Birth Trauma : Does Nature Give a Damn?
Posted by Birthtalk.org on May 14, 2012
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 ;)