Birth trauma research is really important right now. You don’t have to travel very far around the world of birth information these days to encounter discussions of ‘birth trauma’. It is clear from a number of sources that traumatic birth experiences (which are experienced differently from person to person, of course) can significantly affect a mother’s experiences, well being and mental health. This was the starting point taken by researchers from the UK, in a paper that I recently shared in my Birth Information Update.
The researchers undertook a qualitative study in which they interviewed ten mothers, aiming to “explore maternal self-perceptions of bonding with their infants and parenting experiences following birth trauma.” (Molloy et al 2020).
I won’t lie about the fact that reading some of these women’s words is harrowing. But this kind of honesty is what we seek in qualitative research. These women’s words remind us that trauma is complex. People experience things differently. There is much talk from some areas of the kind of trauma that derives from intervention or the words and actions of professionals, and that is certainly confirmed in this paper. But in talking about the sources of their feelings, the women also reference being upset by information from outside sources (childbirth education being one example), by their expectations of themselves, by societal pressure. It’s important not to focus only on one area when sources of trauma are multiple, and also individual.
If you’ve heard me speak, either live or online, you might know that one of the things I refer to often is the way that our current approach to maternity care has served to undermine woman’s own knowledge. When we insist that pregnancy length is fixed and not fluid, when we force women to follow due dates defined by machines and not their own bodies, when we constantly prioritise medical definitions over women’s own instincts, we undermine a vital source of information and a well of trust.
Sadly, this has been further confirmed by this study. “Women saw the start of their parenting journey as contributing to this emotional disconnect from their infants where their self-knowledge and understanding of their own bodies was dismissed by professionals, which in turn led to them doubting further decision making and knowledge about parenting. They began to mistrust their own instincts. They also felt they couldn’t talk about what they really felt for fear of being branded ‘bad mothers’ or having children removed.” (Molloy et al 2020).
I doubt that the results of the study will surprise you greatly:
“Women who experienced birth trauma often described disconnection to their infants and lacking confidence in their parental decision making. Many perceived themselves as being ‘not good enough’ mothers. For some women the trauma resulted in memory gaps of the immediate post-partum period which they found distressing, or physical recovery was so overwhelming that it impacted their capabilities to parent the way they had imagined they would. Some women developed health anxiety which resulted in an isolating experience of early parenthood.” (Molloy et al 2020).
And the authors conclude that, “Women who have suffered birth trauma may be at risk of increased fear and anxiety around their child’s health and their parenting abilities. Some women may experience this as feeling a lower emotional attachment to their infant. Women who experience birth trauma should be offered support during early parenting. Mother-Infant relationships often improve after the first year.” (Molloy et al 2020).
Limitations? As Molloy et al (2020) acknowledge, the study population were self-selected. All but one of the women described herself as ‘White British’, and the other as ‘Eastern European’. The researchers also acknowledge this, and the fact that this is a rather specific group. That’s especially important when one considers the experiences of Black and Brown women in maternity care and how badly we need to work out how to improve their experiences and outcomes. The authors note a plan to undertake further work to include more diverse populations.
The authors do express a bit of hope in their summary. “Other than anecdotally, little is understood or known about a mother’s experience of parenting through PNMH illness. Exploring mothers’ perceptions of their parenting experiences and capabilities may inform the development of services which are there to support parents with PMNH illnesses, and early parenting. This also goes some way to explore the link for women between their birth experience and how they feel able to parent. Those women who struggled to develop a relationship found that this improved over time. This may also give hope to mothers who are struggling with their parenting relationships.”
We can only hope that work like this will help make a difference to those experiencing birth trauma.
This was a ‘study of the month’ in my Birth Information Update, a monthly newsletter in which I share up-to-date birth-related research and thinking. If you’d like to hear about new research, make sure you’re subscribed to our free newsletter list, which means you’ll get Sara’s monthly Birth Information Update and details of our current projects.
And if you’re a midwife or other birth worker who enjoys unpacking research, seeing what’s behind the headlines and sharing wisdom with like-minded others, come and join Sara and colleagues from all over the world in one of our online courses!
Molloy E, Biggerstaff DL, Sidebotham P (2020). A phenomenological exploration of parenting after birth trauma: Mothers perceptions of the first year. Women and Birth. In press. https://doi.org/10.1016/j.wombi.2020.03.004