“After a traumatic experience, the human system of self-preservation seems to go onto permanent alert, as if the danger might return at any moment.” Judith Herman
Trauma-informed clinicians know that EMDR (Eye Movement Desensitization and Reprocessing) works for clients in the aftermath of single incident and complex trauma. For women who have given birth and endured what they perceive to be a traumatic experience (emergency C-Section, stillbirth, complications resulting in adverse outcomes for either mother or baby, baby in NICU, long labor, induction of labor, insensitive medical staff), EMDR is no exception in terms of being a helpful modality for trauma recovery.
Birth trauma is a unique experience that acquires the term “traumatic” through the lens of the survivor. What may be traumatic for one person may not be for another. The experience of trauma for a woman giving birth is exceptionally personal and subjective given the vulnerability of the patient and the intersection of potentially perceived lack of medical or emotional support.
Trauma researcher and author of the seminal work, Birth Trauma: In the Eye of the Beholder (2004), Cheryl Tatano Beck states that a woman can perceive a birth to be traumatic through her own perception of being stripped of her dignity (interview with Walker Karaa Ladd, 2014). In other words, there could be no potential medical danger to mother or baby, but because the woman has experienced the recounted event(s) as traumatic, it is defined as such. Medical practitioners may view a routine episiotomy or an extended induction as uncomplicated, but to the mother experiencing the procedure on a visceral level, such a bodily invasion can be received as a profound violation, rendering the mother as powerless, alone, and helpless.
For a subset of 9% of childbearing women, these patients develop Postpartum Post-Traumatic Stress Disorder (PSI, 2018). As mentioned above, the traumatic incident could include medical emergencies such as prolapsed cord, emergency C-section, pregnancy complication (pre-eclampsia, gestational diabetes), forceps/vacuum extraction delivery, postpartum hemorrhage, baby in NICU, among others (PSI, 2018). A woman who has experienced sexual abuse is also at a higher risk of perceiving childbirth as traumatic due to potential flashbacks of physical rape and violation. As well, women can experience a safe and healthy delivery but perceive the experience to be absent of emotional support and replete with poor communication from medical staff, which in turn can generate legitimate birth trauma. It is the woman’s perception of the experience that dictates whether or not she has experienced birth trauma from a psychological standpoint.
Symptoms of Postpartum Post-Traumatic Stress Disorder include: intrusive re-experiencing of the event, flashbacks, heightened sense of awareness coupled with hypervigilance, avoidance of stimuli associated with event (i.e. mom cannot return to hospital for follow-up appointment because of psychological connection with trauma), increased arousal (startle response, insomnia, hypervigilance, irritability), anxiety and panic attacks, and in some circumstances, dissociation (PSI, 2018). The good news is that Postpartum Post-Traumatic Stress Disorder is treatable. With qualified clinical care, a woman will recover. The key ingredient to a swift recovery is getting help right away and understanding that the symptoms of Postpartum PTSD are temporary when treated.
Use of EMDR for Birth Trauma: As a clinician working with the adult population, I do practice EMDR with survivors of birth trauma, including for the partners who may have witnessed a perceived traumatic event. I find that helping the client to restore a sense of self efficacy and agency, reclaiming their sense of personal power, safety and liberating oneself from any self blame or shame from the experience goes a long way in releasing trauma. The three-pronged brain-wise protocol developed by Francine Shapiro (1998) is incredibly helpful in lowering the physiological “held” charge of the trauma (Levine, 2010).
As clinicians and medical practitioners, we have a duty and obligation to partner with a mother delivering her baby in the most empathic, supportive manner possible. Further training for Ob/Gyn personnel should be essential in medical programs, taking into consideration the psychological wellness of mothers giving birth to the next generation of people on this planet. A woman’s subjective experience of child-bearing needs to be taken into consideration and not dismissed. Labor doulas are a key component of bridging a team approach to helping women have a voice while they labor and deliver their babies. In addition, clinicians can help new mothers to heal birth trauma through trauma-informed modalities such as EMDR.
Postpartum Support International- postpartum.net
Solace for Mothers – solaceformothers.org
Prevention and Treatment of Traumatic Childbirth (PATTch) -pattch.org
Traumatic Childbirth (2013) by Cheryl Tatano Beck and Jeanne Watson Driscoll
Retrieved from February 14, 2018: https://www.ncbi.nlm.nih.gov/pubmed/26563636
Retrieved from February 14, 2018: https://journals.lww.com/nursingresearchonline/Abstract/2004/01000/Birth_Trauma__In_the_Eye_of_the_Beholder.5.aspx
Retrieved from February 14, 1018: https://www.scienceandsensibility.org/blog/book-review-traumatic-childbirth-and-an-interview-with-the-author—cheryl-beckWa
Retrieved from: http://www.postpartum.net/learn-more/postpartum-post-traumatic-stress-disorder/
Levine, Peter (2010). In an unspoken voice: how the body releases trauma and restores goodness, North Atlantic Books.