Unveiling the Hidden Crisis: Addressing Birth Trauma and Transforming Birth Culture in the UK

Recognising and speaking up about birth trauma isn’t about scaring people, but about understanding and supporting the very real, harrowing experiences that thousands of women and birthing people face every day.

An inquiry into birth trauma in the UK has found that poor care is too-often “tolerated as normal”.

With approximately 30,000 women and birthing people suffering negative birth experiences every year, it’s clear that there’s work to do. In this blog, I’ll look at why birth trauma is an important conversation, and how the current recommendations don’t get to the crux of the issue: society doesn’t value birth.

Why talk about birth trauma?

Trauma in birth is often treated as an inherent part of the process. “Of course it’ll be awful, you’ve just got to grit your teeth and get through it as unscathed as possible.” And unfortunately for lots of women, it’s become just that. I guarantee that if you gather 3 or more Mums in a room, at least 1 of them will have a traumatic story to tell.

Have you ever wondered why so many women are quick to spill their difficult birth stories when given the opportunity? It’s because they’re hardly ever given the opportunity.

Birth is done behind closed doors and should not be spoken about in polite company. If you have a traumatic experience, certainly don’t go on about it all the time. It’s done now, you just need to get over it. And you really shouldn’t tell a pregnant person or someone trying for a baby about your experience, because you might put them off. 

So firstly, it’s a wonderful thing that this is finally being talked about. Recognising and speaking up about birth trauma isn’t about scaring people, or wallowing in self-pity.

It’s understanding the very real, harrowing experiences that thousands of women and birthing people have every day, and helping them feel seen, listened to, and supported.

I look at this inquiry as one of the first steps – it’s not perfect by any means, but at least the conversation is happening.

What is birth trauma?

Quote: The All-Party Parliamentary Group on Birth Trauma (APPG) define birth trauma as: “a woman’s experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotion and reactions, leading to short- and/or long-term negative impacts on a woman’s health and well-being…Traumatic birth experiences are subjective – it is the woman’s perceptions of threat that are most important.”

The fact that suicide is the leading cause of maternal death, six weeks to a year after birth, is horrifying.

To anyone reading who has been close to this experience in any way, I’m so sorry, and want you to know you’re not alone.

Causes of birth trauma

Birth trauma exists on a scale and can come from a range of factors. Both previous life experience such as abuse or depression in pregnancy (something which isn’t spoken about enough) and things that happen in the birth itself, such as assisted birth, preterm birth, stillbirth, or neonatal loss. While some birth difficulties are out of our control, it’s the combination of birth complications with poor professional care that adds dramatically to psychological distress.

Effects of birth trauma

The stories people shared in the inquiry are devastating to read. From a lack of compassion and being denied basic needs, to full medical negligence and obstetric violence, it all rings far-too familiar. As someone who has experienced birth trauma first-hand, I know the debilitating impact it has on every aspect of life and how difficult it is to unpack. I’ve shared my personal experience of birth trauma in a separate blog, which you can read here.

It puts women at a higher risk of depression, which is all-too-often written off as baby blues or being ‘over-emotional’, or in some cases, treated with medication but with little-to-no counselling or therapy support.

Birth trauma can make it harder for some to bond with their babies. Not only can mental health difficulties such as anxiety and depression affect both a mother and father’s relationship with their baby, but physical injuries can also affect someone’s ability to pick up, carry or play with their child for years to come.

The profound physical and psychological impact of birth trauma also affects the other relationships in a person’s life, rippling out into marriages, older children, friends, family, and work.

Quote: “Some women had had to give up work. Many spoke of having their self-confidence, and their sense of worth, destroyed. Others wrote of living with constant physical pain or incontinence as a result of damage sustained during the birth. One woman provided a list of injuries she had sustained as a result of birth…she can no longer carry out simple tasks such as standing to wash dishes.”

Dehumanisation

Women who shared their stories spoke of being treated as a “birthing vessel”, where birth is something that is done to them rather than something they experience. We’re told over and over again that “a healthy baby is all that matters”, and women who see birth as an experience are selfish, deluded, and don’t care about their baby. It becomes an ‘either-or’ scenario – sorry love, you can’t possibly have a healthy baby and a healthy mum, it doesn’t work that way.

A lack of compassion and kindness is distinct theme that runs through many people’s stories, with women feeling dismissed and ignored by their care providers. Expectant mothers are labelled as ‘over-anxious’ and told to ‘calm down’ – their instincts and knowledge of their bodies are not trusted as reliable sources of information.

A list of the common themes identified in the birth trauma report: - Failure to listen - Lack of informed consent - Poor communication - Lack of pain relief - Lack of kindness - Breastfeeding problems - Postnatal care - The impact of covid

These facts are even more stark for birthing people from marginalised groups and communities – black women are almost 4 times more likely than white women to die during pregnancy, childbirth or in the postnatal period. Experiencing both direct and indirect racism, they aren’t listened to, believed or trusted. LGBTQ+ birthing people are misgendered, discriminated against, or left out of the conversation entirely.

In the most heartbreaking of scenarios, concerning stillbirth and neonatal death, women’s experiences were almost all characterised by two things: mistakes made during labour and a lack of compassion towards the mother.

Too little attention is also paid to the birth partner. A review of research found that in the UK, approximately 7,000 people every year develop PTSD after witnessing their partner give birth. While the focus is understandably on the mother and baby, many birth partners feel unable to ask for help, or that they have to stay strong for the sake of the family. Society doesn’t exactly deal well with supporting men’s mental health and emotions, leaving many fathers to suffer in silence.

Recommendations

The APPG inquiry gives recommendations for improving perinatal care across the UK, including recruiting more midwives, commissioning research into the impact of birth trauma, and offering mental health screenings. However, most of the recommendations don’t focus on the crux of the issue; they seek to ‘solve’ things by introducing more medical intervention and how to tackle birth trauma after the event. Now, don’t get me wrong, this is highly necessary and valuable work. But I believe the recommendations need greater focus on preventive measures – how can we as a society, come together to reduce the number of women and birthing people experiencing birth trauma?

The truth is that we need something of a birth overhaul.

A core problem stems from how we view birth as a society.

Society doesn’t value birth. It’s a means to an end. I’ve likened it previously to a medical procedure such as a colonoscopy – something you have to grit your teeth through and hope you don’t shit yourself. It’s unpleasant and messy. All that matters is a healthy baby, and your main aim to is to get out as unscathed as possible.

“Trauma is just part-and-parcel of having a baby.”

“Everyone has a horrid time, and look, they’re fine now. You won’t remember it after a while.”

“It’s just one day. Getting too caught up on the birth and not the baby is like putting all your effort into the wedding and not the marriage.”

That last one particularly pisses me off.

Firstly, most people put far more effort into their wedding day than their marriage. Secondly, a wedding is a party, birth is a physical and psychological transformation. Unless you’re having to physically shit out a three-tier cake, it’s not the same thing.

Because we don’t value birth as a society, our perception of it is skewed. It’s done behind closed doors and you’re not to talk about it. Most of our understanding of birth comes from highly dramatized and unrealistic depictions in TV and films – lying on their back in a hospital bed, screaming through gritted teeth. Most of us don’t know what real birth looks like, sounds like, or feels like until we’re in the middle of it ourselves.

Over the centuries, western culture has sought to control women’s bodies, including birth, by creating (i.e., making up) man-made definitions and numbers, rules and timelines, and then blaming women’s bodies if they don’t meet their ‘standards’.

Patriarchy, innit.

While medical advancements have undoubtedly saved the lives of countless mothers and babies, we’ve entered dangerous territory in which interventions have become routine procedures, to the point that most of us, including medical professionals, have lost sight of what physiological birth is and how to protect it.

Sadly, many antenatal classes add to the problem. Most still rely on definitions of birth that stem from unethical, patriarchal studies (it’d need a whole separate blog – but you can read about it here!) Or they tell women to simply reject a medical approach and focus on a natural birth, while failing to recognise that 90% of women will give birth within that system, and have spent their lives being conditioned by society that it is the ‘safest’ way to do it. Truly effective antenatal and hypnobirthing education should help expectant parents unlearn these perceptions in an honest, non-judgemental way, that doesn’t make women feel like they’ve ‘failed’ if they do end up having medical intervention.

My mission has always been to change the narrative around birth in society – that’s why I start all my antenatal and hypnobirthing classes by taking parents through an unlearning process. We look closely at birth culture and where influences have been unhelpful, unrealistic, or just plain untrue.

I’ll be truthful – the wording of my mission has always been different internally.

I was told I’d put people off by mentioning the dreaded ‘p’ word, or heaven forbid, ‘feminism’ – burn the witch! But the truth is, birth, like so many things, has been fucked about with by the patriarchy. It has sought to subjugate and control women bodies, and it’s so engrained, that just the act of calling it out is seen as combative – you’re a difficult woman and should get back in your box.  

My internal mission has always been to dismantle the patriarchy, one birth at a time.

So, fuck it, that’s what I’m going with now. If it’s not your thing, I’m probably not the right antenatal teacher for you, and that’s okay.

Birth is a transformative experience that shapes your being for the rest of your life. Let’s give it the value it deserves.

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