I hear a lot of birth stories and it isn’t good when a mum tells me that she didn’t feel safe, listened to or supported during labour.
As a practitioner, I work with expectant parents to help them prepare for labour and birth and I try to be realistic about where the challenges can be and how they might be able to manage them. But it’s really hard for parents when the maternity system doesn’t offer options and when midwives are too over-stretched to provide the right level of care, let alone to listen and provide reassurance. It can take a lot to be assertive when you are in pain, overwhelmed and vulnerable.
Many of the birth stories I hear are from women who want to talk through their labour and birth, to make sense of what they experienced, especially if they are preparing for birth again. But every now and then I listen to women tell their birth stories and they are upset and traumatised and it is largely down to lack of communication/information as well as how they were spoken to, which had an impact on their labour, their options and how safe they felt.
As someone who has worked within the birth world for over 20 years, the needs haven’t changed and the interventions and trauma are increasing.
Women need continuity of care, they need personalised care and options, they need to feel safe and secure and to be communicated with in a clear and grown up way - so many women comment that they are treated like a child.
I was diagnosed with PTSD and treated with EDMR and psychotherapy after the birth of my third baby - my placenta needed to be removed in an operating theatre, which left me feeling vulnerable and frightened.
With increasing induction rates - they can be as high 50% in some maternity units - rising caesarean rates, the closure of birthing centres, the withdrawal of homebirth services and the shortage of midwives, maternity units are experiencing a crisis I have never seen before.
Research shows that 4% to 5% of women will develop post-traumatic stress disorder after birth, which translates into about 30,000 women a year in the UK.
And there is no easy fix to this because so much needs the change within maternity services with more funding, staff and improved facilities so that women are treated as individuals with time, communication, options and care. And midwives need to be able to provide care without being over-worked and stressed.
If you are pregnant, I don’t want you to frightened but please do prepare well - know more about your local maternity facilities, hire a doula if you can and know more about your options, where the challenges can be and how to have a voice in pregnancy as well as in labour.
This won’t fix bad care and communication but it may help you to shout louder, to say what you need and to encourage medical staff to see you as an individual - I realise this makes it seem like this is on you but I want to equip you as well as I can with perspective and realistic coping strategies.
This is such a big issue and it impacts so many women - birth can be painful and exhausting and it can become complicated but it shouldn’t be traumatic for so many women and we shouldn’t expect birth to be awful. I’m all for interventions when they are needed but women shouldn’t routinely be denied options and forced down a medical pathway, they shouldn’t be stuck on a bed and left feeling like what they need doesn’t matter.
The most basic requirement of maternity services is for women and babies to be safe but there is much more to it than this - women shouldn’t be left mentally and physically scarred. And you deserve so much more.
I’d love your comments and questions on this and please do share it.
Thanks for reading.
Janine
It has been almost one year since the birth of my first baby, and as I think ahead to giving birth to the next baby, all the terribleness of a year ago is creeping back up. It is hard because you want to tell yourself you are wiser and more educated this time around, based on what happened before, but it is so hard in the moment to manage it all. There's so much that depends on the quality of the care providers you select, who can all seem great in the months leading up but then fall short when the day comes. I had midwives who preached and promised natural birthing options in a calm, community hospital setting (not what I received in the end), and a doula who claimed she never overbooked herself (but she did and did not answer my calls when I went into labor, and was so exhausted when she did finally get to me that she wasn't at her best). It is shocking how hard it is to get the right kind of support. All I can hope for is to be stronger this second time around--in the moment and in the prep, when I select the care providers.