This is the second part of a two part series on Birth Trauma. In Part 1, which you can read here, you met Sara who was fearful of becoming pregnant with a second child. Although she was riddled with anxiety, she was unaware she had a real problem: because she’d experienced trauma after the birth of her first child she feared getting pregnant. Although birth trauma is a real psychological condition, with concrete symptoms and a diagnostic criteria, many people internalize their experience, feeling shameful instead of seeking support.
My chance encounter with Sara was pivotal. A few weeks later she reached out asking for a referral to a local therapist. Through our informal talks I was able to help Sara understand how her unique experience left her vulnerable to experiencing a traumatic birth (also called postpartum PTSD), and that it was not only extremely common but treatable.
Sara, like many women I see in my practice, was unaware that her symptoms were worth paying attention to. The most common coping strategy I hear about is the attempt to ignore symptoms- to sweep them under the rug so to speak. But this approach is rarely successful for very long.
Women who eventually enter my office for therapy are typically struggling with one or more of the symptoms addressed in Part 1 of this series- symptoms that interfere with their ability to function at home or at work. In this article I’d like to offer some recommendations for healing from traumatic birth and/or preventing a subsequent similar experience.
Treatment of Traumatic Birth, or Postpartum PTSD
While many women who experience some symptoms of Postpartum PTSD will resolve their emotional stress with positive support from friends or family members, others will continue to struggle and will benefit from professional help. Recommended treatment for Postpartum PTSD starts with a thorough assessment by a trained mental health provider.
It’s critical to be assessed by someone who specializes in maternal mental health for a correct diagnosis to be made. Therapists unfamiliar with postpartum PTSD might inadvertently recognize the symptoms as postpartum depression or anxiety. Although some of the symptoms are similar, the underlying experience of a birth trauma calls for a different treatment approach.
Both medication and therapy are evidence-based recommendations for treating birth trauma. Many therapies work quickly and effectively with postpartum PTSD, such as EMDR, which I offer in my practice. Narrative, group, and body-based therapy can be helpful treatment modalities.
Avoiding a Subsequent Traumatic Birth
Whether you're anticipating a future pregnancy or currently pregnant, there are many things you can do to reduce the likelihood of experiencing a subsequent birth trauma.
Include your partner in this process. While it might seem obvious to some, others may feel isolated by their initial trauma and not realize the important role a partner can play in providing support and mitigating a subsequent traumatic experience.
Hire a doula. Simply put, a doula is a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible. If for some reason the birth is not going according to your ideal plan, a doula will intervene during labor with the intention of alleviating the trauma to reduce a woman’s chances of developing PTSD.
Take a childbirth education class. It’s important for women (and their partners) to be educated about what is supposed to happen during childbirth and what happens in the body during the birthing process. Childbirth classes also help to inform expecting parents about options during birth including: pain management, birthing positions, and how to cope with complications during birth.
Develop a written birth plan with your birth team. Discuss and include the interventions you are open to, those you want to avoid. Explore your back up plan. Remember to plan for the postpartum period and to consider the support that will help ease your adjustment to motherhood, or to mothering an additional child.
Talk to someone you trust. Work through any past traumas with a therapist, or at the very least discuss your history with your care providers to best prepare for the experience of labor and birth. Meeting with a psychotherapist or body worker specializing in perinatal mental health allows you to focus on beliefs, emotions, sensations and andy past experiences that may influence your upcoming birth.
Help Is Available
Birth trauma is highly treatable; the first step of course is to recognize there's a problem. With help you can avoid additional suffering and complications for both mom and baby. In San Diego, Postpartum Health Alliance offers a warmline with trained volunteers as well as a provider directory to locate trained therapists and other birth professionals. Outside of San Diego, Postpartum Support International can connect you with therapists worldwide who specialize in maternal mental health disorders.