Friday, June 05, 2009

The Year of Birth Trauma....

Been sitting on this blog for a while because of the inevitable flack it is likely to attract... Though, perhaps not, perhaps it will be so ridiculous people won't bother to waste their time commenting ;)....

Anyway, one particular parenting forum in Australia has dubbed 2009 the "Year of Birth Trauma".

I believe in birth trauma, I believe it is more than just physical trauma, I believe it can be emotional and psychological. I believe it is not widely recognise, and is often dismissed as simply post natal depression, wild post birth hormones, or even "too high expectations"...

I believe because it isn't widely recognised it isn't properly treated and definitely not properly prevented.

There is something else I believe that might not sit well with some people.

I believe that it puts BABIES in danger, real life, not just "one of the sad facts of life" life-threatening danger.

I once heard a woman say she would rather have a dead baby than another baby born in hospital, all because of her birth trauma. She said this in the context of discussing what to do in the event of premature labour (before 35 weeks) when a midwife would usually refuse to attend the birth at home. The women discussing this were all very strong advocates of homebirth over hospital, and all things being even, I would be right there with them hoping all women saw the benefits of having your baby at home...

In this discussion it was widely agreed that a 33 week baby would have a fairly good chance of surviving, albeit with little ability to self regulate temperature and probably a weak suck, but with plenty of kangaroo care the baby would likely be ok.

When that question was put out about a 28 weeks gestated baby, the "better dead than hospitalised with tubes etc." point of view was put forth. If the baby only had a precarious grasp on life, then shouldn't that baby live their short life in the loving arms of their parents, rather than isolated from human touch and subjected to painful procedures, which, even if the child survived, the child would be forever deeply traumatised by...

Part of me wants to embrace this argument, but then I wonder, could it be that this argument better serves the traumatised mother who can't face entering a hospital again, than the baby who's life is at threat.

How many mothers will be more strongly motivated by their birth trauma to avoid a hospital at ANY cost, than to access medical assistance for themself or their baby.?

Atm, the "death is just another part of life" argument is circulating as an explanation for not needing to access medical assistance except to register the death of a child, and yet, that argument seems to go against the survival instinct that has propelled humans to dominance on this planet (whether or not that is a "good" thing)...

I can't help but wonder if this loss of survival instinct isn't the most obvious symptom of Post Traumatic Stress Disorder we have!


Joy Johnston said...

Sif I think it's good that you have written about birth trauma. It seems to me that people who think would prefer for a premature baby to die rather than go to hospital are horribly mistaken. Life is not black and white - life/death. There are lots of grey areas in between, and the baby born prematurely is at risk of morbidity - brain damage, developmental delay, ... that could be prevented by better care.
I'm not arguing that everything done in neonatal nurseries is humane, or could not be improved.
Birthing under your own power, without medical interventions or drugs, makes sense if we can separate out the wellness from illness. When illness complicates the natural process (whether it's a chest infection or heart failure or a premature baby) the mother and baby are both likely to be better off with appropriate medical support that addresses the illness, but enables health promotion at the same time. The decision to go to hospital when certain complications are present is as simple as going to the dentist when you have a tooth that hurts.

Sif Dal said...

I think the part that concerns me is that women, in their own trauma - and with that fear of the system that caused the trauma - stop thinking about the needs and rights of their babies.

Yes, most invasive hospital procedures will affect the child's bonding with the parent, but this is not irreperable, though I have read several accounts of women not feeling bonded to their babies even years after the traumatic birth experience.

My own birth, though not premature, included a high forceps assistance which left bruising for several weeks after my birth. Worse than this, I was seperated physically from my mother for 4 days (during which time she didn't see or hold me).

I think this impacted very negatively on our bonding for a couple of decades, but eventually we were able to work through it all.

For my part, I'm glad she didn't decide to have me at home at 43 weeks. I can't say categorically that I would have died, though it was a very long labour during which I was stated to have died three times, and once born it was discover that I had a very short umbilical cord - yet, I think my placenta was intact as mum doesn't remember haemorrhaging or anything like that.

Fear can motivate people to decide that ANYTHING, even death is preferable to the potentiality of further trauma, but do women have the right to choose avoiding trauma to themselves over preserving their babies lives?

Do the woman have the right to decide that their child would rather die than have life preserving invasive treatments?

Is this any different to parents deciding that it's better to cut their daughters or sons than to leave them intact and let them face ostracisation from their community. In that case their fear of ostracisation is greater than their fear of cutting their child.

PTSD is fear. Women who claim to have PTSD cannot claim to have no fear of hospitals. So their fear is what stops them for accessing birth assistance in situations where safety is compromised.

Joy Johnston said...

Sif the problem with complicated births is that you don't get to control or choose your complications. So when you ask "Does the woman have the right to decide that their child would rather die than have life preserving invasive treatments?" the simple answer is usually no.
The complication may also affect the woman herself, as happens when obstructed labour occurs. For example, obstetric fistulae that we rarely see in Australia, but are much more common in developing countries such as African nations where emergency obstetric care is not readily accessible. Surely that would be far more traumatic in most instances than the alternative?

Jayne said...

Interesting post. I definitely am a woman who has suffered birth trauma with both my labours and births, the first one being a long, hard, painful 5 day spurious posterior labour, the second being an extremely painful posterior presentation & induction following a month of pre labour... On each birth anniversary I re-live my labours-as you probably noticed with all my twitter/FB updates Sif LOL! I truly understand the very real nature of birth trauma, because I experienced it, and continue to experience it on each birth oldest child is now 8 and it hasn't gone away! I consider that week of pre labour to be one of utter hell-which saddens me because it should have been a joyful time. likewise the trauma of a hard painful medicated birth and severe PPH which I experienced following my second birth continues to haunt me (thanks to you and others at least I was supported during that one though!) The people who say the only necessary outcome are a healthy mother and baby are very sadly deluded. The continuing psychological repercussions mothers may experience can be very debilitating.

BUT-I do NOT and can NOT EVER understand how anyone could wish for a dead baby before submitting to medical intervention. Anyone who thinks this is sick, and needs help. The amount of trauma I am experiencing due to births which were over medicated and in the first case, under supported have NOTHING on the trauma I'd feel if I lost a baby. I am feeling very emotional even writing this-how anyone could think a dead baby is a better outcome than a live, healthy baby assisted by medical intervention is beyond me. Utterly gobsmacking idiocy at work there. it makes me angry as all hell.

Good Job!