Dear Natasha – a response to Grazia Editor Natasha Pearlman’s recent birth trauma article

Dear Natasha

I read your Times article, now reproduced in the online Mail, with a mixture of emotions – primarily sadness that someone felt so unsupported and uncared for during her birth.  Rage too that our maternity services is able to let women down on what seems like a regular basis and that your story does not stand alone.  And a sense of despair that those of us who work so hard to try and improve the situation aren’t reaching enough people, or having enough of an impact to make the necessary changes.  It is those people who have traumatic or terrible experiences in birth whose voices are heard loudest, and with reason.  No one should have to experience what you went through – no one should feel unheard and unsupported.  No one should feel like their birth experience is still affecting them negatively on a day to day basis years afterwards.

Trauma, for it does seem as if your birth experience has been traumatic for you, is a bitch.  And it can play out in so many ways.  The interesting thing is that someone can have what would be interpreted by many as a traumatic experience and not feel any of the symptoms of trauma at all, and someone could have a relatively “easy” time in other people’s eyes and be left with horrible, recurring feelings.  What matters is the feelings.  And so many of the debriefing and reflecting options available can actually be more negative than positive, helping to retrigger and retraumatise the person involved, allowing the amygdala (the monkey brain) to head off in to fight or flight yet again, stirring up the crazy heartbeat, sweaty palms, bowel-evacuating, dizzy panic feelings once more.  So it is important to find the right option for you in helping to recover from your experience.  Ultimately no one wants to stay in trauma long-term – it affects relationships, self-esteem, life choices.

Birth is a really sticky topic.  It’s emotive.  There are those who fall in to the pro-natural camps and those who are resolutely anti.  As a doula it is often assumed that I wholeheartedly and exclusively support those mothers who want to breathe their babies out in water at home.  And, believe me, those births can be magical to watch.  However, I am not naïve – I realise that that experience is not available to everyone, for many reasons.  I have also supported magical caesarean sections.  Many women choose to work with a doula having had a negative first experience of birth.  Knowing that you have continuous care and attention from someone who has built up a relationship with you, understands your previous experience and the potential trigger points can be invaluable and has been proven statistically.  A doula will help you to negotiate your options with your care-providers, without foisting her personal opinion or judgement on the situation.  She will listen, empower, help to move you to a place of readiness for a subsequent labour.

Antenatal preparation is key and I am really interested to hear people’s experiences of classes and courses.  How to achieve the right balance … how to keep it real without terrifying …  how to show the possible magic without setting up unrealistic expectations … how to help women and couples take responsibility for their unique situation … how to pitch something that suits the women with huge medical complications AND the women who have a low risk, straightforward pregnancy?  It is complicated and I don’t envy the teachers.  I do, in one-to-one situations, always want to look at different potential scenarios so that women are empowered and know their choices – we never know how birth is going to go and sadly I haven’t managed to create a crystal ball or magic wand yet!  But I am passionate about physiology and so shocked and surprised how little emphasis is placed on physiology in antenatal prep.  Understanding how the body works, what causes the mechanical changes – the dilation, the contractions, the pushing etc is invaluable.  But so is discussing comfort measures and that includes pharmacological pain relief.

So, what do I wish for?  More than anything I hope you find a place of acceptance of what happened for you in your birth, a release of the feelings that are affecting you personally and in your closest relationships.  Separate to that I have a much bigger wish, and one that seems challenging given the current state of our NHS.  I hope that we can magic a significantly larger number of midwives in to our birth units, midwives who are properly supported in delivering quality, compassionate care, midwives who are able to be “with woman” as their name suggests, not run ragged, exhausted, unable to eat, sleep or even go to the bathroom during a ridiculously long shift.  I pray for communication and respect between health professionals, a recognition that the job each of us does is valuable.  I pray that anyone who experiences trauma in the birthing room, from mothers to partners to health professionals is able to find an effective way to recover and not carry the trauma forward with them into the rest of their lives.  Perhaps if we get those things there will be more positive stories coming out in the press, rather than distressing ones.  Given that half of the population might choose to have a baby at some point in their life wouldn’t it be great if the majority of what they heard was affirming?

Sophie Brigstocke is an award-winning birth and postnatal doula, as well as Director and Doula Course Facilitator at Nurturing Birth.  See here for more information

Click here to hear Sophie talking about the “superpowers” of doulas, particularly around listening to previous birth trauma experiences

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