The perinatal period generally means anything during pregnancy and up to a year after birth. It covers pregnancy, birth, infant feeding and the early postpartum days and weeks with your baby. Perinatal trauma is anything traumatic that you associate with these events. It could be pregnancy complications like hyperemesis, premature birth and NICU stays, birth trauma, birth injury, breastfeeding trauma, miscarriage, still birth and baby death.
The experience of trauma is really personal. Events can be experienced as traumatic whether it’s happening to you directly or whether you’re observing it. For something to be traumatic, you believe that you or someone very close to you (for example your baby or your partner) is in imminent danger of serious harm or death. It doesn't matter if this is an objective fact. It’s all about how you perceive it.
No one can know if you are traumatised by an event just by hearing the nuts and bolts of what happened. Trauma is all about how you felt at the time, how stressed your nervous system was and whether you had the opportunity to stand it down fully after the event ended and you knew you were safe again. Loads of different elements can play into whether you or I experience something as traumatic; the same event could happen to different people and one person may experience it as traumatic when the other doesn’t. This can be problematic when you turn it on yourself and feel that your trauma wasn’t bad enough, it happened to so-and-so and they are fine, and you feel shame for not being able to let it go and move on.
Trauma is like a psychological injury, rather than an illness. It’s a specific response your mind and body has to something awful that happened to you. It is not a flaw or a weakness. It’s your mind doing its best to keep you safe, so that the same thing never ever happens again.
How can trauma show up in day to day life?
Trauma can show up in many, many different ways. It can look like uncontrolled flashbacks or nightmares about the event.
It can be avoiding people or places that remind you of the event.
It can be feeling irritable, short tempered and distant from loved ones.
It can stop you from wanting to go through another pregnancy and birth, even if you’d like more children.
It can be feeling let down by your partner to the point you can’t stand them touching you - or being in the same room as you.
It can be feeling ashamed that you didn’t stand up for yourself, froze, became super compliant with things in a way you didn’t think that you would.
It can be feeling triggered hearing other people’s stories or news items in the media.
Feeling this way is totally understandable from a nervous system point of view. When we feel threatened - whether that threat is real or perceived - our nervous system responds to preserve our life. A cocktail of hormones is released that prepares us for Fight or Flight - fighting off and aggressor or fleeing to remove ourselves from the situation. A less widely talked about response is the Freeze response. This is damage limitation mode, when we shut down, maybe to the point of dissociating, become super compliant with those in power around us and just get through it. When you’re in a situation where you’re having a baby, or having a medical procedure, the freeze response is usually the one that happens as we know we can’t fight or run away. But this behaviour can be really confusing and unsettling when it’s not how you see yourself in day to day life.
You don't have to feel this way forever
However understandable these feelings are, you do not have to be stuck with them forever.
You do not have to be defined by them.
There are ways to detach the strong negative emotions from the event that lead to you to being retriggered, feeling as if you are Right Back There.
Working on this does not reduce or minimise what happened to you - you’ll still remember everything but it will be a part of your past, not controlling your present and therefore directing your future. By removing the strong emotional link, you can make decisions based on what you really truly want, put things in place to nurture and heal yourself, build resilience and emerge into the life that you want to be living.
If you'd like to hear about how I may be able to help with this, please get get in touch.
Physiological birth is unpredictable. No matter where someone sits on the spectrum between birth being a natural, normal part of life and something that is inherently dangerous and needs to be monitored and managed closely, most people will concede that you cannot wholly predict how it will unfold.
People's opinions (on anything and everything) stem from a combination of their education, beliefs, wider worldview and own lived experience. Unless you make a conscious effort to see things from other people's points of view and to acknowledge that what might be right for you won't necessarily be right for someone else, it can lead to very heated discussions, putting it mildly.
With this in mind, some people believe that because you can't predict with complete accuracy how a birth will go, there is no point in preparing for birth, or for putting together a birth plan. It'll go how it'll go and you're fooling yourself if you believe you can control it. That this leads to unrealistic expectations and ultimately, to disappointment.
While I agree that you cannot control how birth progresses, I do believe that you can influence it. That you can prepare yourself mentally, emotionally and physically to give yourself the best chance of coming through the crucible of birth stronger and more confident than you were before. That you can understand the process of birth and how controlling your environment can give your body the best chance to release the necessary hormones for the process to unfold smoothly. That you can understand how important the subconscious beliefs we all hold about birth (which is itself an unconscious process) are and how these can influence a birth's progress. And also, that you can think about the things that are most important to you in the event of your baby's birth, so that if events take an unexpected turn, you can still own what's happening and feel fully part of the process.
More practical ideas for ways to achieve this will become the subjects of future posts. What helped you to prepare for birthing? What helped your partner or other support prepare? What, in retrospect, do you wish you'd known in advance?
Getting back to work after having had my third baby (who is about to turn one next week) has had me pondering about space. Not stars and planets, but the space in your life for new things, be they people or projects or whatever.
We talk about 'making time' for things, but we're kidding ourselves really. We can't make time. We can only redistribute it; prioritise differently.
One of the things that can be hard in pregnancy, whether it's your first or your fourth, is making the space to really focus on the new life growing inside you. To give you and your baby time to just be together. This can be especially hard if you've lost a baby, at whatever stage. This new little bean may feel too tentative, too fragile, to really allow yourself to acknowledge. But whenever you feel you can make that connection, you're building a relationship that will last a lifetime.
Practicalities. How do you do it? I know lots of people have found it hard to find the time to do the things they'd like to to support themselves through their pregnancy and to prepare for birth (and beyond). Finding the reason for the lack of time can be helpful. Is there something worrying you? Could you do with more emotional or practical support?
Is there anything you could drop or adapt to give you just a minute (literally) each day where you could turn inwards and say hi to your little one? It doesn't have to be a Big Thing. You don't have to be artfully arranged on a white sofa wearing yoga pants. You could be in the shower, on the loo or waiting for the kettle to boil to take a few deep breaths and check in with your baby. This can, of course, be harder when you already have a child or more; but look for those little moments in the day where a minute of quiet presents itself. I know, I know; easier said than done. But give it a go and see what happens.
Starting small – baby steps – will help you to make space in your days (and your heart) for your baby. As time goes on, one minute may become five, or ten, or one minute many times a day. Then carving out the time to do the things you want to do will feel more possible.
'How you were born' is a beautifully illustrated book telling the story to a child of how they came in to the world. From the excited waiting, planning and preparing during pregnancy, to labour and birth at home and then breastfeeding, each page captures the beauty and emotion of the everyday miracle of a new life entering the world.
A lovely book to read to a child to help explain where they came from, and also to help make sense of the coming of a new sibling.
Published by and available from Pinter & Martin.