Millions of women give birth everyday to beautiful babies without complications. Our bodies are generally designed to give them a safe, secure prenatal home and to help usher them into the world. But as we well know, and many of us have experienced, things don't always go to plan.
The complications that can occur range from those with short-term impact to those which present the worst possible scenarios - neonatal or maternal injury or death. It is easy to understand mothers or loved ones being broken-hearted when one of the latter scenarios take place. But sometimes it is harder for people to understand broken-heartedness in response to situations that aren't deemed that serious.
Many women have very specific expectations of their pregnancy and labour experience. No matter how much they are encouraged to expect the unexpected, the influence of media and the women in their lives tends to contribute to specific ideas of what will happen. Some of these women are natural born planners, making rigorous plans in line with these expectations. But unfortunately their body or baby has different ideas. For these women, feeling out of control and helpless to the complications, in addition to the impact of the complications themselves, can be extremely traumatising. Even after mother and baby experience full physical recovery, the emotional trauma can persist long after. What we can learn from this is that trauma is not always proportionate to the severity of the complication but is a reflection of how an individual responds uniquely to challenging life events.
In other instances, pregnancy and labour outcomes can be much more serious and naturally the negative impact from these can be far-reaching. A mother's ability to recover well from this trauma depends on many factors, such as personal resilience, life outlook, social support and access to resources. There are some women, whether the complications are severe or not, who will experience trauma but find ways to overcome and perhaps even become stronger from it. However, there are many who struggle significantly long after, sometimes never recovering from trauma. No matter the health and well-being of themselves or their babies, they remain broken-hearted. This reality is one that should be taken seriously and accepted without judgement.
There is a condition called Takotsubo syndrome, or 'broken heart syndrome', which is a recognised medical condition. It is caused by severe emotional distress, like the loss of a loved one or relationship breakdown. It's impact is not only on the emotional 'heart' but on the physical heart, causing symptoms like a physical heart attack. Research conducted by the British Heart Foundation discovered that sufferers of broken heart syndrome experience endure long-term and often permanent heart damage. Scans of the 52 individuals studied revealed that many of their hearts no longer pumped properly and there was evidence of scar tissue. Approximately 3,000 people a year are afflicted with this condition in the UK alone.
For me, this research not only provides enlightening information but for thousands of women like me it offers validation. Birth trauma is not something that is widely discussed, recognised or readily-understood. The focus in obstetric healthcare is entirely medical; there is no emphasis or interest in how complications in this area can impact a woman emotionally and in seemingly unrelated physical ways. I suffer from heart palpitations and have been thoroughly investigated for a cause, of which none has been found so far. If I were to question a medical professional about whether it could be connected to the emotional trauma I experienced when I gave birth to my daughter, I'm certain the possibility would be dismissed. If the deep impact of emotional trauma is overlooked in most medical circles, it may explain why it is even more underestimated in social circles. For many, it is so easy to listen to a woman holding a healthy toddler and wonder why she doesn't 'just get over it' when she brings up how she's still affected by her birth experience with that child. She probably hears 'Your baby's fine! Just count your blessings!' more often than she cares to recount. However, the research above shows that emotional trauma is real and its impact is real, potentially causing actual physical damage to the heart. For women who lose a baby, whether to miscarriage or stillbirth, and go on to have other children there are also assumptions made. People think that a new baby will erase the pain of babies who have been lost. However, that mother could literally be suffering from permanent heart damage caused by the devastation of her bereavement. The loss of her baby remains etched on her emotional and physical heart. Besides that, a baby doesn't have to die for the mother's trauma to remain. The terror of when a labour suddenly becomes life-threatening for her, baby, or both, or the agony of visiting her baby in special care and seeing them helplessly covered in tubes and wires - the impact of these experiences can haunt women's memories for years after. Although she has made a significant recovery, even now when I close my eyes and remember my daughter having seizures at 3 days old in her cubicle on the special care ward, tears immediately spring to my eyes. And that was 12 years ago. The pain of birth trauma is REAL in EVERY way. And it stays with you, sometimes forever.
It doesn't matter whether people on the outside deem your birth complications to be serious or not. Women shouldn't be pressured to 'be tough' and to 'just get over' what they've endured. A woman is incredibly vulnerable when she is pregnant and when giving birth. Her whole person is committed to performing one of the most important human acts ever. Therefore, when birth trauma happens, it affects the whole person. Women should be supported to access available resources and be helped to develop mental and emotional skills for recovery. If more of this support was given to women in primary antenatal care and hospital obstetric services, as well as community organisations, perhaps we would see a reduction in the incidence of postnatal depression. Perhaps many women would be in a stronger position to embrace the role of motherhood, which is hard even if you haven't had a complicated pregnancy or birth. Emotional trauma is not always avoidable; it is completely natural and normal to respond with distress to birth complications. A lot of women don't have sufficient coping skills. However, if the impact of distress is taken seriously and more women are supported effectively, it will inevitably have positive outcomes for their personal well-being, their relationships with their babies and with other loved-ones.