It's Birth Trauma Awareness Week and some birth workers in the birth community are saying that we should really call it what it really is: “Obstetric Violence Awareness Week”.
I wanted to share my two cents on this topic because I experienced birth trauma myself and reading this today, it was a bit of a trigger for me! I feel that this is not the entire piece of the pie and that there's many other factors to be considered when talking about birth trauma, and we should not just slap statistics of OB violence and call it a day, putting it all on them. There are many other players and many other factors that contribute to birth trauma.
We need to discuss.
First of all, Obstetric violence in south Florida (and all of America) 100% exists.
There are a lot of obstetricians out there whose bedside manner is remarkably questionable.
I have seen it first hand (I’ve worked as a birth worker in MANY hospitals in south Florida from Jupiter Medical and Palms West in Palm Beach County all the way to Broward Health Coral Springs and the Memorial Regional Hospital Networks, Mount Sinai in Miami, Broward General Fort Lauderdale and even Holy Cross, many many more, so I have seen obstetric violence and poor obstetric bedside manner and it’s very real). But if we are being completely honest, it is not always Obstetric Violence what causes Birth Trauma, grouping Obstetric Violence & a poor bedside mannered OBGYN together is completely falsifying the root cause of birth trauma.
You can’t group a negligent / abusive OB/GYN with one that has a poor bedside manner — one is wildly horrifying and an injustice and one is being a jerk.
Neither is OK.
BUT it is NOT THE SAME.
Both certainly exist and are prevalent in our country and especially here in the tri-county area of south Florida where I work, and BOTH can certainly cause birth trauma but we need to discuss why and also what else besides the actual obstetrician can there be birth trauma. Read further…..
HOW SOMEONE’S PERSONALITY CAN IMPACT BIRTH TRAUMA / PERCEPTION
ONE EXAMPLE, ME
How can personality impact birth trauma? Let’s talk about personalities… I am an incredibly sensitive and gentle woman. I observe how people speak to me and to others, are they gentle and sensitive and present (or not) and how that makes me feel and how it makes others feel.
And just because I want my birth team to be gentle, sensitive and patient does not mean I have to be approached with “gloves on” because I’m too childish or sensitive. Let’s not pretend sensitivity is something to be ashamed of, and let’s not be condescending saying that only “needy” women pay attention to bedside manner (recently said to me by a person who said they don’t care if their provider is nice and warm, only medically competent).
So an obstetrician who isn't sensitive patient and gentle could be seen by myself as a bad doctor for not being the provider that I need them to be (warm) and this could later down the road contribute to birth trauma.
ANOTHER EXAMPLE
Whereas another birthing woman may not pay as much attention to how gentle or sensitive their doctor is because that's not something they take notice of, and it is not a priority for them. She may be focusing on am I healthy, is the baby ok, and accepting ‘matter of fact’ responses from her provider without needing a warm, sensitive presence, and she’s 100% OK with that.
That doesn’t mean she’s heartless. That doesn’t mean she has no emotions and is not sensitive. It just means different.
And so for a mama like this, birth trauma from a not-warm OB during a complicated birth may not occur. Instead, the birth trauma may occur due to medical or physical causes.
HOW SOMEONE’S BODY [uterus, cervix] OR BABY CAN IMPACT BIRTH TRAUMA
When our baby or our uterus takes the wheel
Sometimes our bodies or our babies completely take the wheel and no matter what our education & preparation for pregnancy/childbirth or our confidence in our ability to birth is, or even if we have the best birth team we could've possibly hired for ourselves, there's such a curveball thrown our way that no one ever saw coming and that on its own despite our best efforts and a super supportive birth team can leave us with birth trauma.
This does happen more commonly then we are led to believe.
I have often seen a very prepared and confident mama have to be completely flexible and go with the flow because nothing that she prepared for even remotely went according to plan.
My bestie wanted an epidural, but gave birth in 96 minutes and didn’t get to have one, guess what, she loved her birth team and loved her OB, but still considers it a traumatic birth. So who is going to tell her otherwise???
WHAT OTHER FACTORS BESIDES PROVIDER, PERSONALITY, BODY AND BABY CAN CONTRIBUTE TO BIRTH TRAUMA?
HOW DOES INTUITION, OR IGNORING YOUR INTUITION AFFECT BIRTH TRAUMA?
I also don't think that 100% of the blame during birth trauma awareness week should be placed on obstetric violence because there's a heck of a lot more people in the birth community who hold similar levels of responsibility for a women's birth trauma besides just OBGYNS.
For example I hired a home birth midwife and a labor doula for my second birth and it was far more traumatic for me than my first birth.
[It's important to note that this is my singular personal biased experience so my experience is different from everybody else's]
Both of my births were negative experiences because I chose the wrong birth teams each time.
I did not listen to my intuition and I let things such as insurance, accessibility, finances and fear control how I chose my birth teams which is not a place that anyone should be starting from when building their birth team so please keep that in mind when it comes to my own biased personal experience.
However, please note, and this is important because my first birth was with an OBGYN I hired, that I don't recall my first birth as traumatic (even though it was very scary), I never associated it with the words birth trauma.
It wasn't until my second birth that I truly experienced what I personally perceived as birth trauma, I felt that my birth team did not support me and was thinking how much longer is she going to be in labor, I felt like I was inconveniencing them because I was a high maintenance mom who needed a lot of emotional support [which now as a Doula myself six years later I provide my clients with lots of emotional support and I specialize in working with women who struggle with anxiety] which I feel my Doula back then had not a single inkling of intuition about the anxiety that was preventing my labor from progressing. I also feel abandoned by them when I was transferred to the hospital and I feel like the trauma that occurred to me during my second birth went completely over their heads.
That is my perception. Everyone else thought it was a good birth. But my perception is valid. My trauma is valid. So is yours if you’ve ever been made to feel like you should be grateful for a healthy mom, healthy baby and forget about your trauma, by the way.
HOW DOES CHOICE AFFECT BIRTH TRAUMA?
However there's another component to all of this that I haven't yet discussed which was that it was my choice, (regardless of the fact that it was a poor choice that was made on my part), it was my choice nonetheless to hire those people to be my birth team.
In fact, as part of my own processing and healing from that second birth experience over these last 6 years, was taking back my power and accepting that my choices lead me down the path to my experience.
Had I chosen the right birth team for my birth based off intuition, regardless of how the actual labor and birth would have transpired would I still have felt birth trauma? That is a question that will never be able to be answered but there's a possibility I could have still experienced birth trauma just from being an anxious and sensitive mom I could have very well still perceived my second birth as traumatic.
BIRTH TRAUMA IS NOT A ONE SIZE FITS ALL
Nevertheless, I think that when we're talking about the topic of birth trauma it is so vital to address all these topics because birth trauma is not a one size fits all, [which is something we talk about often in the birth community that birth is not a one size fits all and both teams are not a one size fits all and neither is birth trauma.] While obstetric violence very well contributes to a great portion of the one in three women that have reported having trauma during birth, (and that's just the people who have reported it because they are aware of it), there are so many other aspects that are responsible for causing birth trauma within an individual and so it is my belief that birth trauma should not be grouped under the same umbrella as in caused predominantly by obstetric violence.
WHAT DO WE DO?
I think that birth trauma is a very important topic to discuss in our nation so that we can start working on ways of confronting it so that birthing women can be more equipped with proper tools of making better, more educated personal choices based off their knowledge and intuition, so that they can have the best odds in avoiding bad birth trauma.
However, I think that there's also the danger of grouping birth trauma under obstetric violence because we're avoiding the fact there’s many other key players in birth who could very well replace obstetric violence as the main reason that caused birth trauma for moms. We are avoiding that home birth midwives and certified nurse midwives and labor and delivery nurses and doulas and partners and spouses and family members and friends and babies and baby positions and umbilical cords and uteruses and perineums can all very well contribute to the cause of birth trauma.
HOW ABOUT EMOTIONS, ANXIETY, SPIRITUALITY, PSYCHOLOGY AND BIRTH TRAUMA???
Is birth ONLY physical?
Let's stop pretending as a country that emotions, spirituality, psychology have nothing to do with the birthing process.
We need to bring up the difference in the birth community between anxiety, fear, emotions, spirituality, psychology vs. the physical and medical.
A woman who walks in to birth completely equipped with all the tools for birthing, has given birthed multiple times, does prenatal acupuncture and chiropractic care and has the fullest confidence in her most amazing birth team can suffer equally from Birth Trauma because her body or her baby did something completely unexpected.
Equally can a woman who planned to give birth to her first baby with an OB/GYN who isn't warm and friendly and told her that she needs to have a scheduled induction with zero medical inclination.
I'm going to wrap this blog up but I don't want to leave future and current pregnant moms hanging wondering well how can I make sure I avoid Birth Trauma with my upcoming birth.
So here are my personal recommendations for a great place to start:
Listen to your intuition, I cannot emphasize this enough. If you are with a provider or birthing facility such as a hospital or a birth center or with a birthing support person such as a Doula, if someone in your birth team does not feel like a good fit for you, if you are doubting their recommendations, if their behavior towards you does not feel enriching and supportive, the first thing you can do is listen to your intuition!!! No one can possibly tell you who the right fit for you is going to be better than your own intuition. Things will stand in your way such as distance, accessibility, finances, insurance, availability, it can be difficult to make a change to your birth team. Nevertheless, you are never backed into a corner and you are never without options. No matter how difficult your options are to achieve, there are always options, you should never be forced to stay with a birth team that isn't the right fit for you. Making a choice or a change can make life inconvenient for you and that's where number two comes into play:
Use your wisdom! You are a wise birthing woman, even if this is your very first time, even if everybody around you has made you feel like you know nothing, repeat after me: I am a wise birthing woman. Use your wisdom and decide what your priorities are. If your priorities are to have the closest possible provider and facility, while mental health and your experience is not as important to you, then take your power and tell yourself this is my choice to prioritize proximity over experience! Surrender to the fact that your experience may end up being traumatic as a result of your priorities.
This leads me to the number three. If you do not know what your options are then you don’t have any options, right? Have you heard that saying? Take the time during your pregnancy to educate yourself on the psychology + physiology of childbirth. Take a hospital childbirth course and a birth center childbirth course and compare how the two make you feel and what information you've been able to extract and assimilate from those courses. Take an alternate childbirth course that has nothing to do with information but taps into the spiritual and emotional (such as hypnobirthing, I personally love the hypnobirthing instructors at the Orchids Nest and at Amazing Births and Beyond). See how that makes you feel and tap into whether you're a more emotional or spiritual woman or both, or perhaps you are neither and you are 100% laser focused on the medical and being safe and healthy. Get to know yourself.
Get to know who the highly recommended birth providers in the community are whether obstetricians, certified nurse midwives or home birth midwives. Find out who are the recommended doulas with the most experience, find out what everyone's philosophy of birth is. Interview them, be direct with them, don't feel pressured into making a decision. You always have time. If your baby has not yet been born, then you have time.
If after reading this post you still feel like you have questions or need more support, I'm always happy to help however I can and to get you in touch with local resources and trusted providers.
