8 Ways to Manage Birth Trauma (and Take Steps Towards Emotional Healing)
You envisioned what your birth would look and feel like from beginning to end. You read birth and parenting books, consulted with the members of your birth team about your options, and developed a birth plan that not only feels right for you, but honored your priorities. But then, your birth plan takes unexpected twists and turns and you leave your birth space traumatized while processing intense emotions.
For example, maybe you hoped to have a birth free of any interventions, but consented to an epidural to help you manage your discomfort after several hours of labor. Maybe your labor was quick and your birth precipitous, prompting feelings that you were not an active participant in your birth. Maybe your labor spanned a few days, depleting you of much-needed energy and resulting in heightened feelings of anxiety. Maybe you had too many loved ones in the birth room, making you feel more like a hostess than the person of honor. Maybe you wish you had chosen a different environment for your birth, like a birthing center instead of a hospital. Maybe your birth plan did actually transpire as you expected, but you felt invisible to your birth team when you articulated your preferences. Bottom line, you feel cheated of the experience that you anticipated and dreamt of over the last few weeks, months, or even years. Whether you felt a loss of control, feared for your and your baby’s life, experienced pain, or felt unheard, feeling traumatized or disappointed after your birth is not uncommon and you should not feel ashamed if you need time to process what occurred in the birth space. You are not alone. In fact, up to 30% of birthing persons report a traumatic birth.
I encourage you, no matter your birth story, to reflect on and thoughtfully process it with time. But how can you process your birth story productively and healthily? Read on for 8 ways to manage birth trauma while also taking steps towards emotional healing.
Talk about Your Birth Story.
Often after birth, you feel a desire to process and share your story with loved ones because the experience is raw and transformative. Rehashing the birth with your partner and anyone else who was in the room is a common desire. So is recounting the story to complete strangers in a moment of vulnerability. Sharing your feelings and thoughts about your birth is a great first step to slowly relieve yourself of your trauma and disappointment. Most of your loved ones will be happy to lend a supportive ear and share in your feelings, particularly if they, too, have also given birth and can relate.
It is helpful to recognize that the unpredictability of birth often cannot be attributed to anything we did or did not do. If your birth plan changed abruptly, talk to your care provider about your birth and ask them to walk you through their reasoning for any specific changes. Bring your doula into the loop during a postpartum debrief to get their perspective. Many doulas offer at least one postpartum session and that is the perfect time to talk about your birth story. As you tell your story and talk to those who were also in the room, like your care provider and doula, you can make sense of what occurred.
While recounting your birth story, it is common to feel emotional. As many as 80% of women feel the “baby blues” after birth which can contribute to feelings of trauma and disappointment. For professional and specialized support, consider asking your care provider for a referral or check out qualified mental health professional directories from Psychology Today. You can also find postpartum resources by visiting Postpartum Support International. Finding help soon is particularly important if it you feel it is difficult to bond with your baby or take care of yourself. Qualified mental health professionals can evaluate you for perinatal mood and anxiety disorder (PMAD) and post-traumatic stress disorder (PTSD). For individuals who have associated trauma or disappointment with their birth, a qualified mental health professional can further make recommendations for treatment.
Is your partner wrestling with feelings of trauma and disappointment, too? Get help together and actively search for a qualified mental health professional who can service both of you in this capacity or consider joining a postpartum support group in your city together.
Finally, know that while it is tempting to share the explicit details of your story to a loved one who is expecting a baby of their own, recognize that can cause your loved one to feel unexpected anxiety. As you tell your story, your friend may establish boundaries by expressing that they are not comfortable hearing such details. Instead of candidly sharing your story with your pregnant loved one much like you would your birth team, try to share the story in a way that allows your pregnant loved ones to learn from your experience. For example, let’s say that you had a bad experience with your epidural because it was not effective in managing your pain. If your friend mentions wanting an epidural during her labor, you can say, “Epidurals can be a great way to manage pain. But before you get an epidural, make sure you talk to your birth team about what that pain management method means for your experience. My epidural was not an effective form of pain management which made my birth more difficult than I expected. Learn as much as you can before your labor about the benefits and risks”. Or if your friend mentions wanting a home birth, you can say, “Home births are great! I planned for a home birth, too, but had to be transferred to the hospital. It was scary for a birth plan to change abruptly, so check with your care provider about the steps that would occur if you had to go to the hospital so you are prepared mentally”. By sharing some of your experience and reframing it with thoughtful advice, your loved one can learn from your experience and consider the implications for their own birth plan.
Write Your Birth Story Down.
Carve out a couple of hours in your day, grab a pen and paper, and journal your experience. Or sit at your computer and type it out. Write your birth story down in detail and explore your feelings. Feel free to draw images, write poems, and use other storytelling methods to fully capture the emotions surrounding your labor and birth. Let your birth story be raw in its essence.
Before you start writing, think back to how your labor and birth occurred sequentially. Begin by answering these questions:
How did you know you were in labor? What were the first signs?
Where were you when you went into labor? At home? The hospital? Another place? Describe the location in detail.
Did your labor occur spontaneously?
Was your labor induced? Why? How did you feel about getting induced?
When did your water break? Did it occur spontaneously or artificially?
How did you feel when you realized you were in labor? Who did you call or text? What emotions arose when you realized you were in labor? Did you communicate those emotions to your loved ones?
Who was around during your labor? Your partner? A friend? Your doula? Your care provider?
What were the colors you saw in the space? What were the smells? What were the sounds? Did you eat or drink anything? How did your food and beverages taste?
Did your shower or get into a birth pool/tub during your labor? How did it feel?
What language was used in the birth space by your birth team? Was the language encouraging? Discouraging? Empowering?
Were any interventions used outside of a possible induction?
If you had a vaginal birth, how did pushing feel? Did you feel your birth team was supportive?
If you had a cesarean birth, what led up to it? Was it planned or an emergency? If it was planned, what were the reasons? If it was an emergency, how did you know and what did you feel?
How did you feel when you first held your baby? What were the first details you noticed about your baby?
Did your partner hold your baby? How did it feel to watch your partner hold your baby?
Once you have written as much as you can, talk to anyone else who was present during your labor and birth to help fill in any gaps. Maybe your partner’s understanding of the sequence of events is different than yours. Maybe your doula remembers things you said during the time, but it was all a blur for you. Next, if you had a hospital or birthing center experience, ask those facilities for a copy of your medical record so you can review and reconcile your account with the information documented. Include these new or clarified details in your birth story to flesh it out. Use this time to ask your care provider to clarify why certain steps occurred.
When should you write your birth story? With time, your memories of your birth may change so capturing it as soon as possible allows you to get the details down sooner rather than later. One of the benefits of writing your story down sooner is that you may discover unexpected bright spots. For example, you may have worried that you did not advocate for yourself during your labor only for your doula to recall that you asked for a care provider to walk you through a specific intervention before consenting. Maybe you recall that you pushed very briefly, but your partner tells you that you pushed for a couple of hours. Our perspective of what occurs in the birth space can take shape with time.
Accept and Grieve your birth story.
When a traumatic incident occurs in our lives, it is not uncommon to undergo the stages of grief - denial, anger, bargaining, depression, and acceptance. Birth is no exception. For some, birth is associated with powerful and painful memories, triggering a desire to grieve the birth that should have been. Let’s walk through the stages here:
Denial. The first stage of grief involves denial. This is a very normal response to when we feel overwhelmed by the circumstances that surround us - we tend not to believe what is happening and wish to remove ourselves from this reality. Let’s say your care provider recommends an induction because you are at 42 weeks pregnant and showing no signs of labor. You agree to this recommendation after evaluating the benefits and risks, but are disappointed that your labor did not begin on its own. As your birth plan shifts, you may say to yourself: “This is not what we planned. Why is this happening? Why is my body not doing what I need it to do?”.
The second stage of grief is Anger. You may feel intense emotion about what is happening, including anger towards members of your birth team. For example, you may wish that your care provider explained the risks of an induction in more detail after the induction is underway. Or you may feel that you could have pushed your baby out successfully without that intervention. Rationally, we know that even the best laid plans change unexpectedly. But it does not absolve one of feeling angry at the individuals or circumstances that we believe have caused us pain.
In the Bargaining stage of grief, we think of “if” statements and assign the blame for what happened to ourselves. “If I had verbalized that I did not want to be induced…”, “If I had opted for a home birth…”, or “If I had chosen a different care provider…”. These statements are our way to bargain because we feel hopeless. It is completely normal to want to regain control of a situation, particularly when it is as intimate as birth.
In the Depression stage of grief, we feel a sense of sadness and regret. We think about the impact of the birth on our relationship with our babies - we may struggle to bond with our children and our relationships with our loved ones may suffer as a result. At this time, we may be at increased risk for postpartum depression and require professional support. For example, you may feel discouraged and overwhelmed if the induction was very painful and traumatic.
The final stage of grief is Acceptance. When our birth plans suddenly go an unexpected route, we can eventually come to a point where we accept what has transpired. We then open the door to extending grace to ourselves during healing.
How you manage your feelings of grief is not only personal, but specific to your circumstances. Grieve your birth story and understand that there is no time limit to processing the details until you’ve reached acceptance.
Gather Support.
Processing your birth story may require the support of several external parties to ensure your path to healing is firm. Now is the time to solidify and recruit members of your postpartum army. Remember that your postpartum army can be support you, your baby, and your partner. When it comes to breastfeeding, establishing an infant sleep schedule, and generally taking care of yourself, there’s never too much support. When your support system is lacking, you can feel it emotionally, mentally, and physically.
When taking care of your baby during the first few years of life and before calling for help, truly think about what you need. Are you finding that you do not have time for a home-cooked meal throughout the day? Is laundry piling up in the corner and making you wonder how someone so tiny can be so messy? Desperate for someone to hold the baby while you take a nice warm shower? Concerned about postpartum healing and want reassurance that what you are experiencing is normal? Notice that you are not able to hold your pee and think you might need help strengthening your pelvic floor? Take note of where you lack the most support and find army members to fill that gap. Support members can include:
Your partner.
Family members/loved ones.
Care Provider (Physician or Midwife)
Lactation Consultant.
Therapist.
Pelvic Floor Therapist.
Pediatrician.
Postpartum support group.
Fill in the gap sooner rather than later to ensure your support network can take you through the next through months.
Be kind to yourself When reflecting on your birth story.
When something frustrating or upsetting happens that impacts our lives, we often have a habit of focusing on our regrets. We make a lot of “I should have/I could have” statements, placing blame squarely on our shoulders. Recognize that there are several things that can happen in the birth space that are not your fault. If you find yourself recounting your birth story and focusing on what you did wrong, it is time to change the narrative. Stop and choose your words carefully. Saying, “I should have chosen a different birth setting/care provider…it’s my fault this happened” or “I should have told my care provider that I was not comfortable with induction…I did this to me” or “I should have labored at home longer” can significantly halt your healing process. It can be difficult not to internalize these feelings and wonder what you could have done differently. Be kind to yourself as you process your birth story. Remind yourself that you did the best job you could do in your situation and you made the decisions you did with the information you had at the time. Root yourself in fact rather than the hypotheticals. Reframe your birth story so that you extend compassion and grace to yourself. Forgive yourself for what has transpired and recognize that fault does not lie with you.
Instead of “I should have…” in moments of birth story reflection, repeat these “I” statements:
“I made the best decisions I could have during my labor and birth with the information I had at the time.”
“I trust that I acted in the best interest of myself and my baby.”
“I feel upset about how my birth transpired, but I know that what happened was not my fault”.
“My body did not fail - it fed, nourished, and housed my baby. There were circumstances during my birth that were beyond my control and that does not change that my baby and I have come so far.”
“I worked hard to bring my baby earthside and I am proud of myself for being the best mother I can to my baby”.
“I recognize any pressure I felt to have the perfect birth and remove it from my mind and body.”
By removing blame from your mind and instead focusing on words that highlight what you did right, you can move towards a path of healing.
Refrain from Comparing and Idealizing.
When you find out you are pregnant, following social media feeds about pregnancy and birth to learn as much as you can about this time is quite common. Also common? Looking at social media feeds and comparing your pregnancy and birth story to others. For example, if you pictured a home birth that resulted in admission to a hospital, you may feel triggered by images of what appear to be peaceful and uneventful home births. Or you might have had a high-risk pregnancy that required intervention only to hear from a friend that they had a no to low intervention birth from beginning to end. Hearing these stories online and offline can be encouraging when you see your experience reflected in others, but discouraging when you see someone else experience the birth you envisioned and did not experience.
Before you compare your birth story to others, recognize that life is never black and white. Perfection, as appealing as it is, is not attainable. If you find perfectly curated social media feels harmful during your healing after the birth, protect your emotional and mental health with a social media break. During this social media break, ground yourself in what is true: You beautifully birthed your baby.
Enjoy the Present.
After your baby’s birth, you may have felt numb. Even weeks later, you may feel disconnected from your baby. This effect can be compounded if your baby had health problems and needed to stay in the hospital, away from you. Recognize that a traumatic or disappointing birth does not mean that you cannot have a loving relationship with your baby. Now is the time to really make beautiful memories with your baby on your terms. For example, if you do not remember your baby’s first bath because the first week was such a blur as you coped with your feelings, take some time to have precious bonding bath time sessions with your baby. Or if you felt robbed of skin-to-skin moments during the hour after the birth, bring your baby close for many cuddles throughout the day. These moments still matter. As you grow into who you are as a parent, know that one moment does not have to dictate your future. While a traumatic or disappointing birth can initially impact your relationship with your baby, getting help early facilitates meaningful bonding with your baby.
If you worry that you may never want to have another child after experiencing a traumatic or disappointing birth, these feelings are perfectly okay. Research has indicated that our birth experiences can impact if we will have more children in the future, particularly if the experience was traumatic. While a traumatic birth experience can cause you second guess a desire to grow your family, please know that the next birth can be different. Reclaim your power and find a care provider who can facilitate your birth vision.
Prioritize Your Happiness.
After birth, life can feel very raw and you may find yourself contending with a new normal. Prioritize hydration, nourishment, and rest during the postpartum period. Your mind and body have been through quite the journey, and it is okay to take care of you. Do not hesitate to ask for those around you for support so you can find time to simply shower or prepare a quick lunch. Add specialists to your postpartum network, like a postpartum doula, lactation consultant, therapist, and/or pelvic floor therapist to ensure your needs are taken care of soon after you bring your baby home.
Take advantage of follow-up appointments with your care provider to ensure you get help when you need it.
Bottom Line
Birth stories have many ebbs and flows, occasionally causing you to vacillate between feelings of trauma and disappointment. Recognizing that you need space to process what has occurred in the birth space is a vital part of the postpartum period, even if your birth went as expected. After birth, this is an important time to take care of yourself, build your support network, and seek help. Trust and know that you can overcome a difficult start, thereby opening the door to a beautiful present and future.