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The term birth trauma is used to describe the effects of birth on the bodies and minds of those who were present. It can mean physical damage to the mother or baby. Or it can be used the describe the psychological impact of a birth experience, the feelings at the time and the after effects on mental well being. Psychological trauma can affect anyone who was present; mother, partner, even baby or midwife. Obviously, physical trauma can also lead to psychological trauma, but it is also possible to have one without the other. A physically traumatic birth does not necessarily lead to emotional problems and likewise a person can experience psychological trauma without having been physically harmed.

So, the term ‘birth trauma’ covers a breadth of suffering, from severe requiring medical intervention, to relatively mild. Its effects can be long lasting or heal quickly. It is a term that can feel both overused and understated! What can’t be overstated and shouldn’t be under estimated, is the impact that psychological trauma can have on a new family and the long term implications for mental health.

About 1 in 3 mothers consider their births to be traumatic. It’s not clear what this figure means though. Does it mean that 2 in 3 women had positive experiences? I suspect not, but I guess it says that for most, difficult feelings associated with their birth experiences pass with time. It becomes just one of those things that happened to them, but they have been able to put it in the past. 

However, there are many who are unable to quickly move past difficult feelings about their birth. They may be reminded every time a friend gets pregnant. Most pregnant people have met someone that can’t help but retell the horrors they went through. For these story tellers, the story just needs to be told over and over in an effort to come to terms with what happened to them. For others, baby groups and pregnant friends may become a source of discomfort, bitterness or fear, something to be avoided. They may find unwanted memories throwing a shadow over their child’s birthday.

They may wrestle with feelings of shame over being bitter, angry or grieving. Surely, they think, they should be filled with the joys of motherhood, and why can’t they be happy for their pregnant friends? They think they must be a bad mother or a terrible person. All this extra stress and worry is exhausting and demoralising at a time when they most need to be on top form, taking care of their baby.

For a small number of sufferers, these lingering feelings can be so severe that they lead to anxiety, sleeplessness, isolation and depression, affecting relationships with their baby, partner and family. Some of these mums get diagnosed with PTSD. PTSD stands for Post Traumatic Shock Disorder and its thought to affect between 1 and 6% of new mums. 

Symptoms include 
*Intrusive thoughts: being unable to stop racing thoughts and memories.
*Hypervigilience: being constantly on guard against bad things, real and imagined. Being unable to relax when baby is out of sight.
*Dissociation or memory loss: feeling disconnected from emotions and feelings, or a feeling of unreality. Being unable to recall parts or the entirety, of the birth or times shortly after.
*Anxiety: feeling fearful, like something bad is going to happen. Feeling like everything is too hard or overwhelming. It can also manifest as excessive irritability or rage.
*Depression; feelings of hopelessness and pointlessness, unable to find joy in things that had previously been pleasurable.

Even if a mother doesn’t have enough of these symptoms to diagnose PTSD, experiencing one or more of these symptoms can still be significant, distressing and debilitating. Conversely, parents may be misdiagnosed with post natal depression, which means that the source of their distress is not being adequately dealt with.

The good news is that the effects of birth trauma can be treated and symptoms can be reduced. For milder forms, just being able to talk to someone who really listens can be enough to help them to process what happened. This could be a good friend, an understanding stranger in a support group, or a debrief with a health care professional, doula or counsellor. 

For the more severe forms however, talking can actually do more harm than good. Many seem to instinctively know this and will avoid anything that reminds them of their trauma because of the way it makes them feel. For the most traumatised people, talking or even thinking about the traumatic event causes a panic response. It feels like the event is happening right now, it’s not over and they are not safe. This is because their body is convinced that they in danger and activates their fight or flight system. They are flooded with adrenaline and cortisol and they become overwhelmed with the urge to run, hide or defend themselves. 

In cases of severe psychological trauma, talking or thinking about the traumatic event then becomes a feedback loop, reinforcing and strengthening the panic association with the memory. This requires treatments that take the body and brain response into account, and that work by turning off the adrenaline signal to the brain and disassociating the intense emotions from the memories of the event. 

The main treatments for trauma and PTSD which are available on the NHS are trauma-focused CBT and EMDR. You can access this through your GP or self refer through Manchester’s Self Help site
Yoga, massage and mindfulness have both been shown to reduce the effects of trauma, allowing the traumatised person to relax and helping to reconnect dissociated people to their bodies. 
Many doulas and midwives offer a treatment called Rewind, which anecdotally, seems to be an effective yet gentle way to remove the symptoms associated with trauma. 

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