In last week's RTÉ Guide, Dr Eddie Murphy poses the question: Why are the needs of women in traumatic birth situations too often disregarded?
In recent weeks, on his radio show, Joe Duffy has featured stories about traumatic births. They have been so powerful, so moving and I have been overwhelmed listening to such hurt narratives. I believe, based on my experiences in the therapy room, that the frequency of traumatic births for women is underestimated and that the powerful stories shared by women with Joe Duffy have healed many wounds and opened up others.
I want to reflect on two important parts of this story:
- How birth-related trauma is under-recognised
- The role of compassion.
One of the most competent people I have met in my therapy room is Mary (pseudonym), a funny, articulate, joyful lady whose mental health journey started after her first birth. Her traumatic birth was ignored by professionals should have known better, and her life cascaded into a hellish post-natal depression requiring hospitalisation and disruption to her early bonding with her son.
The worst part was the guilt and fear she would carry for decades. She feared another pregnancy and would the same thing happen again. She felt guilty about the pain that she had caused her husband and her family. She felt trapped by a mental health system that focuses on mental illness and medication.
You can’t medicate your way out of trauma.
I have a special interest in trauma, possibly from my nursing in A&E, and coronary care. Over time, this developed in my psychology practice to looking at trauma and post-traumatic stress disorder. Emotional and psychological trauma is the result of extraordinarily stressful events that shatter your sense of security, making you feel helpless in a dangerous world.
For some pregnant woman, this is a vulnerable time. I think this vulnerability is overlooked too. Traumatic experiences often involve a threat to life or safety, but any situation that leaves you feeling overwhelmed and isolated can result in trauma, even if it doesn’t involve physical harm. The more frightened and helpless you feel, the more likely you are to be traumatised.
When events go out of control, e.g. emergency C-section, unwell foetus or newborn, then these emotions become overwhelming. This can lead to responses including post-natal depression, post-natal anxiety and PTSD.
What I know is that when it comes to trauma, the memory and the event, if not worked on, get stuck together and this can lead to cognitive, behavioural, and emotional symptoms.
Indeed, when bad things happen, when you’ve experienced an extremely stressful or disturbing event that’s left you feeling helpless and emotionally out of control, you may have been traumatised. Psychological trauma can leave you struggling with upsetting emotions, memories, and anxiety that won’t go away. It can also leave you feeling numb, disconnected and unable to trust other people. I would encourage anyone feeling this way to seek help from their GP or those with experience of treating trauma.
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Listen back: Joe Duffy discusses a selection of maternity stories on RTÉ Radio 1's Liveline.
Where is the kindness and compassion?
In that series of Joe Duffy shows, there were accounts about the lack of kindness and compassion, not to mention downright negligence. Stories recounted harshness and hurtful, dismissive statements by healthcare staff, midwives, nurses and doctors.
Here’s what I know and it’s a difficult message to give and receive: When people are stressed, exhausted and burnt-out, they have no capacity for kindness and compassion. Staff will act in a perfunctory manner, devoid of sensitivity, warmth, and empathy when in this state.
As well as helping women deal with traumatic births, we have to support staff too. Health managers care struggle to hear this, but research evidence shows this; although compassion and sensitivity are in short supply in a completely overworked health service, the go-to reaction to any criticism is all too often that all staff are professional at all times.
When it comes to our healthcare system, particularly in childbirth, I think the stories on the Joe Duffy show need to be played to new and existing staff, along with talking to them about why staff might end up acting like this towards the women in their care.
Unfortunately, doulas and childbirth educators have been privy to similar stories over the years from women who have reached out to us, looking for someone to talk to. To know that women have a public platform to share their stories and to truly be heard is a real positive outcome from the show.
At DoulaCare Ireland, we support clients nationwide, some of whom will have had birth trauma. These women and their families often feel they cannot speak about their experiences or they will be treated badly on subsequent pregnancies. Those who do speak out often feel they are brushed aside or their trauma is belittled by hospital staff.
However, none of these things is fixed in stone and in a profession filled with people who are naturally caring, giving them back the space to exercise compassion and to give the women in their care the attention they need and deserve can be achieved. Sharing the stories of when this doesn’t happen can only help.