Birth Trauma Awareness Week
This year, Birth Trauma Awareness Week falls on the 15–21 of July 2024 and the theme is Informed Consent. The debate around informed consent (permission) in prenatal and birthing care is ongoing among maternity experts, families, and the government, especially after the NSW Parliamentary Inquiry.
Informed consent is essential for respectful maternity care. Everyone deserves to know their choices, risks, and alternatives during childbirth. Everyone has the right to make the decisions that are right for them. Yet, in healthcare, this principle is often ignored or misunderstood, potentially causing trauma for birthing individuals and families.
Birth Trauma is a woman’s experience of interactions and/or events related to childbirth that cause overwhelming distressing emotions and reactions, leading to short and/or long-term negative impacts on a woman’s health and wellbeing.
Birth-related trauma can be physical or psychological, or a combination of both. Birth-related trauma impacts mothers, birthing parents, fathers and non-birthing parents.
Physical trauma (birth injuries) may or may not be identified straight away. You may be the first to notice that something isn’t right
Physical trauma can present as:
- Perineal tears
- Bladder damage
- Pelvic floor muscle damage
- Pelvic organ prolapse (POP)
- Infected stitches
- Incontinence/leaking of wee or poo
- Pelvic fractures (public bone, coccyx, sacrum)
- Cesarean wounds
Birth can be wonderful, but sometimes it is frightening and even traumatic; this is known as Psychological birth-related trauma.
Psychological trauma may present as:
- Postpartum post-traumatic stress disorder (PTSD)
- Postnatal depression and/or anxiety (PNDA)
- Obsessive Compulsive Disorder (OCD) (For example, obsessive thoughts that can affect our behaviour, such as checking on baby constantly or recurring thoughts that impact your enjoyment of daily life).
The main contributing factor is the expectations of birth not lining up with reality where women expected their birth to go smoothly, can end up with unexpected complications. Miracle Babies Foundation believes that Kangaroo Care (skin to skin contact) can assist in reducing birth trauma for the mother herself, but also provides benefits to the health of the baby.
Miracle Babies E Information Hub has been created in collaboration with parents and health professionals to provide families with Evidence, Education and Empowerment.
The Information Hub has articles on Post-traumatic stress disorder, Postnatal Anxiety and Postnatal Depression, as well as a range of others.
Miracle Babies Employee, Chantelle, shared her Birth Trauma story and explained how the hospital staff were not supportive or sympathetic to the birth of her daughter, Zahra. Here is her story:
"2018 I fell pregnant with our 3rd child, we were so excited to be adding another little munchkin to our family. At 15 weeks via 3d ultrasound we found out we were having a baby girl after two boys we were over the moon. One night around 18weeks, I woke up with a funny feeling like I needed to pee, but as I sat up, I felt this gush I panicked and asked my husband to turn on the lights to my absolute horror it was blood lots of it, I went straight to the hospital to get checked and monitor the baby. The baby was fine, they couldn’t really explain where the blood had come from, both of us were ok they kept me in for a few days.
They noted during the ultrasound that my placenta was low lying and that eventually it would move. When I had another ultrasound around 25weeks my placenta still had not moved and the baby was breeched, from that point I was told that I was to avoid anything going inside of me as it could cause a bleed, either resulting in the baby bleeding out or myself. I had another bleed that resulted in me going back into hospital, at this point they gave me steroids just in case the baby needed to be delivered and was transferred to Liverpool hospital for another few days of observation, then was sent home.
Each bathroom trip from that point was always filled with anxiety every time I’d wipe, I’d check the toilet paper to make sure there wasn’t any blood. When there wasn’t anything, I’d take a deep breath and wait till the next time. This unfortunately went all the way up till the day she came to earth side.
After 30 weeks I had another ultrasound to determine what was happening with my placenta, in the ultrasound they could see that there wasn’t any gap between my placenta and the womb it seemed to be as one. They wanted to do an internal ultrasound but after what the doctor told me I declined, they explained that it would help them to get a better understanding of what they were dealing with, but I was terrified that something bad could happen. They started throwing around the idea that I could have placenta previa.
I had a hospital appointment a few weeks later, they referred me to get an MRI so they could get a real insight into what was going on, the results came back a week later. It was determined that I had placenta accreta and that she was still breeched. It’s a serious condition that occurs when the placenta grows too deeply into the uterine wall. From this point it was all systems go. During this appointment they explained to me the best case scenario which was everything will be fine and go to plan and the worst case scenario bleeding out.
They wanted to make sure they had a plan in place for everything, I had to sign informed consent for tying my tubes, c-section, blood transfusion and Hysterectomy if required. The doctor said we aren’t going to wake up half way through to get your consent. At this point I was keen to get her out so I know she is ok, the thought of a hysterectomy was far from my thoughts, especially only being 26.
They organised the date to go in for the c-section 26th of February 2019.
I was admitted into Liverpool Hospital on the 25th of February, they wanted to run tests before the surgery the following day. The morning came. I was nervous, anxious but was so excited to put all the worry behind me and have my baby girl.
I was taken into theatre where my low half was numbed, they inserted Iliac Balloons into my major blood vessels connected to my uterus, this was so during surgery they would blow these up to stop major bleeding. I was then put to sleep, I was in surgery from 12pm till I woke up at 7pm in recovery. This is when I was informed that they had to perform a hysterectomy due to so much blood loss 2.5 litres and that required two blood transfusions. During the surgery, they found a cut in my bladder that had to be repaired and a Urinary Catheter inserted while it healed itself. Zahra came into the world at 35 weeks, they then told me that Zahra had respiratory stress and required CPAP for the first 3 minutes and then was weaned to low flow oxygen she was admitted to NICU where she would spend the next week. I had to lay flat for 4 hours before I was allowed to sit up, I was relieved it was over.
I was finally taken to my room and given my phone and when I opened a message from my husband saying how proud of me he was and how scared he was as he had no idea of what was happening, most of all how beautiful our daughter was then when I scrolled I seen pictures of her. This broke my heart, getting to see my baby for the first time in a photo. With the amount of medication, I was on I could barely keep my eyes open, I felt extremely numb and like I had been hit by a bus.
The next day rolled around, and I was yet to physically hold my baby, I wanted to so bad but I was barely able to look after myself. They planned to take me in the afternoon in my bed to the NICU.
I remember being wheeled through, wondering which baby was mine, and as soon as I got to hold her I knew everything was going to be ok. We both spent the week in Liverpool, sitting there in NICU hearing all the other mums talking about their next baby and all their plans broke me, I cried quietly while holding my last baby taking in every second of my lasts.
Once it was time to go home, the real healing had to begin. I was blessed to be able to have 3 beautiful babies, blessed to be able to come home but mourning the loss of something that my body was able to do and now can’t do took a massive toll emotionally and physically. My beautiful baby girl Zahra is now 5, started kindergarden and is thriving. It has taken a long time to be able to look at those first pictures of her without crying, now I look at that with amazement and how far we have.
