Giving Birth After Trauma

Giving birth is a profound experience which greatly affects our physical, emotional, mental, and spiritual selves. The process of birth is impacted by a woman’s ability to trust her body and tune into it’s wisdom. However establishing trust with your body can be very challenging if you’ve experienced trauma.

The experience of trauma can be defined as a single or set of overwhelming experiences which cannot be integrated.

Because these experiences are so overwhelming for us, our amygdala interprets them as dangerous and thus responds by sending us into fight or flight. When we are in fight or flight, our sympathetic nervous system is highly activated and our reptilian brain takes over while our neocortex (our thinking brain) shuts down.  Sometimes even after the traumatic event is finished, our amygdala becomes sensitized to cues or triggers that remind us of the original overwhelming event, signaling to us that we are in danger even when the danger has long passed. The experiences of pregnancy, labor, birth, and postpartum bring up many triggers for those who have experienced trauma, particularly sexual assault.

These may include:

-physical/vaginal examinations and/or touch

-being in a hospital or the possibility of invasive medical procedures

-unpredictability of labor and birth (the uncertainty about when it will start and how long it will last and the fear of not being able to control your own behavior)

-body changes during pregnancy

-the experience painful contractions

-lack of privacy and modesty

Some of events may also be triggering for those who haven’t experienced trauma.  However those who have experienced trauma are more likely to find standard procedures/interventions triggering because they can sometimes evoke unconscious traumatic memories especially if the trauma involved the same parts of the body as birth.  If we are triggered during childbirth, our body might respond by going into fight or flight which sends the body into a state of stress and panic. The experience of stress, anxiety, and fear can cause the pelvic floor muscles to contract involuntarily and/or cause the release of hormones which stall labor such as adrenaline, norephinephrine, and cortisol.

Many people who have experienced trauma are often unaware when they are reacting to triggers based on past traumatic experiences.  Our culture often associates trauma with significant event trauma such as the experience of a soldier going to war. However the far more common experiences of trauma include events such as childhood attachment trauma, the experience of oppression, sexual assault, previous traumatic birth experiences, bullying, or a past history of an abusive relationship.  To make matters more confusing, sexual assault is very normalized in our culture and we may not recognize that what we experienced was actually assault.  Also, traumatic memories are also sometimes pushed deep into our unconscious such as a protective mechanism (particularly common with the experience of childhood sexual abuse) and we may not be consciously aware of them.

Because our neorcotex shuts down during traumatic events, we often don’t have coherent narrative memories of these events. Instead, traumatic memories show up in our lives in the form of implicit (unconscious) body or emotional memories.  Examples might include: uncontrollable emotions and shifting between intense emotional states, bodily tension, shallow breathing, intrusive images, feelings of shame, feelings of fear or anxiety, dysregulated arousal (feeling hypervigilant or numb and disconnected). Often when we are triggered we don’t recognize that the elements of our current state are actually implicit memories of the traumatic events that we experienced.

Research has shown that empowering a birth experiences are are directly related to feeling in control, feeling a sense of accomplishment, and feeling well cared for.

This is the opposite experience of victimization or sense of helplessness you may  have experienced during a traumatic event. Some strategies for creating an empowering birth experience and minimizing feeling triggered or re-traumatized include birth counselling and hiring a doula to attend your birth.

Birth Counselling

Birth counselling is a type of therapy focused on identifying fears and concerns, exploring triggers and finding strategies to deal with them.   By working with a birth counsellor, you can create a birth plan which gives you a chance to outline your strategies for coping with triggers in a concrete way so that your doula, midwife, or doctor are aware of them. In a birth plan, you can also state your needs and preferences for medical procedures. This allows you a sense of control during the birth process. Birth counselling also focuses on relaxation and grounding techniques to help you feel calm and safe and more fully in the present moment which can help you to avoid being re-triggered by past memories .

Doula:

A doula is a woman who provides care to the laboring woman by encouraging and guiding the the laboring woman and her partner. A doula can help provide emotional support and comfort measures, which lower stress and anxiety,  reducing the effect of prolonged labor and improving obstetric and newborn outcomes. She can also provide information to help you make decisions so that you can feel a sense of control over what is happening to you and help you to implement your strategies for coping with triggers as well as relaxation techniques. She provides continuous support which can be comforting for a woman if she has a fear of abandonment or being left alone. Additionally she is familiar with the process of labor and can help your partner, who may be very supportive but might still get overwhelmed by the intensity of childbirth.   

If you have experienced trauma and/or are experiencing anxiety or fear around childbirth, you might be interested in learning more about birth counselling. I also offer a limited number of sliding scale counselling sessions to women who experience barriers particularly women who are immigrants or refugees, Indigenous women, or women who have financial barriers.

I’m a Registered Clinical Counsellor and Certified Intuitive Eating Counsellor in Vancouver, BC specializing in women’s health including reproductive and perinatal mental health and disordered eating and body image.