Silver Birch: What happens when birth does not go as planned

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It is normal to feel how you do.

There are many stories, thoughts and feelings that exist around birth. For some birth can be a beautiful, powerful, and joyful experience.

For others it can be long, intense, and frightening. Some say birth is “the happiest day of your life” and we hear stories about how we should feel during and after birth.

For many, this is a myth, and some are left feeling scared, harmed, and alone. They may then feel like they need to ‘play down’ their feelings to fit in.

Have you heard people say, “Oh but it was all worth it”? Not everyone feels this way. Birth can cause harm that impacts on your identity, parenting, and relationships.

This leaflet aims to support you if you have not experienced your birth in the way you hoped to. It is ‘okay’ if you are struggling, you can heal from this. You are not alone in your journey.

If birth has not been what you had hoped, then you may be feeling:

Sad
Angry
Alone
In pain
Silenced
Dismissed
As if you didn’t ‘do well’.

It is normal to feel these emotions after a birth, particularly if it has not gone as planned.

Your response

How you experience your birth is unique to you.

It doesn’t matter whether your birth plan was followed, whether there were medical complications, or whether you had a vaginal delivery or caesarean section. What matters is how you feel about your birth.

Family and friends will have their own feelings about your story, but what really matters is how you feel and how it has affected you. Birth is a very personal and vulnerable time for a person. It can change you - both in a positive and a negative way.

Some people will experience something called trauma responses from their birth experience in the weeks, or months following the birth.

Trauma responses look different for different people but can include:

Flashbacks
Unwanted images or memories from the birth
Nightmares about the birth
Feeling on edge, irritable, and easily startled
Avoiding any memories of the birth
Changes to your mood
Having difficulties getting to sleep.

Your mind

As humans, we have the most amazing brains that are constantly taking in information through our different senses:

Sight
Sound
Touch
Smell
Taste

Our brain takes this information and stores it into memory using different brain areas. We know that trauma memories are processed differently to our normal, everyday memories.

When something really frightening happens to us or we experience trauma, our brains are unable to fully process information in the way that is usually does. Our ‘threat’ part of the brain (amygdala) may take over and shut down our problem solving processes so that our memories do not get processed in the usual way.

This means that trauma memories are often vivid and not in order and can come into our minds when we don’t want or expect them (also known as flashbacks).

Because these memories are linked to the amygdala, you may find that when you have a memory of the trauma, your threat part of the brain, your brain thinks you are in danger again and your body goes into fight-flight-freeze mode.

When a flashback or nightmare happens, there are ways that we can tell ourselves that we are not back in the trauma and that we are safe.

These are called grounding and soothing techniques.

5 4 3 2 1 Technique

This technique can be used anytime, anywhere to help you to feel calmer and more present.

What’s around you?

5 things you can see
4 things you can hear
3 things you can touch
2 things you can smell
1 thing you can taste

Say them out loud if this helps.

Physical Grounding

If things feel difficult or you are remembering something that has happened that was very distressing, this can feel overwhelming in your body, and you may lose a sense of where your body’s boundaries are. It may help to reconnect with your body to help you to feel more stable and grounded.

Notice your feet on the floor. Wiggle your toes. Feel the ground beneath you and press your feet into the floor. If you are sitting, feel your body supported by the chair beneath you.
Press your fingertips together in front of you. Press your hands against each other. Feel the strength pushing through your fingers and hands.
Roll your shoulders back a few times, releasing any tension in your neck, shoulders and upper body. Gently move your upper body, stretch and release. Extend your fingers, or arms as far as you can. Gently roll your head.
Touch the chair you are sitting on. Notice the texture. Or clench and release fists.
Jump up and down. Walk slowly and notice each footstep.
Bring your attention back to your body, noticing any differences in how you feel in your body.

Soothing Rhythm Breathing

Breathing in a controlled way can help us to calm our fight-flight-freeze response and activate parts of our brain that can help us to feel safe and relaxed.

Follow the link below to access a short breathing exercise which will help to calm you before your appointment.

Compassionate mind rhythm breathing playlist Soundcloud

Further help

If you feel that your birth did not go as you had hoped, and you feel that you need to heal from your experiences, there are a range of things that can help.

Understanding what has happened to you through a debrief or birth reflections session may support you in making sense of some aspects of your birth. Speak to your midwife or health visitor if you would like to request a debrief.

Understanding what your options are: This includes options around debriefs, treatment for mental health difficulties, and making complaints. Speak to your midwife or health visitor about options if you feel able to. Otherwise, there are websites listed at the end of this leaflet that can help you understand your options.

Understanding what birth trauma is, and how it affects people may also help you to make sense of what that means for you. At the end of this leaflet there is a list of websites and services that provide more information on birth trauma.

Grounding techniques can help to manage some of the trauma responses that you may be feeling. Grounding helps to bring us back to the present moment and reminds us that we are safe and that we are not back in the birth or the traumatic experience. The key is to keep practicing these techniques.

You may feel that you want to make a complaint about the care that you received during the birth, and you are entitled to do that. Contact the Patient Advice and Liaison Service (PALS) in your local hospital to explore ways to make a complaint.

You may feel that you need some help for the way that you are feeling. You can speak to your midwife or GP about mental health options to support you through this difficult time. You may be worried about asking for help due to worries about what might happen or what people may think. It is ok to ask for help and many people do need some help to make sense of the difficult things they have been through. You are not alone.