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Getting a voice when there’s a lot of noise around.

14 July, 2019

Every day, every week and every month of the year seem to be designated days, weeks and months recognizing associations, health messages and groups so that their special theme can be imparted, spruiked and disseminated. This past week – 7th to the 14th July – has been the week designated to NAIDOC Week and Birth Trauma Week.

The ABC has done a brilliant job this week bringing Aboriginal issues to the front of our attention with wonderful discussions on shows like The Drum, Q&A and Radio National and reporting on indigenous topics nightly on the news. But the pressure to be heard in these “weeks” is tricky because there are so many of them and people can be prone to switching off from issues…. because basically they are just trying to exist, to survive, to pay the bills – just to get through each day, so listening to each message can almost become tedious.

A new designated week that was just launched last year is Birth Trauma Week. Birth Trauma Week recognizes the injuries women have sustained either physically or psychologically through childbirth regardless of the mode of delivery.

The Australasian Birth Trauma Association (ABTA) is an Australian not-for-profit organisation established in 2016 to support women and their families suffering from psychological and/or physical trauma from a difficult birth experience. Trauma means a wound, serious injury or damage but this damage can be physical or psychological (which can be deeply disturbing and distressing).(1)

The delivery of a baby can be a positive experience for many women, but for some it can be very negative experience, resulting in physical and/or psychological injuries (trauma). The psychological trauma may be the result of an extreme disconnect between a woman’s expectations of what would happen and the shock of what actually occurred. It may also relate to feelings of loss of control and a sense of not having a ‘voice’ in the face of authority, and unexplained interventions during the labour, as well as any physical damage that resulted. It is important to note that some women may have severe emotional distress after a traumatic birth, even though they did not have physical birth injuries. (1)

Amy Dawes (with her beautiful baby) who founded ABTA in 2016 with Prof H Peter Dietz

ABTA was established as a charity by Amy Dawes and Professor H Peter Dietz in 2016. Amy is a mother who suffered her own traumatic birth and is very open about the journey she has been on. You can read more about her story in this blog that I wrote a couple of years ago. There is a Governance Board for ABTA which overviews the organisation and they are running their first conference called Uniting Professionals in Birth Trauma Care this August (if you would like to attend this is the link to the conference details).

Amy’s dream of establishing this group revolved around ABTA being able to offer support to those who are affected by their childbirth experience. They aren’t trained clinicians or counselors, they are mothers who wish to help others and the members of the Facebook group include women, who have experienced mental health disorders, birth injuries such as a perineal tear or pelvic organ prolapse, industry representatives, and healthcare professionals such as pelvic health physiotherapists.

If you are having trouble recovering from your birth experience or adjusting to life with your birthing injuries, the Peer2Peer mentoring group that ABTA has may be a helpful support for you. The girls who have turned to ABTA for support often say: ‘You are not alone’. ABTA is there to offer support and advice to anyone who needs help coming to terms with a traumatic birth experience. This group is a safe space to ask questions without fear of judgment. (They do recommend that you talk to your GP, midwife or health visitor about how you feel).

Part of the problem about recovering from a traumatic birth is the assumption that if at the end, there is a healthy baby and a healthy mother (ie she is alive regardless of how battered or bruised she may be) then it’s been a good outcome. This is something like saying – If your plane gets hijacked on the way from London to Paris and it takes 15 hours of extreme anxiety and fear with a man who has a threatening weapon in his hand and you don’t know whether you are going to live or die, but you ultimately get to Paris safely…… then you have to completely disregard the things that happened on the plane and get on with life – no de-briefing, no psychological counselling for recovering and no understanding of your ordeal from friends or relatives.

But of course that wouldn’t happen.

Everyone would expect there would be time and counselling offered to each and every passenger and the world would be entirely sympathetic to what the travelers had just experienced.

And yet with childbirth it is different. There is an expectation that women demonstrate bravado and just get on with life as quickly as possible because hey – they are alive and baby is alive. But the women are in shock, they feel damaged (and in many cases they are very physically damaged, but somehow have to get on with looking after their new baby when they can barely sit, stand or walk!) It’s truly a wonder that recognition of birth trauma has taken so long to emerge as an issue. Birth trauma truly does impact on women and discounting it because for millennia women have just soldiered on, is disrespectful to women.

Awareness of birth trauma varies enormously with partners and extended family, health professionals and the general public often not getting it. The mother herself often can’t understand what she’s experiencing and when she goes to mother’s group or other friend’s places where there are women describing their happy birth outcomes and are already returning to the gym to exercise, it is often impossible for them to cope with these stories of joy and happiness.

Women can be very debilitated for month and even years if they do not address their feelings and thoughts, as well as getting appropriate post-natal assessment and treatment for their pelvic floor injuries from a pelvic health physiotherapist. What women have found from ABTA is common ground. Women with stories like theirs. They have found a support network and a non-judgmental shoulder to cry on.

But what is most important from this new Birth Trauma Week every July is the fact that the wider community may learn about the devastating consequences of a traumatic birth and be more understanding of why a woman or a family may be responding differently to societal expectations after the birth of their child and be more understanding and supportive of their needs and wants. Importantly health professionals will recognize the importance of referring the woman to the appropriate health provider – whether it be the pelvic health physio for complete assessment and treatment of her pelvic floor post-natally or the psychologist or psychiatrist to deal with the emotional and psychological impact of her birth story.

If you have pelvic health issues please seek help from your nearest pelvic health physiotherapist (google The Australian Physiotherapy Association Find a Physio) and they could then help you find a psychologist if you also need help with PTSD or PND. I have also included a chapter on Traumatic Childbirth in the new edition (Edition 3) of my book Pelvic Floor Essentials and post-partum recovery strategies are also covered extensively.

And finally on the last day of Birth Trauma Week and NAIDOC Week, I hope that we all take a moment to recognize that, whether you care about these two issues or not, there are some people who have enormous interest and invested their heart and soul into these topics and deserve our respect and goodwill. There are a lot of mothers out there who have suffered as a result of their births and there are many Indigenous Australians who deserve to have recognition within our Australian Constitution.

(1) https://www.birthtrauma.org.au/about-us/

 

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