I have birth disappointment. I've had two cesareans, and I am not thankful for them. I do not believe they saved my life. Sometimes I am angry. At times I am frustrated or sad. Sometimes I lie awake for hours wondering where things went wrong. None of these things make me a bad mother.
As a mother coping with birth disappointment, I can tell you that depression in mothers is terribly misunderstood. Birth is broken in America. As women we are asked to accept interventions without question and pressured to make decisions when at our most vulnerable. We have 5 minute prenatals with an obstetrician that might be present during our births. Electronic monitors tell nurses when we are worthy of their attention and pitocin is now as essential to birth as the baby itself. So it's no wonder that even the most prepared mothers often come out of birth having experienced interventions. For a mother that enters birth with certain expectations, unplanned interventions, use of pain relief, or cesarean birth can be devastating.
Dealing with feelings of anger, shame, sadness, or disappointment regarding your birth can be difficult. Well-meaning family and friends remind new mothers that they have a healthy baby despite the experience, and while the sentiment is meant to make the mother feel better - after all, what better prize is there? - it generally only makes her feel worse. Often the mother feels judged, as though others see her as ungrateful or selfish. However, the feelings associated with birth disappointment are valid.
Birth is a momentous experience in a woman's life. It is transformative for the woman regardless of whether it is her first child or her fifth. It is her first experience mothering that child, and it is important to her. It is not simply a means to an end.
It is key that women are allowed to cope with birth disappointment rather than try to ignore it. Birth disappointment can affect a woman's desire to have children. Some are too scared to want more, others become obsessed with trying again in an effort to heal the previous trauma. Ignoring it could certainly put mom at higher risk of PPD and PTSD.
The first step in healing birth disappointment is to acknowledge it and accept it as valid. So here is what having birth disappointment means and what it doesn't mean.
Having birth disappointment means:
- A mother experienced unplanned, and often undesired, interventions.
- A mother may have experienced an undesired outcome, such as a cesarean section or episiotomy.
- A mother's birth memories elicit undesirable emotions such as anger, fear, or sadness.
It does not mean:
- The mother does not love her child.
- The mother was uneducated or poorly informed.
- Interventions were not necessary.
Women who are experiencing birth disappointment should take some comfort in that they are not alone. Realizing what you are experiencing is normal and valid allows you to take healing steps. Below are some strategies for coping with birth disappointment.
Ways to cope with birth disappointment:
- Join a support network. Not only will you benefit from having others who understand your feelings, but it can help you feel more empowered about future births. The International Cesarean Awareness Network (ICAN) has chapters that meet monthly in most areas. Birth Network National has chapters in many states that offer monthly meetings on a variety of birth topics.
- Talk with your care provider. If you are lucky enough to have a really supportive care provider, discussing your birth experience with them might provide better insight into why things didn't go as you wanted. Even if you don't have a strong relationship with your care provider, think of this as an opportunity to understand what happened during your birth. It may also give you an indication of whether or not you want to use this provider for future births.
- Seek medical help, if necessary. PPD and PTSD following birth is more common than most women realize. At a time when you are supposed to be happy, often mothers feel that they can't speak up about being depressed. However, PPD is most likely caused by a hormonal imbalance out of the woman's control. SSRIs might be necessary, or talk with your provider about hormone therapy (My doctor put me on natural progesterone pills. By the next day I was laughing, and I no longer needed them at 2 months!)
- Write out your birth story. While time supposedly heals all wounds, it can also just make things fuzzy. Sometimes the further you get from an experience, the more likely you are to forget minor, but important details. Three years from now all you might remember is getting an epidural not the reason you had for getting one. Ask your partner or labor support person to help.
- Be gentle with yourself. I have to give credit to my midwife for this one. It's something I remind myself of daily. Whether or not you could have changed your experience with different decisions is a moot point. We all did the best we could with the information we had at the time. Reminding yourself of this can help when you experience moments of self-doubt or self-recrimination.
My feelings are valid. I will not be ashamed of them.
I will allow this experience to be part of me, but not dictate who I am.
My birth experience does not determine who I am as a mother.
I will be gentle with myself.
If you have a friend or loved one who is experiencing birth disappointment, be patient, listen to them and express genuine sympathy. Avoid lectures on gratitude. Do not try to remind her of her blessings. Your gentle reminder can send her into a shame spiral. Instead respect her experience and offer support. Often the love and support of others can do more to help heal her wounds than any other strategy.
Readers: If you have dealt with birth disappointment, what helped you?