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Saturday 8 April 2017

Did I have a traumatic birth? - why things don't always have to 'go wrong' to be wrong...

 

It has taken me a really long time to write this post...27 months in fact, and even now there is still a part of me that asks, do I have the right to suggest that my birth experience was traumatic? Should there be a real medical emergency and threat to life in order to feel this way, or can the after effects of a certain scenario be enough?



Did I have a traumatic birth? - why things don't always have to 'go wrong' to be wrong...


So many parents go through the most horrific experiences and often we use these as a benchmark to assess our own. We tell ourselves that we were 'lucky' that didn't happen to us, and in comparison our experience feels like something we should be grateful for. I know I definitely felt that way.
 


Every now and then though, I would look at the other end of the scale and joke that Catherine, the Duchess of Cambridge would never have been treated in the way that I was during her labour with Prince George.

I imagine her stood in the hospital corridor outside the induction suite where her and Prince William had been left alone and ignored for 2 hours during her labour and transition...wrapped in a wet bed sheet with blood running down her legs, a baby pushing it's way out. I almost snigger at the idea of her confusion, shouting at her husband (Prince William) that she thought she was doing a poo, whilst he tried to help her find a private labour room to give birth - unsure of where to go. I wonder if the midwife would have been so quick to tell her that she was wrong, that she can't be so far along so soon - labour takes much longer than this. Would she have been scalded by her midwife during the pushing stage for 'doing it wrong' too?

It's a funny image. Mainly because it would never ever happen to them...but if not them, why anyone??

This was just a small snapshot of a scenario during my experience - there were other more frightening moments and equally, more positive (in hindsight) ones. During the 2 hour window where we were left alone I managed my labour until fully dilated with controlled breathing and a helping hand from my husband - who really stepped up as a birth partner, despite the fact I'm certain he was absolutely terrified, but managed to hide it really really well. 



My recovery afterwards was a long, slow process. I'd suffered a 3b tear during labour which required surgery, coupled with low iron due to blood loss, horrific flashbacks and the effects of postnatal PTSD which continued every day and every night for well over a year - perhaps the most 'traumatic' thing about it all was that the majority of upsetting events could have been avoided had we been placed with a midwife who had chosen to handle our care differently.

I'm not putting this one on the NHS, or even the hospital - they do an amazing job and I fully support and appreciate the difficult job they have in today's current climate. The team I had in theatre afterwards were fantastic and the aftercare on the ward after surgery, although understaffed and overworked, was good.

I don't think anyone should underestimate, however, the difference that the attitude and treatment from even just one person within that huge clockwork can have when that person is in charge of your care at one of the most vulnerable moments of your life. It takes very little for a moment to go from feeling positive to negative....it takes even less effort to make sure that your words are kind and encouraging, your attention is focused and your practise is of a good enough quality. 

I felt awful thinking this, and I'll probably feel even worse writing it down, but I am genuinely relieved that there is zero possibility that I will see the same midwife during my next labour.

By definition, 'trauma' is very subjective. It isn't for someone else to decide that your experience was 'traumatic enough' to be given a label...not that labels help.
Trauma takes place at the intersection of fear and helplessness If you find that you struggle after the birth with symptoms of trauma and postpartum PTSD for a prolonged period of time, please don't wait to acknowledge this like I did. PTSD doesn’t just happen to soldiers. 


Symptoms of postpartum PTSD can include the following:



  • Flashbacks or nightmares
  • Avoidance of stimuli associated with the event, including thoughts, feelings, people, places and details of the event
  • Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
  • Anxiety and panic attacks
  • Feeling a sense of unreality and detachment

I know now that PTSD is more likely to occur in patients who have had previous stressful life events or suffered PTSD symptoms previously due to traumatic events, especially if those symptoms were not fully treated in the past. Yes, that car accident you were in as a child/ teenager can come back around and cause the same after effects years later for something entirely different.

I also wrongly assumed that postpartum PTSD was always linked to PND. It isn't, the two are  different and should be treated as such - but - you can have both at the same time and you can have one because of the other. A lot of my aftercare with health visitors and midwives afterwards focused on questions around whether I was suffering from PND. There was no mention of PTSD, and I felt genuinely confused as to what was happening to me.

Admitting to the struggle of PTSD can be really hard, especially if it wasn't mentioned as a possibility at the time or you don't know of others in the same situation. For many, there can still be a real stigma attached to any condition which isn't purely physical. 


The birth trauma association states that, " It is important to remember that PTSD is a normal response to a traumatic experience. The re-experiencing of the event with flashbacks accompanied by genuine anxiety and fear are beyond the sufferer's control. They are the mind's way of trying to make sense of an extremely scary experience and are not a sign individual 'weakness' or inability to cope".


It can be hard to put yourself first when you've just had a baby. Issues such as colic, reflux, establishing breastfeeding and sleep deprivation can all take up so much time and energy...thinking about your own struggles often takes a back seat. It is important to remember though, that it is never too late to find help, whether you are 6 weeks down the line or 6 years - if it still affects you, it still matters. x



The moment we met 💕 For a really long time the memory of this moment has been tarnished by other more unwelcome thoughts and flashbacks surrounding my labour and birth experience with Arthur, making it almost impossible to recall the really special moments without having to re-live the difficult ones...the idea of having to do all of this again in 16 weeks time filled me with dread. Yesterday I had a 'debrief' meeting on the labour ward where he was born, exactly 27 months after the event took place. I had no idea this service was available until I became pregnant again and my midwife recommended having the meeting. I would urge any one who has questions, concerns or ongoing fears about their experience to request this service - or at the very least request their hospital notes to read through in order to clarify their thoughts. Never underestimate the power of having your memories, thoughts and anxieties verified and recognised. Yesterday my concerns were acknowledged, but also the really positive parts of my experience were highlighted - the fact that my body did exactly what it was supposed to - but the quality of care I received overshadowed everything that was going 'right' and made it seem like it was all going wrong. I'll know better next time 💕 If you would like to read more about my birth story and Postnatal PTSD you can view my blog post here: http://www.arthurwears.com/2017/04/did-i-have-traumatic-birth-postnatal-PTSD.html
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