Midwives like Hannah Dahlen spend a lot of time discussing birth trauma, but remarkably never mention the elephant in the room: PAIN.
Pain is a known trigger for PTSD. Indeed, uncontrolled pain can be a core trauma.
Research shows that the prevalence of PTSD among injured survivors of stressful events is higher than that of survivors without physical injury, thus suggesting that secondary Stressors (e.g., severe uncontrolled pain, a prolonged state of acute anxiety, uncertainty regarding the immediate future, loss of control, and inability to monitor contact with the environment) may play an important role in the formation of PTSD.
Dr JaneMaree Maher explains the traumatizing effect of labor pain in her paper The painful truth about childbirth: contemporary discourses of Caesareans, risk and the realities of pain:
By demonizing epidurals, midwives may be causing the birth trauma they are bemoaning.
… Pain will potentially push birthing women into a non-rational space where we become other; ‘screaming, yelling, self-centered and demanding drugs’. The fear being articulated is two-fold; that birth will hurt a lot and that birth will somehow undo us as subjects. I consider this fear of pain and loss of subjectivity are vitally important factors in the discussions about risks, choices and decisions that subtend … reproductive debates, but they are little acknowledged. This is due, in part, to our inability to understand and talk about pain.
Furthermore:
… [W]hen we are in pain, we are not selves who can approximate rationality and control; we are other and untidy and fragmented. When women give birth, they are physically distant from the sense of control over the body that Western discourses of selfhood make central …
Can you imagine discussing the the trauma of a limb amputation without mentioning the pain? How about discussing the trauma of severe burns without mentioning the pain? Ridiculous, right? So why are midwives bewailing birth trauma but refusing to discuss pain, the elephant in the room? Because midwives want to maintain and claw back turf lost to obstetricians and other providers and therefore demonize epidurals, the most effective form of relief for childbirth pain.
Epidurals give women control over their own bodies and control over the way in which they behave. This allows women to represent themselves to others as they wish to be seen, instead of pushing them into a “non-rational” space. Excruciating pain is traumatic, not simply because of the agony, but because being in agony makes it almost impossible to advocate for oneself, to make important decisions, and to exert control over your care.
Coincidentally, another mainstream media article was published recently and may shed additional light on the apparently rising incidence of birth trauma: Almost 70,000 fewer women are given pain relief during childbirth compared to a decade ago, NHS figures show.
The number of women not given pain relief during childbirth has plummeted by 70,000 in a decade, figures show.
Mothers-to-be are often offered anaesthetic, pain-killing injections or gas and air to ease the agony of giving birth.
But a NHS Digital report revealed there was a six per cent drop in women who went into labour without these drugs between 2008/08 and 2018/19.
Here’s the part that had me rolling on the floor laughing so hard I could barely catch my breath:
Experts told MailOnline they were baffled as to why the change had occured …
It was suggested that it could be down to an increase in midwives providing care for women throughout their pregnancy, meaning their birth goes more smoothly.
Seriously? Have these “experts” forgotten the ill fated Royal College of Midwives “Campaign for Normal Birth”?, the Campaign that was abruptly shuttered in 2017. UK midwives relentlessly demonized epidurals, and — worse — interfered with women getting them, telling women they didn’t “need” them.
The Campaign for Normal Birth deliberately subjected women to agonizing pain, compounding that pain by refusing to give women control over how and if they experienced it.
And as for births going “more smoothly” with midwifery care, the Campaign for Normal Birth was ended because it led to a rash of preventable DEATHS. That’s hardly smooth care.
There’s one thing that I have noticed as common to stories of birth trauma; few of the women had epidurals except as a last resort or for C-sections. Moreover, I’ve never read or heard of a story of birth trauma or PTSD that involved a woman who planned on getting and got an epidural in a timely fashion. It must happen, but it’s not common.
Imagine if labor were painless, or nearly so. Would it be as traumatic? Would it render women unable to advocate for themselves or exert control over their care? Of course not. A woman who is not in excruciating pain can have reasoned discussions with her providers about her preferences, particularly important if an unanticipated complication arises.
The decrease in epidural use in labor suggests that midwives — in a bitter irony —may be causing the very complication that they are bemoaning. By insisting that relieving labor pain is a moral weakness and a danger to the baby (both of which are completely untrue), they deprive women of relief and increase the risk that women will develop birth trauma. Pain is the elephant in the room and midwives need to face up to it.
