How to Cope When Birth Takes a Traumatic Turn
What is birth trauma?
When you get the news that you’re pregnant, many different things run through your mind. You think about what the baby will look like, what their personality will be, and what type of birth experience you will have. For most women, giving birth is imagined as a magical experience. You’re told that it will be the happiest moment of your life. But what happens when it’s not?
The truth is that nearly one-third of women have a traumatic birth. A traumatic birth is any birth experience that is very scary or overwhelming. Women who have unexpected medical procedures during birth, complications, or who have a baby who was injured or required medical attention are more likely to report that their birth was traumatic.
A portion of women who experience a traumatic birth go on to develop post-traumatic stress disorder (PTSD), which is a mental health condition that involves changes in thoughts and feelings, avoidance of the trauma, increased arousal and reactivity, and unwanted reminders of what happened. Many women who have a traumatic birth are not even aware that they’re suffering because of it. Some go on to get help for PTSD or postpartum depression and anxiety. Others push through, but find that their trauma keeps coming back.
Pregnancy after a traumatic birth
Getting pregnant again after a traumatic birth can stir up a lot of different emotions. You may feel excited and hopeful but also scared, anxious, and even depressed. Sometimes symptoms of PTSD that have previously resolved can return. Women who thought that they had worked through their trauma may be surprised by what resurfaces. These feelings may intensify as the pregnancy goes on and childbirth approaches.
If you are pregnant after experiencing a traumatic birth and find yourself struggling, you are not alone. Fortunately, there are things that you can do to manage your anxiety and cope with your past trauma as you prepare for birth again.
How to manage anxiety in a future pregnancy
Understand that what you are feeling is normal. So often women report feeling like they are “going crazy” when they struggle with a new pregnancy. It doesn’t help that other people in their lives often tell them to “just relax” or “stay positive.” When they can’t do this, they feel like even more of a failure.
Here are some strategies for coping with your anxiety about an upcoming birth:
- Utilize mindfulness techniques: Mindfulness is an effective technique for managing all types of anxiety. It involves awareness of the present moment without judgment. There are many ways to practice mindfulness, but one technique I often use with my clients is called “leaves on a stream.” In this exercise, I encourage the person to picture themselves sitting on the bank of a stream. I then tell them to recognize when they are having a negative thought, place the thought on a leaf on the stream, and send it away. When another thought pops up, put the thought on a leaf and send it away again. Keep repeating this process. People often feel frustrated that they keep having thoughts, but I remind them that it’s not about stopping your thoughts, which is impossible, but rather acknowledging them and not getting swept away by them. The more you practice, the easier it becomes to let your thoughts float by.
- Focus on what you can control: Many women who experience a traumatic birth report feeling like they had no control when they were giving birth. The truth is that many aspects of childbirth are outside of your control, but there are some parts where you do have a say. For example, you can choose your provider, birth plan, who to have in the room with you, and other aspects of your environment. If you feel overwhelmed by a lack of control, encourage yourself to focus on what is within your control, rather than all of the things that aren’t.
- Advocate for yourself: If you’ve experienced a birth trauma, there’s a good chance that you didn’t feel heard. Many women who have had a traumatic birth report a breakdown in communication with their providers. As you approach your upcoming birth, you may struggle with how to advocate for yourself. It’s important to know that you have a right to stand up for yourself and express your needs. If you’re having trouble, consider asking a partner or another support person for help, or write down your requests and email or hand them to your provider. A good provider will be open to what you have to say.
- Avoid scary birth stories: When you’re pregnant, people may want to connect with you by sharing their own birth experiences. While this can be helpful in some cases, scary birth stories can worsen your anxiety. If someone starts sharing a negative story, remember that you have the right to ask them to stop.
- Be mindful of where you seek information: When you’re facing a scary situation, it’s normal to want to find answers. For many of us, this means turning to the internet. The problem is that scrolling excessively online or on social media for answers to questions can cause you to feel even more anxious. It’s more helpful to stick to a few legitimate sources for information, such as your OBGYN, midwife, or doula. If you do turn to the internet, try to keep it limited to a few established websites.
When to get help
If you’re trying to manage your anxiety on your own, there may come a time when you would benefit from peer or professional support. We often tell ourselves that if we push through, things will get better. But the truth is that there is no reason to suffer when help is available.
Postpartum Support International (PSI) offers many options for support, including:
- Chat with an expert: A free weekly call for moms and dads who have questions or need support.
- PSI HelpLine: This non-crisis helpline responds to calls and texts between 8 am and 11 pm EST. You can call the helpline at 1-800-944-4773 and dial #1 for English or #2 for Spanish or text 800-944-4773 (to text in Spanish contact 971-203-7773). If you are experiencing a crisis and need immediate support, call or text the 988 Suicide & Crisis Lifeline.
- Provider directory: A listing of certified perinatal mental health providers. This is a good resource if you are looking for a therapist or psychiatric provider. You can search the directory for providers offering in-person and telehealth visits and narrow down your search by factors like location, insurance, etc.
- Online support groups: PSI hosts more than 50 free virtual support groups on a variety of topics, including birth trauma support, birth trauma support for BIPOC birthers, and a pregnancy mood support group.
Conclusion
It’s very common to experience anxiety during your pregnancy after you’ve had a traumatic birth. As you get closer to giving birth again, you may find yourself feeling more and more anxious. Using mindfulness techniques, advocating for yourself, and focusing on what is within your control are tools that can help you manage your anxiety and prepare for giving birth again. If your anxiety is very high or isn’t getting better, consider seeking out professional or peer support. There is no reason to suffer when help and support is available.
About the Author
Emily Guarnotta, PsyD, PMH-C
Emily Guarnotta, PsyD, PMH-C is a licensed psychologist and certified perinatal mental health provider. She is the owner of Phoenix Health, a therapy practice that supports families experiencing mental health concerns like postpartum depression and anxiety, birth trauma, infertility, and loss. As a provider and mother herself, she has witnessed the emotional challenges that parents can experience as they navigate the reproductive years. She seeks to make mental health care more accessible for new parents across the United States.
PSI GA’s Traumatic Birth Data Sheet
Postpartum Planning for Expectant Parents
