When we say the words birth trauma, most of us think of babies and what they go through in birth. But mothers are experiencing one of the most transformative experiences of their lives when they give birth, and birth is getting more complicated than it has ever been. Women are inundated with choices from start to finish in their pregnancies—the frequency of ultrasounds, whether or not to vaccinate, where to birth, which birth classes to take, even how to breathe. While most women make the choices they feel will allow them to have the best birth experience possible, no one can control or know exactly how birth will go. Women often suffer in silence, not noticing their new pains or limitations, as they are focused on their babies and families. If they do realize how they feel, they don’t know where to turn.
Trauma is not defined by an experience itself; it is not the event that happened. Trauma is determined by our body’s ability to metabolize an experience. Something that is traumatic for one person may not be disturbing for another. More important than why this happens, which may be the coalescence of our personal, familial, and cultural history, is how we recognize it and what we can do about it. To be human is to experience trauma. Fortunately, to be human is also to experience healing.
The Nature of Trauma
So why do some women experience trauma while others don’t? In Birth in Four Cultures, Brigitte Jordon explains that there are three primary factors that determine a woman’s sense of satisfaction about her birth experience:
- her perception of control;
- how supportive she found the birth environment and the people in it; and
- her prior vulnerabilities including her own birth and childhood, prior abortions or birth experiences, and her history with depression.
Even the most prepared woman, one who has chosen every part of her birth scenario as well as her support team and has done healing work on her own past, may experience a birth that registers as trauma. Trauma is a loaded word, but it is not a life sentence.
In Michaela’s story, the lingering imprint of trauma was caused by not feeling in control at that specific moment during her birth. Her body recalled and reexperienced a feeling of helplessness when in that particular physical position. The position sent her body into a mild freeze, and she didn’t have full access to her voice. You can see how delicate this situation is, given that, overall, Michaela was in control and in a supportive environment.
Birth itself is a vulnerable act. We are usually naked, exposed, and fully open in the most intimate part of our body. Our neurochemistry heightens our sensory awareness. In giving birth, we feel and sense more. This affects and influences our memory. As a result, subtle behaviors and position changes can strongly influence a woman’s internal experience.
Birth injuries are physical injuries that occur during childbirth, as described in chapter 7. If you have never heard of the term birth injuries, you are not alone. Geraldine Barrett et al. found that over 80 percent of women in the United States emerge from childbirth with some kind of pelvic scar tissue, and the CDC reports that over 30 percent of women deliver babies via C-section, which is major abdominal surgery. Women who experience birth injuries are more likely to experience birth trauma and PTSD.
Birth trauma and birth injuries are more frequent than we realize. Between 25 and 34 percent of women report that their children’s births were traumatic, even though the staff and their support team may not perceive it that way. Birth trauma includes more than just danger of death to mother or baby; it also includes physical injuries and the perception of danger, as well as feelings of extreme fear, aloneness, disrespect, lack of control, or helplessness. When we only think of a major catastrophe, death, or accident as trauma, the smaller but also significant, undigested pieces are left untreated and dismissed altogether. In doing so, women may blame themselves for an inability to move on or to feel satisfied about a birth that everyone else thinks went great. (See Chapter 4’s “Cross-Training Your Nervous System”).
In the case of a birth that needs healing, writing out a birth story can potentially cause more harm than good. If you notice that your heart accelerates or you start to feel anxious or frantic when considering returning to the events of the birth, then this is not the time to revisit your entire birth experience. Instead, you can work with your experience in other ways.
Recall if there is one moment when you felt helpless or overpowered. While there may be more than one moment, see if you can choose just one. This is important—you can’t work with every moment at once. If it is not immediately obvious what moment that is, then choose the first moment in the experience that you remember feeling out of control.
Renegotiating a Birth That Needs Healing
- Choose ONE moment in your birth experience when you felt helpless, overpowered, or out of control.
- If you feel a very high level of activation when recalling this moment, start with your powerful imagination. Visualize what you would have liked to have happened. Imagine what you would like to have said, how you would like to have moved, possibly who you would have liked to have with you at the time. See the whole scene in your mind the way that you would have liked that moment to have gone.
- If the level of activation feels medium, write down the answers to the same questions as above: What you would like to have said, how would you have liked to have moved, or who would you have liked to have with you at the time?
- Now that you have imagined or written about how you would have liked to react, speak, move, or respond in that moment, notice how you feel in your body. Stay with this practice of noticing for at least thirty seconds.
- Then let your eyes wander around the room and notice things that catch your eye. Where do your eyes land? Notice what happens in your body and your breath. As you orient back into the room you’re in, become more present in the here and now.
It is very important that you not skip to rewriting your entire birth story the way you wish it would have happened. This is not about denying the circumstances of the birth you had or living in fantasy. This is about giving your nervous system a chance, in small pieces, to complete a cycle of self-protection and agency that may have been thwarted during the birth. The nervous system is sensitive and responsive, so working with one moment at a time is the appropriate pace for a birth that needs healing. You might not feel an immediate change, nevertheless, respect a slow pace in working with sensitive material. if this process is appealing to you and also effective, then you may be compelled to renegotiate more than one moment. if you decide to work on more than one moment, leave a day or so in between, so that you have a chance to process the changes.
if at any moment, this process feels like too much, return to the rule of threes (from “Cross-Training Your Nervous System”). Sometimes it is necessary to have a trained professional that you can develop trust with guide you through this process of renegotiating the birth events.
If you experienced a traumatic birth, seek out the help of someone who is a trained counselor and versed in working with women and trauma. Birth Story Medicine, the work of Pam England, is a powerful modality for processing birth material; it is led by women practitioners who are specifically trained to help women find the medicine, the healing gems, in their birth stories. I also recommend working with a Somatic Experiencing practitioner who can work with the physiological patterns in your body, possibly utilizing touch. Birth is a visceral experience and also a sexual experience. Because birth and sex happen through the body, deep healing often happens by including touch and the body in the process of coming to resolution and closure of the birth experience.
I wish there were a better word to use than trauma to discuss these issues. Trauma is a word that people tend to either under-identify or overidentify with. It becomes a label that we cling to or reject.
The truth is that we have all experienced trauma in life. Not one of us moves through life perfectly able to process and digest every circumstance and event that comes our way. That unprocessed or undigested material gets stuck in our system. Afterward, we are on autopilot, often repeating thoughts or behaviors that we may not even notice have been ingrained from the experience. Many women realize that their birth experience was traumatic for them because they cannot stop thinking about what happened and continue to feel the emotion of it. Many other women experience postpartum depression or anxiety, major shifts in their self-image, sexuality, or relationship, and don’t realize that it is related to something that happened during the birth experience.
Whatever the outward circumstances of your birth were, if there are still parts of your birth experience that haunt you, that you find yourself going over and over, that just don’t sit right with you, make sure you do the exercises in this chapter. They will help you begin to own your own birth experience. Beyond that, please give yourself the relief of seeking out a professional, whether therapist, midwife, or postpartum doula to help you. Trying to just get over it won’t work without looking more deeply, and sometimes that requires the support of a wise person who knows something about birth and can help you understand your experience.
An excerpt from Kimberly Ann Johnson’s book The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions, and Restoring Your Vitality.
Purchase The Fourth Trimester here, and be sure to check out Johnson’s latest book, Call of the Wild: How We Heal Trauma, Awaken Our Own Power, and Use It For Good.