Birth trauma – have your say

As a counsellor it comes with the turf that I rarely talk about myself. Never in a session, and only occasionally on my website. That’s because psychotherapy is all about you – the client. And me chiming in with my own experiences could be irritating or stifling, rather than reassuring. However, I’m about to make an exception to this rule. I’m going to share my birth trauma with you. In the hope that you might share yours with the government. Who earlier this week announced they’d formed an inquiry to look at birth trauma. Specifically what causes the distress, how it happens and whether it could be prevented.

As far as birth trauma goes, mine barely makes the bar. This is not a story of death and disaster. Compared to some childbirth tales it’s normal, typical. Possibly even pedestrian. However, for a while, the memory of it haunted me. And I wonder now, if it played a part in my decision to have only one child.

My experience of birth trauma

I was induced at 42 weeks, after my previous three sweeps had absolutely no impact. My son was single-minded about staying put. I’d read many times that an induction made labour more painful, and I did consider waiting it out for a couple more days – wondering if he’d make his own way into the world. But the duty midwife informed me my placenta would be degrading, which could put my baby in the way of potential risk. So, of course, I went ahead with the induction. No further discussion needed.

Five hours later my waters have broken and I am in the hospital, in what feels like the late stages of labour. The pain is bigger than me. It is unlike anything I have experienced before. I throw up, I writhe, I pace around a dark ward. My partner tries to comfort me but his presence is pointless. The agony ramps up by the minute, and very soon I am wishing I was dead. That we were both dead. I have failed. I am not strong enough to manage this pain and I don’t think I can survive it. And then it stops. It just stops.

Disappointing but not unusual, the midwives say. This happens sometimes – especially with inductions. The only sensation I have left is like the cramping of a strong period pain. They check the baby is all good (he is), and give me some morphine to help me sleep. Which I do. A beautiful deep sleep, after my futile hours of labouring.

Get ready to wait

What happens next is…nothing. I wait, but I’m not sure what for. It’s the summer of 2018 and there is a 35C heatwave. The ward is oppressive, boiling, stifling. There’s no air conditioning or cooling system and I’m too uncomfortable to eat more than a mouthful. The heat brings on migraines. I throw up all over myself, and the kindly, deft, efficient midwives clean me up and change me.

And nothing is exactly what continues to happen for the next 48 hours. I ask if I can go home, but they reply that it’s not recommended. They want to keep an eye on me, although I’m not sure why. Perhaps they’re waiting to see if my labour will start again. They don’t say. And in my confused state I don’t ask. This is how the time passes now- too uncomfortable to eat, too hot to sleep, regular migraines and no information about what the plan is. My birth trauma starts here.

And then at 2am on the beginning of the fourth day, I’m informed there’s a bed ready for me downstairs. My labour will be started chemically. That’s fine. That’s great. In fact, it’s a massive relief. On my way down to the birthing unit I feel encouraged. The end is in sight and I’ll be back home soon.

The midwife takes one look my exhausted, bloated face and recommends an epidural – it’s clear to all that I no longer have the energy to actively labour. An injection in my spine follows. The anaesthetist informs me that I must sit still and move towards the edge of the bed. I don’t have the mobility to do this. My bump is huge, I’m bloated. He places his cold hand on my back and I jump. “Don’t do that.” he admonishes “It’s so dangerous.”

Always treat your patients with respect

I do understand his point. He’s about to put a needle in my spine. And a jump by me could lead to damage, paralysis, disaster. But the way he speaks to me, as though I’m a child who needs telling off, is unsettling. And suddenly I’m aware of the massive power imbalance. My life feels quite literally in this man’s hands. I can barely move let alone go through labour again. All my hopes rest on him to make this epidural work.

And I’m aware I look pitiful. Three nights with no sleep, little food and intermittent migraines have left me slow, confused and, if I’m honest, just a little pathetic. I see him in his smart day clothes, with his authoritative bearing and impressive medical knowledge and I sense he’s irritated by me. My blood pressure goes through the roof which my midwife seems alarmed by, but feels inevitable to me. This remains one of the single most stressful exchanges of my life.

Later on the anaesthetist pops back to remind me that if I need more pain relief I only have to press the button. “What button?” I say. He can’t hide his disdain. Only 30 minutes ago he explained this, and now I’ve forgotten. Unkindly, he mimics my sentence giving a sarcastic laugh, to indicate how exasperating he finds my confusion and then leaves the room.

But no one is all bad. And to his credit the epidural works perfectly and the hormones do their thing. Ten hours later, I’m ready to push. But of course I’ve had an epidural, so I feel like a person pretending to push and not really pushing. Like in a film. This continues for an hour. And then suddenly the lead doctor decides, enough is enough. “You’re tired and your baby is tired.” she announces. She calls time on the para pushing, and out of nowhere a squad of healthcare professionals crash into the room.

My legs are put in stirrups, forceps are laid out on the table, my bed is reclined. It feels medieval. And Barbaric. The atmosphere is fraught, the team bicker among themselves about the best way to deliver the baby to avoid breaking his arm. And the pain! The pain of having that baby wrenched out of me is indescribable. I am convinced I am going to die on that table. So much so that when they place him in my arms for the first hold, and begin stitching me up, I can barely believe we both made it. It all turned out okay.

Managing the aftermath

Okay-ish. Except I have lost a litre of blood. And combined with the lack of sleep, the lack of food and general exhaustion I very quickly slip into a confusion that borders on psychosis. I can’t remember where I am, or whether I can ask the midwives for help. My arms feel too weak to breastfeed my baby, and when the midwife tries to explain the technique I can’t wrap my mind round the words she’s saying. I hear her, but my brain can’t process it.

The doctor arranges a blood transfusion for the next day. And as they’re sorting me out, putting a line in, and checking through the paperwork a staff nurse enters my curtained cubicle. She doesn’t apologise, but she does say there’s been a mistake. She informs me that both baby and I should have been given antibiotics.

My waters had broken 48 hours before giving birth. She doesn’t give any further details about how this oversight happens, but says I do have the right to make a complaint within a year. And then in a final body blow recommends we both stay in hospital for three more days. It’s a period of precaution for them, but a prison sentence for me. I want my home, I want my mum, I need my own bed. If I had the energy I’d have howled along with the newborns.

After the best part of a week I’m allowed home. Together my son and I establish breast feeding, we bond just fine, but at times I’m so weak and sleep deprived from my tortuous time in hospital, that I’m dizzy. And, of course, coming home exhausted with a newborn baby meant there never was going to be any chance of me piecing together the words to write a formal complaint. It was simply beyond my brain capacity at that point. I’m sure the trusts are aware of this, hence the one year time limit. Mum’s being on the back foot with their complaints must surely work in their favour.

However busy I was with baby, the thought of my time in hospital stayed at the back of my mind. In the snatched parcels of sleep I got, I’d often dream I was back there. But this time I was progressing through my labour in a normal way. Moving through the different stages, with a midwife at my side, and both of us managing my pain as we went. It took over a year for my brain to accept, that my disjointed and chaotic experience of childbirth was still childbirth. I was terrified someone was going to make me do it all again – but properly this time.

And although my family, friends and health professionals commiserated on my long, difficult birth, ultimately I did bring home a perfectly healthy baby boy. For a while afterwards I encouraged myself to think of this as a successful birth. I was alive and my baby was alive. Wasn’t that the bottom line?

But is that really all we can expect from giving birth on the NHS, that we make it out alive? This is not Game of Thrones and some degree of birth trauma should not be a given. For mother and baby to survive childbirth seems a very low standard to set. It will never be a comfortable experience, but it can certainly go from bad to better.

Take-aways to help avoid birth trauma

Five years on, with my son now at school full-time, and the luxury to reflect on my experience, here’s what I think may have lessened my own birth trauma;

Better communication: decisions were made about me but not with me. And it starts at the most basic level: Do you even want a sweep? What are your thoughts on induction? These were questions I was never asked. And I didn’t think to question the guidance of health professionals. I probably still would have adhered to their advice, but I’d have felt heard, informed and more in control.

Keep the patient informed: For me the most irritating thing about the whole experience was that I never really understood why I was waiting , what I was waiting for or when the wait would end. It’s hard to predict chid birth. It can be chaotic or incredibly slow, but giving timelines and a process that’s as clear as possible, would have saved me a lot of anguish.

Always be aware of the power imbalance: One of us is anxious, poorly and sleep deprived. The other is not. Can you see the power imbalance here?

Treat patients with respect: It should go without saying, but even if you do feel irritated by your confused, exhausted, pregnant patient please try to hide your exasperation. It’s only polite and will make the world of difference to their mental health and sense of safety.

Review your own processes: I have no idea why the hospital missed the fact that we both need antibiotics. My son and I are lucky. The oversight didn’t harm us, but it seems a really basic error. My heart sinks for others who may not have been so fortunate.

So, there we have it. That was my experience and I encourage you to think about yours and submit your feedback. We all deserve a higher quality of care then what’s currently available. And maybe this time the government will keep this promise, and make some changes.

If you have any questions at all, or feel you’d like to share your own birth trauma with me. Then please do, I’m a fully qualified counsellor with experience in birth trauma and the impact it can have on self esteem

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