Throughout my pregnancy, I fantasised about the “golden hour” — the first hour after birth — that I’d share with my baby when he arrived. I pictured myself smelling his head, stroking his tiny back and whispering “Happy birthday” and “I love you” as I gently encouraged him to latch and begin breastfeeding.
But because I spiked a fever during labour, hospital policy required my son to go directly to the NICU for a precautionary stay where they’d monitor him for signs of infection. Instead of a golden hour, I got just a few precious minutes before a nurse pried his little fingers from my hospital gown and whisked him away.
That was just one moment among many that added up to a traumatic birth experience. There was the nurse who tied the band of a foetus heart-rate monitor so tightly around my belly I could barely breathe. Another rolled her eyes and tossed a barf bag at me when I pleaded with her to raise the head of my bed before I threw up. Then there was the NICU nurse who grabbed my baby from me and force-fed him a bottle of formula because I wasn’t “doing it right.” I was devastated by all of it.
I’m far from alone when it comes to birth trauma. Some estimates suggest up to 44% of birthing people experience trauma during childbirth, including physical or psychological injury and serious health complications. That can lead to relationship issues, disrupt the joy of having a baby, impact future family-planning decisions and cause long-term mental health concerns. All of that was certainly true for me.
Maya Jackson, the founder and executive director of Mobilizing African American Mothers through Empowerment, a pregnancy and birth services organisation that Jackson said has served over 700 families since its founding in 2018, sees the medicalisation of birth as a key reason for high levels of birth trauma.
“We have medicalised birth as treating a disease rather than caring for a person,” she said. “It’s less about the person’s lived experiences, things that may have impacted them over the span of their lives, and more about getting the baby out — and getting the baby out by any means necessary.”
Sometimes trauma during childbirth is hard to avoid. A medical emergency, for example, where your providers have to act fast to save your life or your baby’s, will be stressful no matter what. But other times, advocating for yourself when something feels wrong, or having someone else advocate for you, can prevent a bad experience from becoming worse.
Childbirth experts say there are a few things you can do, before and during birth, to have the best experience possible and stand up for yourself if you feel you aren’t being heard.
1. Know your own body and health history
The first step to advocating for yourself is knowing yourself. That’s why Jackson advises her clients to get to know their own bodies and health histories — including family health histories — before getting pregnant. That might mean monitoring your body so you know your baseline — for example, your typical energy levels and what “healthy” feels like for you — paying careful attention to things that trigger your anxiety, and asking your relatives about their medical histories so you know of any illnesses or issues that could come up during pregnancy.
In doing so, pregnant people will “have a blueprint of how their body works and functions, and if things do arise, they are able to articulate, from their lived experience, what they know to be true about themselves,” Jackson said. “I think a lot of times, when we’re receiving care from medical providers, we’ve been taught that they’re the only experts in the room. But the first expert is you.”
2. Choose providers who support your birth goals
When you’re thinking about the kind of birth experience you want to have, the providers and location you choose will be critical.
Kayleigh Summers, a licensed clinical social worker who founded The Birth Trauma Mama after her own near-fatal childbirth experience, said choosing providers who understand informed consent and collaborative decision-making is the first step.
“I would want a provider that truly believes that I am the expert on my own body and they are the expert on everything on the medical side of birth — and that both of those expertises are equally important,” she said.
Jackson recommended that families learn as much as they can before deciding where to give birth, such as the hospital’s cesarean section rate, as well any policies that might affect your birthing experience, like whether you’re allowed to eat during labor, if monitors must be worn at all times, and if a doula is seen as a visitor or member of the medical team.
And speaking of doulas: Summers and Jackson agreed that they can be wonderful additions to your birth team, in part because they can offer a continuity of care that you might not get in a hospital setting, where you may not even know the nurses and doctors delivering your baby.
While doulas are not a silver bullet — they’re not going to eliminate the possibility of birth trauma, for example — they can be a critical resource, providing information and explaining medical terms while you’re in labor. And though a doula can’t speak for you, they can help you refocus and find your voice.
“When you’re in the midst of trauma, when you’re already being traumatised, it’s really difficult to access this advocacy part of you,” Summers said. A doula can help guide you in those moments.
3. Ask to pause the room
Sometimes birth trauma happens because decisions are made too quickly and patients feel like they didn’t have a say in their own care. One way to catch your breath in those moments is to ask your medical team to stop and pause the room.
Start by asking if it’s a medical emergency — if that’s the case, you might have just seconds to make a decision. If it’s not, there’s typically some time to take a breath. You can say, “I need everything to stop right now,” Summers explained — your doula can help advocate for a pause, too — and then get your bearings.
Jackson said families can ask questions to find out why a certain treatment or intervention is being recommended, request to speak to another provider or have someone else perform a procedure, or ask for the charge nurse (the chief nurse on duty) if you feel your nurse isn’t listening to your needs. You also have the right to decline care and have your reasons documented.
4. Have a reset conversation with your provider
Simply put, sometimes the reason your birth experience is going sideways is bad vibes from your nurse or doctor. If that’s the case, see if you can shift that energy.
“If you have a grumpy nurse who’s not being kind — which I hope is a rarity — I will sometimes have patients just say, ‘Hey, can we talk for a second? I feel like there’s something that’s off here. Am I upsetting you in some way? Because I’m not getting the warm and fuzzies. What can we do to have a better partnership here?’” Summers said. “It doesn’t always work, but I do think it can disarm nurses.”
If you’re still having issues, talk to the hospital’s patient navigator or the charge nurse on duty about your options (or ask your support person to do it for you). Be sure your concerns are documented by the hospital.
No matter how your birth goes, you’re entitled to your feelings — whatever they may be, Summers said.
You can feel grateful, of course — for your baby, for your own life — but you can also “be angry and devastated and sad and full of grief about the experience you had and the losses that you had within that experience,” Summers said. “You can hold two things at the same time.”