I almost died during my first pregnancy – then I was expected to just carry on as normal

As a doctor and a survivor of birth trauma, I know it can have life-long effects - yet women often suffer alone in silence

A traumatic birthing experience has the ability to cause long-term issues such as PTSD (post-traumatic stress disorder), which has only been acknowledged in recent years, leaving many women petrified to have more children. I am one of these women.

As a doctor with over a decade of experience of working with expectant and postnatal mums, and more importantly having survived a difficult birthing experience myself, I know that birth trauma is real. The threat to the life of both mum and child during difficult births is real and the experience itself is profoundly debilitating for many mums. The sad reality, however, is that the majority of women just don’t talk about it. They get up and get on with it, just as society expects them to do.

When I fell pregnant seven years ago, having enjoyed good health to that point, I had no reason to believe that my birth experience was going to be anything less than perfect. I had joined local pregnancy yoga and antenatal classes and was swept away. Engrossed and excited by the anecdotal story-telling, I allowed myself to forget the science. We were encouraged to step away from all medical interventions because our ‘bodies are designed and empowered to give birth naturally’.

‘Complications and traumatic births are not discussed as openly as the beautiful natural births are’

As much as antenatal classes play a significant role in connecting parents and creating a community, I have found that the antenatal education system can often leave expectant parents ill-prepared for the ‘what ifs,’ preparing them to fail if it doesn’t go according to plan.

Complications and traumatic births are not discussed as openly as the beautiful natural births are. You’re led to believe that you’ll have a natural spontaneous vaginal delivery where you’ll push baby out using breath alone and then effortlessly migrate to connecting with and breastfeeding your baby, with maybe a few blue moments along the way. This is idyllic and every woman wants this but sadly many women do not experience this. Instead, they can endure all sorts of mental, emotional and physical pain to bring their babies into the world.

To cover up feelings of inadequacy, or the sense of failure that comes from having a caesarean section instead of the fully mapped out “natural” birth, new mums compare and despair, opting to suffer alone in silence.

A common issue during birth is to experience a tear of some degree to the perineum. Having a caesarean section, especially as an emergency, means a woman is having open abdominal surgery. Assisted deliveries require the use of instruments to sensitive and intimate areas. It’s a major risk and recovering from such wounds is not only hard, but it often robs you of any dignity as everything down below changes and hurts, disrupting normal functioning for several weeks and beyond.

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It is estimated that 30,000 women a year experience birth trauma in the UK, according to the Birth Trauma Association – not an insignificant number – yet it is still a topic that remains on the sidelines.

Antenatal education has to include teaching women that nobody can fail at birth because it is a unique experience and that no matter how they choose to birth, what pain relief they require or how they choose to feed their baby, they will be supported and nurtured throughout it. Women must be offered accessible counselling for the after-effects of birth early on and encouraged to speak about their experience, positive or otherwise.

I remember proudly presenting my empty birth plan to my midwife after my nine month antenatal training. All the mums in my classes had either claimed to go through the perfect birth experience or were prepared for it. My mindset had become – if they could do it, so can I.

I quickly learned though that I couldn’t do it. Complication after complication – all outside my control – landed me in intensive care with multi-organ failure. I woke up five days later to find a body that didn’t look or feel like mine, to meet a baby who I couldn’t hold or connect with and accept what everyone else was dictating to me. I felt helpless, hopeless and most of all, I felt like a failure. “How could they all do it but I couldn’t?” I thought.

Pain and trauma are subjective experiences that cannot be described by anyone other than the person who has lived through it. This goes for all forms of trauma, which rightly receive much attention and compassion, yet birth is rarely given the same degree of understanding or empathy.

It took me a year to physically recover but it’s taken six years and a second pregnancy now for me to accept and recognise that I haven’t dealt with the emotional and psychological effects of that trauma. Nobody spoke about it so I just got on with it. I live in gratitude for my beautiful son but that experience haunts me.

When I read reports then last week that some women were facing inhumane treatment by being refused epidurals during labour in the NHS, it triggered me. We cannot be adding to the trauma of women who are already vulnerable.

I also recently learned that postnatal reviews, an essential check-in point for mums at their GP practice, are no longer routinely being offered by some practices, which heightens my concerns. I fear and expect that there are many untold stories of women who have experienced birth trauma. I urge them to speak up so we can open the conversation around childbirth experiences.

Dr Punam Krishan is an NHS GP in Glasgow, medical educator and director of the British Society of Lifestyle Medicine.

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