Birth trauma: What is it, the life-changing impact it has on mums and the campaign to improve maternity care leading to the first debate in Parliament
It has taken the exceptional bravery of one MP to lead the first debate on birth trauma in the history of the UK Parliament.
On 19 October Theo Clarke MP courageously shared her own birth injury experience and called on the Government to do more to help mothers who have suffered birth trauma.
During an emotional speech in front of a packed public gallery, Theo described being rushed for surgery after 40 difficult hours of labour as the “most terrifying experience of her life.” She spent nearly a week in hospital and one of her main reflections was the lack of aftercare for mothers. She had previously never heard of birth injuries or third or fourth-degree tears.
Following her return to Parliament Theo contacted the Birth Trauma Association and spoke to several women who had experienced traumatic births. She was shocked to learn of the “postcode lottery” and disparity of care for mothers who have experienced birth trauma.
Together with her co-chair Rosie Duffield MP she subsequently launched an All Party Parliamentary Group for Birth Trauma. The inaugural meeting was held in September which I attended together with representatives from the Royal College of Obstetricians and Gynaecologists (RCOG), Birth Trauma Association, MASIC, Make Birth Better and Maternal Mental Health Alliance. During this meeting the results of a birth trauma survey of more than 1,000 women conducted by Mumsnet were announced - 53% experienced physical trauma and 71% of those surveyed experienced psychological or emotional trauma. A key ambition for the APPG was to have birth trauma included in the Government’s women’s health strategy in a meaningful way.
What is birth trauma?
The Birth Trauma Association describes it as “a broad term applied to those who experience symptoms of psychological distress after childbirth. It includes those whose symptoms qualify for a diagnosis of post -traumatic stress disorder.”
Established research shows that in fact 4-5% of all women will go on to develop a recognised psychological condition after birth; post-natal PTSD. This equates to around 30,000 women a year in the UK.
My personal experience
I'm also one of those women. Fifteen-years-ago I experienced a very traumatic birth that led to a third-degree tear and permanent injuries to both myself and my daughter, and post-natal PTSD. Through my work I now represent other women going through similar experiences following birth trauma.
As an advocate and campaigner helping to give a voice to women who've experienced birth injuries, and to try to reduce the stigma that accompanies symptoms, the following are words that I often use - faecal, flatal and urinary incontinence, dyspareunia, fear and shame. However, words alone cannot possibly explain the pain; physical, emotional and psychological that a woman goes though after experiencing a birth trauma.
Landmark moment was still a time of mixed emotions
It was therefore with very mixed emotions that I arrived at Parliament on Thursday morning. I know many of the women who also attended from MASIC, Make Birth Better and Birth Trauma Association - which I am honoured has asked me to join its board of experts - also felt the same.
Yes, it was a landmark moment to hear birth trauma being discussed in Parliament for the first time. However, the fact was it was decades after many of us present had suffered our injuries, and the debate was heard against a backdrop of failing maternity services with units and staff under huge pressure weighed heavily. That this debate took place just after Baby Loss Awareness week added to the emotion and urgency for change.
Our collective story
Having had time to reflect on her words I truly feel that Theo spoke for all of us who attended the debate, and for all women who have experienced birth trauma. She spoke compellingly and openly, sharing the most vulnerable details whilst continually looking to the public gallery to acknowledge our presence, and that this was our collective story.
There were tears as each of us re-lived our own trauma and a standing ovation as she called on the Government to recruit more midwives, ensure perinatal mental health services are available across the UK and ensure post-natal six weeks checks are provided to all mothers. Theo also called for improved continuity of care, the provision of post-birth services nationally, the roll-out of the OASI (obstetric anal sphincter injury) care bundle to all Hospital Trusts, better support for partners, and better education for women in their birth choices and on risks in order to ensure informed consent.
We heard other MP’s also bravely share their own stories of birth trauma, baby loss and those of their constituents. Rosie Duffield MP significantly raised the issue of ethnicity and maternal health disparity and the “scandal of maternal deaths amongst black, brown and minority ethnic women”.
Following MBRRACE’S most recent report published this month we're painfully aware of the damning inequities that still exist and it was important to have these recorded as part of the debate.
Birth trauma isn't just physical injuries
It was important also that both physical and psychological issues relating to birth trauma were addressed during the debate as these are often intrinsically linked.
Physical birth injuries can include but are not limited to vaginal/perineal tears (of any degree), pelvic floor muscle damage, infected stitches, infection of the womb lining (uterus), fistula (formation), hysterectomy, bladder damage, blood clot/s, prolapse, pudendal neuralgia and bone injuries.
Unless women have access to perinatal mental health services to process the trauma they have experienced and in some cases to receive trauma based EMDR therapy (eye movement desensitisation and reprocessing) it's often impossible to move on to deal with the physical sequalae and explore treatments options such as secondary surgery or SNS (sacral nerve stimulation).
Commitment to reduce birth injuries rates a positive step
Together with my friends and colleagues from MASIC, Make Birth Better and Birth Trauma Association we welcomed the commitment from Maria Caulfield, Minister for Women’s Health Strategy to roll out the OASI care bundle developed by the RCOG and Royal College of Midwives across all maternity units in England by 2024. There was also a commitment to "reduce the rates of severe perineal tears and help manage such injuries better when they do occur”, and the implementation of a nationwide perinatal pelvic health service.
Having seen the development of the OASI care bundle during my time at MASIC and as someone who has suffered the devastating consequences of a third-degree tear this is a hugely significant and positive step forward. I look forward to continuing to work with the APPG on Birth Trauma and our charitable partners to improve outcomes for all women during childbirth.
Find out more about Irwin Mitchell's expertise in supporting mums affected by birth trauma at our dedicated birth injuries section.