'When Birth Didn't Go to Plan'

Our Online Meet-Up for January 2023 focused on the topic 'When Birth Doesn't Go to Plan.' A glimpse into what some of our online sessions can be & some information signposting on birth trauma, processing births that didn't go to plan, birth resolution and support available.

When we plan for birth there are lots of things we can control and be prepared for but there are also things that are out of our control, that we must deal with the best we can at the time. It might be something dramatic like a crash caesarean or a baby who needs medical support when they are born. Perhaps, it might be something that seems very small from other people's point of view but actually has a huge impact on us; such as the way someone speaks to you or how they make you feel about yourself at a vulnerable point in your life. Often when we talk about these things we will find people dismiss our feelings, generally with the well-intentioned specific but really unhelpful observations that your baby is here, or that a certain outcome was meant to be and there's always a next time.... and that you're fine now you should get over it.

We can't go back and change anything that happened in the past but we can listen and validate how you felt then, and how you feel now. We can provide some information and support for moving on from this point. We can offer respect and support for the fact that getting over it is not that simple and sometimes further action and support are needed before you can even think about feeling differently in the future.

It's also important to recognise that although our topic was when birth doesn't go to plan traumatic or difficult things that happen during your pregnancy or after your baby is born as part of your postnatal care can also leave you needing support to understand and move on from.

The session focused on how a birth that didn't go to plan can affect you now and what to do next. What options for processing & resolution may be available? The session was facilitated by Sarah Dauncey, a local doula - you can find Sarah on Instagram @joyfulfamiliesuk or via her website Sarah invited attendees of the meeting to take part in a sample of one thing that may help you process your feelings, including thinking about how you would like to feel in the future and using your imagination and some relaxation.

We began the session with a focus on practical action you may want to take to pass on feedback or receive recognition of the harm caused to you.

This could be in the straightforward action of speaking to your midwife in your postnatal appointments and saying I wasn't happy with something that was said or done to me during my labour (or pregnancy or postnatal) and I would like you to pass on my feedback to the team. Or if that is too soon or feels too much you may want to put your feedback in an email to the head of midwifery.

If you don't want to make a specific complaint but feel you would like to pass on feedback and information about care and how you feel things could have been different for you and should be made different for people accessing the service in future you can attend a maternity voices partnership meeting and share your thoughts there. This is a link to the information about the MVP at our nearest hospital but if your experience was with a different hospital you should be able to find your local MVP by searching with maternity voices partnership and the name of your hospital.

If you would like a more formal way of passing on feedback or making a complaint about what happened to you then you can use the PALS service at your local hospital. This may involve a formal process but it's not confrontational and you will be guided through it. The process should be designed to help you feel confident to share your thoughts and feelings. This is a link to our nearest hospital PALS service but if you were with a different hospital you can find them through an internet search for PALS and the hospital name.

If you don't find satisfaction through this process with PALS you can then pass on your concerns to the health ombudsman.

If you have a complaint about a specific health professional that you don't feel has been adequately addressed through the PALS service you can also pass on your feedback to their professional organisation such as the Nursing and Midwifery Council or the Royal College of Obstetrics and Gynaecology

If the situation surrounding the events of your birth is recognised as a serious incident that warrants an internal investigation or if your PALS complaint leads to an internal investigation and you don't feel the results of that investigation are satisfactory or have achieved all of what you need you can also investigate hiring a medical negligence solicitor.

We then went on to talk about how having a negative or traumatic event as part of your pregnancy, birth or postnatal experience can affect you and what support is available to you.

When an event occurs that makes us feel our life or health or our loved one's life or health is in danger or makes us feel out of control of what is happening to us this triggers our brain's natural protective mechanism of a fight or flight (and when neither of those is possible a freeze) response. This may be something dramatic that's recognisable to everyone who hears about it or it may be something that seems small to someone else but has a big impact on us and our experience. Having a traumatic experience is dependent on our own feelings at the time something was happening not on what was happening.

Equally the way that our experiences go on to affect us in our day-to-day lives can be very varied and completely individual.

Some people will experience a lot of symptoms that may make it difficult for them to go about their day-to-day life and make feeling positive about anything seem impossible. If this is you then you should be offered robust mental health support with your local NHS perinatal mental health service. Sometimes this can even mean inpatient care if it is a mental health emergency situation and there are really good services for this in Hampshire based at Melbury Lodge in Winchester

Some people will qualify for the support offered by local self-referral mental health services such as italk in Hampshire and talking change in Portsmouth.

Other people may be not struggling with their mental health but still finding that symptoms of trauma are affecting their ability to enjoy life as a new parent or to plan for ever having another baby. These people may need to seek out support for themselves and this can come in many different forms, finding one that suits you may be the key to moving on and enjoying your life again.

Some examples of useful therapies you may want to seek out are EMDR therapy, trauma-informed counseling services, birth trauma resolution therapy, havening, TBR three-step-rewind and trauma-informed birth story listening sessions.

Sometimes people find that when they are struggling with remembering the details of what happened or why something might have happened that a birth afterthoughts session with a midwife at the hospital where they will go through what was written in the hospital notes can be very helpful. Another option is to request a copy of the notes from the hospital and go through them with an independent midwife or another suitably trained person.

Finally, we covered planning for another birth after a traumatic experience.

When you have had a traumatic event during a previous pregnancy, birth or postnatal experience planning for another birth must take that into account.

You may not realise how you've been affected by what happened in your previous birth until you come to plan for a new birth. In this case, you may want to choose one of the potential options for dealing with trauma discussed above.

When making your birth plan you will need to think through what will potentially trigger you into a fight or flight reaction because of what happened last time. This might be going into the hospital itself, meeting a specific person, smelling a specific smell, or hearing a certain word or phrase said. Whatever it is for you, that thing can be front and centre on your birth plan. The very first line might be we must avoid this thing because of a previous traumatic experience.

You may want to give thought to your birth team and training them to help protect you from being triggered by things that could happen again. To find and plan things that will help you to stay in a calm frame of mind regardless of what is going on around you. You may want to investigate hypnobirthing, aromatherapy and hiring a doula for example.

If you're really struggling while you're pregnant you can ask for a referral to the mental health midwifery team or to a consultant midwife who can help you make an individual birth plan if you want to do something outside of the usual hospital procedures.

We're still here to support you.

You're always welcome to message us or post in the Facebook group or come along to another meet-up if you have more questions or would like some individual information or support.