Birth trauma – the psychodynamics of ruptured relationship

The time around the birth of a baby is momentous. It is the start of a new relationship, one that is likely to be significant to you forever. Usually anticipated as a joyful event, being pregnant, giving birth and becoming a new parent can however, raise feelings that you might not have expected.

Perhaps the way labour unfolded or the way your baby was born did not turn out as you had hoped. A sense of being out of control or without the kind of support that felt useful to you during birth, may have left you feeling traumatised, even violated. For some women, the sense of foreboding can begin beforehand, during pregnancy, with an intense fear of actually going into labour. And in the aftermath of a traumatic birth experience, you may have found that life with your new baby is more of a struggle than you had imagined. Perhaps there is a sense of being unable to feel the joy, yet afraid to voice your suffering.

First off, none of this is your fault.

We know that trauma can cause a rupture in relationships with others and a feeling of disconnection from your own sense of self (1). It makes sense therefore that birth-related trauma may increase the possibility of challenges around mother/baby bonding and attachment. It has also been linked to postnatal illness (PND). By its very nature, the distress that you feel can affect how emotionally available you might be for your baby. However, it is alternatively possible that you may be suffering from post-traumatic stress (PTS) (2).

Symptoms such as mood swings, angry or violent outbursts, unexplained crying, intrusive thoughts, nightmares and flashbacks may resolve in time with support from your family and friends. However, PTS can persist into the longer-term condition we know as post-traumatic stress disorder (PTSD).

Despite an increasing awareness of the overlap of symptoms between the two, PTSD may still initially be mistaken for PND (3). What is clear is that trauma experienced in the present time is more likely to become complex, to develop into PTSD, when a person has experienced serious trauma at a previous time in his/her life, even if he/she does not remember it now (4).

Bottom line, these issues are indelibly linked to cycles of relationships - how you relate to your partner, to your baby and how your maternity care-givers related to you, how you and your mother related to each other and so on. Where there has been rupture in early relationships, perhaps through prolonged separation or the mental ill health of a parent, the feeling of being unprotected and therefore, unsafe, can be experienced by an infant as trauma and may impact on how he/she goes forward to establish relationships in later life (5, 6). Furthermore, the lived experience of becoming a new mother or a father has the capacity to tap into unconscious memories of the circumstances surrounding your own birth and early relationships (7).

Given the intense, life changing nature of childbirth and new human interactions which are inherent to becoming a parent, when birth is traumatic it is perhaps not surprising that old relationship wounds can be triggered, leading us to feel unsafe and disconnected from ourselves. Birth trauma may be just a small part of a bigger personal history and can link back to past events that still lie buried (8). All compounded perhaps, by the cultural expectation that you ‘should’ be feeling on top of the world with your new baby.

Emotional and practical support can play a key part in helping you to recover from birth trauma. You may feel able to receive love and nurture from your family and/or you may have chosen to enlist the support of a doula (birth or postnatal companion). Yet it might also be that your pain feels just too deep and scary to face at all, which is where the counselling option may be a consideration.

Counselling offers you some quiet breathing space to begin to think and feel through the issues that are arising for you - that you may be struggling to understand or accept - with the support of a trained professional. Engaging in a therapeutic alliance where you feel safe and listened to without judgment, opens up the possibility of reintegrating previous relationship patterns that have been ruptured, with the potential for you to discover a different sense of what your trauma means to you (9). Nothing can change the past, yet the counselling process can support you towards finding a way of being with what has happened so that eventually, the feelings may seem more manageable.

The safer and more connected to yourself you feel, the more likely you are to be open to self-nurture and the capacity to nurture others, as a mother, as a father or as a partner.

REFERENCES

1. International Society for Traumatic Stress Studies. Trauma and Relationships, Public Education Pamphlets and Fact Sheets, 2001 [Online] Available from: http://www.istss.org/PublicEducationPamphlets2/3234.htm (Accessed 9th June 2014)

2. The Birth Trauma Association. Post Natal PTSD, BTA Papers, 2011 [Online] Available from: http://www.birthtraumaassociation.org.uk/publications.htm (Accessed 10th June 2014)

3. Hill, M. Confusing PND with PTSD – and why we need to listen to women with birth trauma. bestdaily.co.uk Mar 6th 2014 [Online] Available from: http://www.bestdaily.co.uk/your-life/news/a555944/confusing-pnd-with-ptsd-and-why-we-need-to-listen-to-women-with-birth-trauma.html (Accessed 10th June 2014)

4. Breslau, N., Chilcoat, H.D., Kessler, R.C. & Davis, G.C. Previous Exposure to Trauma and PTSD Effects of Subsequent Trauma: Results From the Detroit Area Survey of Trauma. American Journal of Psychiatry, 1999, Vol 156, pp.902-907 [Online] Available from: http://journals.psychiatryonline.org/article.aspx?articleid=173498 (Accessed 13th June 2014)

5. Bowlby, J. (1988) A Secure Base. London: Routledge

6. Gerhardt, S. (2004) Why Love Matters: how affection shapes a baby’s brain. London: Routledge

7. Speyrer, J.A. (2011) Maternal Birth Trauma & Post Traumatic Stress Disorder. [Online] Available from: http://www.primal-page.com/matrau.htm (Accessed 13th June 2014)

8. Dennis, S.F. & Linn, M. (2005) Healing Our Beginning. Mahwah, New Jersey: Paulist Press

9. Jacobs, M. (2006) The Presenting Past: the core of psychodynamic counselling and therapy (3rd ed.) Maidenhead, Berkshire: Open University Press