Our panelists: Erin Baird (CNM), Lauren Barnes, Kerri Bond, Kirstin Magnuson (Marriage and Family Therapist) and our moderator, Erica Wolfe. Birth is transformative. We meet women every day who could describe their births from thirty years ago in vivid detail. Part of our mission here at The Motherhood Collective is to transform the culture of fear surrounding birth, we strive to encourage women to educate themselves and create a supportive environment for birth. But the truth is, we all must enter birth with open hands. The stories we would write for ourselves are not always the stories that make us the strongest mothers for our children.
And friends, while birth is transformative -- it is truly only the beginning.
Kerri's birth experience started with a normal pregnancy, but was scheduled for an induction due to high blood pressure. She planned for a natural birth and expected everything to go quickly and smoothly. After several days with no progress, she eventually had an epidural and was sent to the OR due to cord prolapse. Erin delivered her baby and rode with her to the ER holding the cord the whole time. Erin explains that for the cord to be delivered first is very rare, and once the cord is delivered it cannot be put back. At only a few centimeters dilated the cord will be compressed by contractions and the baby's head during labor, which cuts off the baby's access to the placenta in the hours before birth. At nine centimeters the cord can sometimes be delivered with the head, but earlier in labor (such as Kerri's situation) this is not an option.
Erin has had many birth experiences (four), ranging from emergency vacuum to a natural birth. As an educated midwife she had expectations for her births and her abilities that were not met. When birth does not go the way we planned, it can be a difficult thing to come to terms with. Kirstin is inclined to listen to these stories without making suggestions- just being a safe and supportive person for them to tell their story to can be helpful. At six week appointments, Erin makes it a point to debrief with her patients to help them process their birth experience. Feelings of failure and depression are not uncommon and should be talked about and handled professionally in order to overcome them.
Sometimes we get so caught up on the negative aspects of our birth experience that we forget the positives; the times we were strong and the things that went right can get buried under the things we are unhappy about. One audience member found peace in writing the very worst of her birth experience down in the back of a notebook. She could be honest and not hold back, as opposed to when she talked about it with others. Talking with others that have had a hard time accepting their birth can also help by putting things in perspective and moving the feelings of anger into something more productive.
It is important to remember that trauma is defined by the person who experiences it. Sometimes a patient has a relatively normal birth but still feels traumatized by the experience. We often try so hard to prepare for birth but it is something that is ultimately out of our control. Physical and emotional trauma can both have lasting impacts. Sometimes it isn't until later that we realize that our birth was not ideal; one audience member saw in hindsight with her subsequent births that the care she received for her first birth was really not what it should have been.
More than 25% of women describe their births as traumatic. To identify this in our friends and other mothers, there are signs we can look for. "I didn't do well" (or variations of) is a phrase that Erin hears and knows is not a healthy outlook. Without meeting all of the PTSD symptoms, women can still have a negative or distorted view of their birth. Nightmares, flashbacks, avoiding certain triggers or not talking about the birth, difficulty sleeping, hyper-vigilance, panic attacks and overwhelming stress are all signs that a woman is struggling to deal with her birth experience. If a new mother is not sleeping because she is fixated on her birth (as opposed to the normal newborn sleep struggles), she should find someone to talk to. Talking to a counselor, who is a disconnected person that is not otherwise involved in your life, can help you work through your feelings without judgement. Trouble processing your birth experience can lead to postpartum depression, especially if you do not find a safe outlet for sharing your story.
Mothers are not the only ones traumatized by birth- fathers can also have a difficult time processing their role in the birth. Watching helplessly is not a good feeling and can leave them quite upset by the experience. Checking in with your partner and discussing the birth in the weeks following can be very helpful for both of you. A doula can also be helpful for both partners, as they can keep you both informed and provide support for each of you.
Postpartum depression can present in various ways; anxiety, mania or an obsession with the baby or birth are also unhealthy. It can present as obsessive-compulsive disorder, or euphoria on the other end of the spectrum. Euphoria is often followed by a crash, especially if there was traumatic experience that is being denied. It is important to remember that accepting medication is not a weakness but a step in the direction of normalcy and getting your life back on track.
Sometimes birth challenges come down to simple choices, but sometimes they do not not. When asked, “What advice would you give pregnant women regarding giving birth confidently in the future?” Katie Rohs from PATTCh.org says, “Empower yourself with your own knowledge, and choose a care provider that you trust deeply...Don’t be afraid to seek out different care if your needs aren’t being met.” It is important to recognize that we did not make an incorrect choice that lead us to an unwanted outcome.
Some births go according to plan, and some patients are not as deeply affected when they don't. But if you do have negative feelings about your birth experience or the role you played in the outcome, speak up and find support. The Motherhood Collective (and our Grief and PPMD groups) as well as other local and national resources are available to you.