends to keep you company. Surround yourself with caring individuals who can offer emotional support and boost your mental health is beneficial. You can also inquire about a support group near you to share your distresses with those with a similar experience.
- Communicate with your partner: New parents must talk with each other to ensure a better environment for the newborn and the mom.
- Seek mental health support: Whether you have a mental health issue or not, if you feel anxious about your pregnancy, talking to a therapist can significantly help. A mental health professional can help you better understand your complex emotions and enables you to manage them.
How is it Treated?
Caring for the mother’s health is crucial in ensuring the newborn’s baby’s well-being. Therefore, if there is any chance that the mother is undergoing any distress, such as emotional trauma, anxiety, or depressive symptoms, it is essential to seek help as early as possible.
Experiencing some psychological symptoms is common. But if the symptoms persist for two or more weeks after the birth, it could lead to postnatal trauma. And if left untreated, it could also result in severe PTSD.
Depending on the severity of the symptoms, a professional might suggest therapy, medication, or a combination of both to treat birth trauma.
Here are a few treatment options for birth trauma:
- Birth Trauma Therapy: Talking to a therapist to address birth trauma is essential in understanding where the difficult emotions come from and how to manage them. Consistent counseling enables individuals to learn coping skills that can help them reduce or even eliminate symptoms of PTSD. It also helps build a better relationship between the mother and the newborn.
- CBT (Cognitive Behavioral Therapy): In the case of any trauma-related disorder, cognitive behavioral therapy is an efficient treatment technique as it addresses the person’s thoughts, feelings, and behaviors. A mental health professional helps individuals challenge unhealthy behavioral patterns, ideas, and emotions that are detrimental and helps people change their perspective toward the trauma.
- EMDR (Eye Movement Desensitization and Reprocessing): Among all the trauma-focused psychotherapies, EMDR is one of the most effective types of treatment for PTSD. This therapy technique helps people access their traumatic memories in a different light. Individuals learn to reprocess the incidents under the guidance of a professional. It is also a suitable therapy approach for birth trauma, as it typically consists of a short-term format of 8-12 sessions.
- Medication: Depending on the mother’s condition, a doctor might prescribe medicines to treat PTSD (post-traumatic stress disorder), as it also helps with postpartum depression and trauma. Most often, medications and psychotherapy are in conjunction to boost each other’s effectiveness.
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Motherhood is an extraordinary stage of life. Bringing a new life into the world is nothing less than a miracle. The bond between a mother and her child is unlike anything else. It is the foundation of the child’s future. And the mother needs to be in a safe space mentally to nurture the child. However, experiencing birth trauma can significantly affect the mother and her child.
Unexpected incidents are inevitable, as no one can predict the future. But if it significantly harms you or your loved one, consider seeking a professional’s help. Talking to a professional who shows you the utmost compassion and offers a safe space to open up about your difficult emotions is essential for sensitive cases like birth trauma.
At DocVita, you can find a therapist that suits your needs. You can consult a therapist from our team of highly skilled professionals to help you with your unique concerns.
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