Here we are, in the middle of birth trauma awareness week 2019 and I realised that as important as the subject is for people to recognise and talk about, it’s also pretty important for people to know that it can get better and it doesn’t have to affect you forever.
Now, I’ll preface all of this with I was a bit of a dick and went for the head in the sand approach to birth trauma management. Personally and professionally I recommend that you go for a slightly more structured approach that has better success rates! Although having written that I guess I need to be as compassionate to myself as I would to someone else telling me this story. I did try and get help after my first was born; I waved bright red flags at the Health Visitors but one ignored my sobbing and left the house, and others didn’t have the depth of understanding of me to know that I wasn’t fine (and I don’t blame them for that, I blame the system which doesn’t have the continuity of health care that means you’re not just a name on a list of visits or appointments that day). I specifically made an appointment to try and get support from a GP before getting pregnant again and was basically laughed at saying I need to get pregnant first and then I can be referred to the mental health midwife. I spoke about this in my birth trauma video at the beginning of the week but that’s not helpful. For some it would be the difference between having more children and not. The ignoring of people when they stick their hand up and say they’re struggling has to stop. During pregnancy number 3 I told my booking in midwife I was experiencing high levels of anxiety and she said “don’t worry, I won’t write it in your notes just in case”. Just in case what? Just in case I get help?!
Anyway, there I was. Other avenues could have been explored but I went full-blown ostrich instead. Got pregnant, tried to block out the fact I needed to actually give birth. In writing this blog post I’ve tried to remember being pregnant and I can’t. I can remember being pregnant with the first, remember the third but there’s not one single memory I have of me actually being pregnant with my middle child. I experienced panic attacks in the hospital during appointments because the NHS still hadn’t caught up to person-centred care, so I decided to have a home birth with a doula in attendance (for which I’ll forever be grateful to the friends who paid for it for me) and during my “if there aren’t enough midwives to come to you” talk I made it clear I flat out refused to go to that hospital if midwives couldn’t come to me or I needed to be transferred. And it was around that point that I’d got it clear in my head that I wouldn’t have to go to the source of my traumatic event no matter what – which I firmly believed, even if the midwifery staff didn’t – that my attitude to my pregnancy began to change. I could relax into it.
All of that is a fairly long contextual prelude to what came next. Knowing I had the safety blanket of someone to step in and advocate for what I wanted I was able to let go for labour. I was at peace that she’d arrive when she was ready to arrive and, although I’d known what I’d wanted and hadn’t wanted out of my birth the first time, I didn’t have an understanding of how I could help myself achieve that. I was told or read what interventions existed but never how to help avoid them, or even how they’d impact on my ability to give birth. I never knew how crucially important being calm was. We’re sold the idea that ‘what will be will be, accept what happens’ in labour and it couldn’t be further from the truth – things might happen that we hadn’t anticipated but arming yourself with the tools to decision-make through the unexpected puts control back into your hands.
And that’s the crux of it, for me. I felt in control this time. My house, my rules. I hadn’t devolved responsibility or authority to anyone else because I wasn’t on their turf. I hadn’t handed over my labour to people wearing an ‘hello my name is’ badge simply because they were the trained professionals. I was responsible for my decisions and my actions, in a way that never felt true for my first birth. I owned the house and they were my visitors and that had to be respected, and I was treated in a much more respectful way from those who attended me, unlike in the hospital where doctors felt that it was appropriate to walk into a labouring woman’s room without knocking, without introducing themselves, while she was trying to use a bedpan kneeling on a bed after taking opiates. Whether this was the beginnings of change away from paternalistic healthcare over the intervening years, striking lucky with who was on duty or a different dynamic from being at home I don’t know, but it definitely helped. I mean, I guess not owning a bedpan also helped!
As well as this shift in the dynamics of who was present, one of the other things that helped me was going in labour knowing I’d considered what would happen in different scenarios, something I’d not done for the first birth. I think this was likely the beginning of my birth flow chart theory! Instead of a black and white view of what I didn’t want with, crucially, no real understanding of what my alternatives were or how to find out, I knew what alternatives were available for different things that might crop up and I was reassured that I, my husband, and my doula were able to get that information if we got into a situation that needed it. Knowing that there were people positively primed to be the labour breakwater and stop a situation escalating was priceless.
Home birth isn’t for everyone, but for me staying at home and the extra support coming to me instead of me going to it meant that I didn’t have the huge break in oxytocin during the travel time which is where the fear was really allowed to set in during my first birth experience. It almost goes without saying that a calmer, less fearful labour is going to help not replicate the events of the first time round.
After a 7 hour labour during which I was described as “zen”, my daughter was calmly and quietly born in the water in a darkened room arriving en caul. A far cry from the screaming purple baby born under the strip lights of a huge labour ward suite observed by dozens. I immediately described her birth as healing. I still do. It made me realise that birth really is magical, that our bodies do know what to do and that we really, really need to listen to women. My emotional scars took 3 years to heal, but they healed the moment she came into this world (2nd degree tear and all!). So much so I opted to do it again 4 years later and, although this time it wasn’t a healing experience, it was even more beautiful and joyous than I’d experienced before.
