Birth Trauma : Does Nature Give a Damn?

 

In one of our most popular blogposts, titled “Childbirth – as traumatic as a mid-air QANTAS flight emergency?”, we make the following statement : “Birth can be good.  Which can be a hard thing for a woman traumatised by her birth to hear. But really, it explains one of the reasons that it hurts so much emotionally when a birth is traumatic…because IT’S NOT MEANT TO BE THAT WAY.  Nature didn’t intend it to be that way.”.  The last line of this statement has inspired a reader to comment on our blog, a comment that raises many common myths and misperceptions about birth.  And because our blog is titled, “The Truth About Traumatic Birth”, we have replied to the comment with just that…the truth.  We have chosen to share our reply here, as we believe it is important to address these myths that, when perpetuated, actually make it harder for women to gain support & understanding, which can thwart their healing.

Here is the comment, from a reader known as JR :

[You write:]“Nature didn’t intend it to be that way.” This is the danger with anthropomorphizing nature.
In “nature”, a large percentage of mothers and babies die. “Nature” doesn’t give a damn. IT DOESN’T. You know why? All that matters, for evolution, is that enough survive to continue the species. That’s all. 
Nature doesn’t care about your happiness. Nature doesn’t care about your birth trauma.
 Now, you’re mixing up two ideas in your post – one, that “bad births” are the fault of “the culture – they aren’t birth is much easier now than it ever was: and two, that women’s pain and suffering is swept under the rug and no one wants to hear about it. Well that’s true. But to act like modern ways of birth are THE reason for birth trauma is ridiculous. Birth has always been one of the most traumatic experiences in a woman’s life.  JR

JR, thanks for your comment.  You have given us the opportunity to address a few common myths about birth that abound…

Myth One – that birth is much easier now that it ever was

You say that bad births are not the fault of the culture because ‘birth is much easier now than it ever was’.  However, you are making some common assumptions. While birth is SAFER now than it ever was, this does not mean it is EASIER, nor does it mean that it is less likely to be traumatic.  You are assuming that an ‘easy’ birth could not possibly be ‘bad’.  However, you have not defined ‘easy’…

Some women would define an easy birth as a caesarean in a modern hospital with no labour.  Others would define it as a two hour pain-free vaginal birth at home.  Others still would define it as going into labour naturally, having an epidural, and birthing vaginally after 5 hours in a hospital.  But ANY of these births can be ‘bad’, depending on the woman’s experience of the birth…even though they may be considered  ‘easy’. And yes, we do hold our culture’s practices, views, expectations, and poor education around birthing as largely responsible for this.  Why? Because the key factors that can make a birth traumatic have little to do with whether the birth is considered ‘easy’ by others or not.

What are these key factors? One significant factor is the environment surrounding the birthing woman. Another is the woman’s previous exposure to birth, whether via real life or the media, and yet another factor is the quality of her antenatal education.  We would ask :  Is she scared? Is she acknowledged? Are events being explained to her? Can she ask questions? Does she have a good grasp of what ‘supported birth’ really looks like & sounds like?  Has she been victim to the misperceptions perpetuated in the media about birth? These are the factors that can take any birth from ‘good’ to ‘bad’.

Even in a worst-case scenario where a baby is born unwell or does not survive,  how the woman is treated during the birth can take a traumatic event to a new place.  A woman in this situation who has been informed, supported, and acknowledged will be traversing deep grief without the trauma of being maltreated during the experience. So yes, birth is safer now, due also to modern levels of nutrition, sanity & hygiene, and education…at least in first world countries.  But the opportunities for trauma to occur from factors that are due to poor quality of care, support & information are many.

Myth Two – that nature does not care about a woman’s happiness

You said that nature does not care about a woman’s happiness and have warned us of the ‘danger’ of anthropomorphizing nature.  Now of course, yes, we are anthropomorphizing nature…but there is no danger in it, as we are merely using this language to make the topic accessible and easy to understand.  As you said, all that matters for evolution is that enough survive to continue the species.  And it is for that reason that nature DOES support us in a happy transition to parenthood.  You say that ‘nature doesn’t give a damn’, but  if mothers are not happy and attached to their offspring, the species will not survive.   Why?  Well, for mammals at least, happy, attached mothers produce milk.  Happy, attached mothers have ‘let down’ of their milk, and happy attached babies latch onto their mother’s breast easily.  Not to mention that unhappy mothers who are not bonded to their babies struggle to care for them.  An example of this would be sheep who reject their lambs:

“Sometimes ewes reject lambs because the lamb doesn’t act normally in the minutes or hours after it’s birth… Sometimes they reject lambs who have been warmed in water because they lose their unique odor. Sometimes they reject lambs because the ewe herself is too sick to care for a baby.” (Joan Ellison, author of ‘Shepherdess: Notes from the Field’)

Similar situations occur for humans : a  human baby in a high-intervention birth acts differently in the time immediately postbirth to babies from an intervention-free birth where the baby is given skin-to-skin with the mother.  This can affect their ability to latch on for breastfeeding, and perhaps potentially does not unlock the instinctual maternal care patterns of the mother. Women often find bonding and breastfeeding difficult when their babies have been bathed prior to them receiving them, as unbeknownst to them, the smells and feelings of the gooey newborn ignite hormones within the mother that enhance her breastmilk production, milk let-down, and maternal instincts.  These hormones include prolactin and oxytocin. And it is important to know that excess adrenalin (which can be present due to fear or merely from feeling ‘watched’ during labour) INTERFERES WITH  THE OUTPUT of prolactin and oxytocin.  So that means that a traumatized mother, with racing levels of adrenalin, can struggle to breastfeed and care for her young.  That doesn’t appear helpful, in the name of evolution.  So you can see, that nature truly SUPPORTS  mothers to be happy and to be non-traumatised, purely for the continuation of our species. And some common hospital practices thwart those early attachment processes, leading to breastfeeding difficulties, bonding issues, and miserable mothers.  Now, of course, we are not sheep, and we can overcome these hurdles to instinctual attachment and feeding.  But why would this be beneficial from an evolutionary point of view?

Myth Three – that birth has always been one of the most traumatic experiences in a woman’s life

You say : “But to act like modern ways of birth are THE reason for birth trauma is ridiculous. Birth has always been one of the most traumatic experiences in a woman’s life.”.  Well, we’d have to say we disagree.  Birth has always been one of the most SIGNIFICANT events in a woman’s life.  But whether it is traumatic or not, well, that is more dependant on situations outside of the actual birthing scenario…in any time in history.  What is different in modern times, is our levels of nutrition, education, adequate shelter, and access to support services when necessary.  We have addressed this in another blogpost : “And yes, death has always shadowed birth…but you need to look at it in context.  Right now, most women in the western world are big, strong, nutritionally sound and have appropriate shelter, food and safety…  In the 1600’s, the average life expectancy was around 35, and it was, according to the British Library,  ‘an era of war, fire, plague and execution’.  The 19th Century heralded the industrial revolution and, according to one source, ‘the impact it had on the general health and life expectancy of individuals was shocking’. In the early part of the 19th century the life expectancy in most parts of Britain was that of only 20.  There were outbreaks of cholera and typhus, due to the slums, overcrowding, contaminated wells and lack of sewage system etc.  No wonder women were preparing for death alongside preparing for birth.  But our world is vastly different from those time periods, so perhaps we shouldn’t look to these eras to confirm the nature of birth in the 21st century.”

Personally, using our own births as examples, Melissa’s second and third births were not at all traumatic, and neither of Deb’s were traumatic either.  They were intense and challenging and at times difficult, but not traumatic.  We emerged from each of them with strengths and positivity and enthusiasm for birth…not to mention all those hormones we just talked about for breastfeeding and bonding.   And we are not alone. This is not a boast of our ‘birthing prowess’ either – we both are highly aware that our ability to emerge emotionally unscathed and with our mothering instincts intact from these experiences was due to excellent care, top-notch information, A-grade support, and the emotional preparation we were supported in undertaking.

JR, we hope this blogpost explains some of the issues you raised in your comment.  While birth is safer in modern times, it is no less likely to be traumatic (current stats are shocking, and report that one in three women are experiencing traumatic births).  Whilst always a significant event, birth does not need to be – and has not always been – traumatic.  And perhaps this is the most pertinent part of our reply to your comment :  birth is not designed to be traumatic, because to do so, would go against the survival of our species.  Traumatic birth carries with it behaviours and responses that are not akin to supporting a newborn’s survival.  Doesn’t sound very evolutionary to us.  And nature wouldn’t like it  ;)

Kirsten meets newborn Akir in a wonderful empowered birth. She and her baby have the full compliment of hormones after such a birth, and both are keyed up to breastfeed and love each other up and continue the survival of our species

 

 

 

 

 

 

 

 

 

 

 

©Birthtalk.org 2012

<a href=”http://www.hypersmash.com”>www.hypersmash.com</a&gt;

 

16 comments

  1. As a woman of 2 traumatic births, thank you explaining why people/nature/society should care about mothers.

  2. Bazile · · Reply

    This is an awesome article, and I think (or maybe it’s just hope) that many people will find it and discover that birth doesn’t have to be the some sort of horrible event. Unfortunately I don’t think you’re going to change JR’s mind, since best I can tell s/he’s a troll who goes around advocating a highly medicalized managed version of birth. For example (scroll to the bottom): http://myobsaidwhat.com/2012/03/06/were-not-going-to-be-having-one-of-those-midwife-style-inductions-that-last-for-several-days/

  3. Jane Every · · Reply

    Dear JR,
    I’m wondering if you know what the actual definition of trauma is. You are fortunate to have had no trauma or PTSD in your world, and I don’t mean just births. I envy your innocence. Well answered Melissa and Deb. Love to all, you too JR.
    Jane

  4. I don’t believe that birth has ALWAYS been traumatic either. Yes, it has always been uncertain but not traumatic. Trauma is in the eye of the beholder after all. And how many times have I heard the phrases: “women give birth all the time and they don’t all find it traumatic” or “I’ve had an emergency sections and I wasn’t traumatised” and even better “At least your baby is here, and healthy…” For what it’s worth, I’ve had 2 emergency sections and it was the 2nd one that left me traumatised. The difference was the lack of support, lack of communication and lack of care. I’ve since had another baby and her birth was truly wonderful. It was NOT traumatic.
    I also don’t think you will change JR’s mind, but thank you so much for this article.
    XxX

  5. Nature does not provide a 100% guarantee that we’ll be safe and happy, because nature is full of variables and we aren’t the only thing in it. Nevertheless, human bodies are *engineered to give birth successfully and with a sense of well-being*, and this is exactly what will happen under the right environmental conditions. In comparison, modern maternity medical practice not only does not provide a 100% guarantee that we’ll be safe and happy with its treatment, but it is a factory-style industry prioritizing profit and practice based on efficiency and what juries will believe (rather than evidence-based practice,) which is *not an environment conducive to safety and well-being*.

    All four of my births were painful and hard. Yet the only one that was traumatic was the (unnecessarily) medicalized/managed one. That was not a coincidence.

  6. What an awesome post! And I couldn’t agree more with all the wonderful previous comments.

    I really love lotus birth and lotus birthed my second baby. A lot of my critics responded by reminding me that animals chew off the placenta (which not all of them do, but that’s another debate for another time). My response was always: So what? I’m an adult human being, not a dog in a field. A lot of animals also eat their offspring’s feces, but I’m going to go with nappies if that’s quite all right with you. Just because something happens “in nature”, or to animals who live in nature, doesn’t mean we are contractually obligated to limit ourselves to those experiences – our ability and desire to achieve an emotionally fulfilling experience is part of what makes us human. And you know what? The people who trot out the “but in nature” argument don’t believe it either, they just think it makes them sound good. After all, “in nature” human beings squat to poo, but I’m pretty sure the “in nature” critics, including JR, all own plumbed-in sitting toilets.

  7. Lucie · · Reply

    I found my second and third birth the most exhilarating, empowering, hormonal buzz of my whole life, I wish I could ride that high again and again! Fantastic blog post, thank you Melissa and Deb.

  8. My second birth was physically the most complicated, the most painful and did not go to plan, however I felt so well supported and informed it was the best of my 3 birth experiences. Trauma is definately wrapped up in how your treated by those caring for you and the information your’e provided!!! When I describe this birth to others they assume it was traumatic because of what physically happened, but my experience was the opposite because of fantastic support people, staff and information. When I describe my first traumatic birth to others they don’t understand why my experience of it was so bad, until I describe the way my husband and I were treated by the staff, and how unsupported I felt

  9. If birth was generally traumatic by nature, there’s no way people would procreate so much through the ages.

  10. Bonnie · · Reply

    Many times I’ve been told either directly or via insinuation, that I am some how ‘making up’ the intense and confused feelings that I still hold around birth after suffering difficult birth experiences. The real sentiment is usually that ‘women should not complain about the hospital care which saves their lives and and ensures their baby’s survival, if you do complain – you obviously are seeking attention and special treatment for something that really wasn’t that bad’. In my case, my babies and I survived in spite of the health care we received!
    Wake up JR, its not the 1950’s anymore. Women give birth. Sometimes its traumatic. We don’t have to just get on with it and swallow a heap of prozac. We can share it, make sure others don’t go through the same. Or just be there for each other. We can cry and we can say- ‘actually that really sucked’. Women’s liberation means that modern women’s emotional experience of life is allowed to be expressed, by them – as individuals. We’re not just baby machines – we matter.
    Its time JR to stop repeating what your father says, and start thinking (and feeling) for yourself!

  11. Gretchen · · Reply

    Neither of my births (both at home) were traumatic, and that includes my first which was 48 hours of active labor and over 4 hours of pushing. On the contrary, they both in their own way were absolutely beautiful, and I get emotional thinking about both. Birth is meant to be a beautiful and significant event in a woman’s life, not a trauma. Yes, it’s hard work, but if nature intended for it to be traumatic, how many women do you know would have more than one child?????

  12. Birth definitely does not have to be traumatic. I found it a very empowering and beautiful experience.

  13. Wonderful article! Thank you so much! While JR has raised issues, you have answered them beautifully. My first birth was 36 hours, three of those pushing. But you know what, I was in my own home, surrounded by people I loved and it was amazing. Second birth was awe-inspiring, again, in my own home with my body taking over. 7 hours of labour and in 3 pushes – not from me, but my body – she was out. This time round I was hoping for another home birth – but have been amazingly blessed with triplets! I have done my research and will (hopefully) birthing them vaginally, with an amazing OB who trusts my body as much as I do. I am sooooooo excited to birth again. Traumatic – hell no!

  14. I think this video on YouTube explains why birth hasn’t been safe.

    It’s an elephant giving birth and her baby is born still, rather than rushing in the staff trust nature, the mum kicks him around and pulls his trunk until he responds. I’m not saying we should do that with human babies but ever since men got involved in birth nature was moved out, we don’t follow our instincts, we don’t leave women alone long enough to follow their instincts. When birth was done by midwives less women died than when later on men got involved. What was the biggest cause of maternal death? Doctors not washing their hands after doing a post mortem (gross!)

  15. I earned my MA in history with a specialization in Renaissance women’s history, three years before I became a doula. I love this blog post and I’d like to add just a few quick facts to help bring the historical issues into perspective. Yes, people were surrounded by death of all sorts into the mid-20th century, and this affected childbearing women in particular ways as well. Before the discovery and dissemination of antibiotics, it’s estimated that 30-50% of maternal deaths were due to mastitis–yes, mastitis, which we now see as little more than a painful inconvenience, was actually deadly as recently as 100 years ago. Another radical change came when “men-midwives” started attending births–in the 17th century. There were no training programs for the first men-midwives, no licensing requirements as there were for female midwives. Without the generations of acquired womens’ wisdom about how to resolve such complications as breech presentation, posterior presentation, and shoulder Dystocia, much less the minor issues like the importance of washing hands and instruments, men-midwives caused so much pain, suffering, and death that most medical doctors of the time supported their wives in employing experienced female midwives for their own births. Yes, birth has been attended by complications and traumas throughout history, but not for the reasons we often think.

  16. My two births were the most transformational and wonderful experiences of my life where I connected with the powerful essence of myself. This experience was due to preparation, mind set and the care I received before and during the birth using hypnobirthing which prepared my body mind and soul. I feel We become true Goddess’s during the whole pregnancy and birth. We are gifted with the experience of being able to give birth and it can be the most magical life changing experience and doesn’t have to be painful or traumatic. We are so lucky now with all the resources and help available to us.

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