For Birth Trauma Awareness Week, life coach and Celebs Go Dating Agent, Anna Williamson is raising awareness of the lack of informed consent during traumatic labours. Opening up about her own harrowing experience, Anna is also supporting Grazia’s campaign to implement mandatory mental health checks across all maternal care.
Before I gave birth to my son, Enzo, I already had perinatal anxiety. I didn’t realise at the time, but I was also suffering from generalised anxiety disorder. During my pregnancy, I had been ill-advised by my GP to come off my anxiety medication, so I was then very unsupported medically and psychologically during my pregnancy. I put my anxious experience down to pregnancy hormones but, on reflection, it was the anxiety disorder. So, emotionally, I found pregnancy very difficult, and mentally, I was very anxious.
I was fearing birth, but during my pregnancy I was very physically healthy. This was a blessing and I think that just impacted the guilt I felt, feeling that I shouldn’t be moaning, I shouldn’t be complaining, I should be getting on with it. In fact, I felt quite triggered when somebody made a comment, albeit well meaning, saying ‘Oh come on, you just need to get on with it’. I remember it making me feel dreadful. I was thinking, ‘Oh my gosh, yeah, I do just need to get on with it. I’m being a wuss…I’m being a flake.’
And that was a really, really horrible thing because all it meant was that I was silenced. I didn’t tell anybody how I was really feeling after that. So, during pregnancy, I was very anxious, my mood swings were very heavy, I was very fearful of the birth coming up, and I didn’t tell anybody - I didn’t talk to my doctor or my midwife, I just felt like I had to get on with it, which on reflection was the worst thing to do.
When it came to my mental health, I received the obligatory one or two checks from healthcare professionals, but other than that, nobody performed a thorough check on my mental wellbeing.
Then my birth came, and it was incredibly traumatic. I was nearly two weeks overdue, booked in for an induction, but I went into natural labour on the morning it was scheduled. The labour was 40-hours, and I was exhausted, in a lot of pain and experiencing a back-to-back labour (which is where you have back contractions). That scared me because nobody told me that was a thing, so I wasn’t prepared for that at all. I also wasn’t prepared for the interventions I needed. Possible interventions were once mentioned in an NCT class, specifically forceps or a ventouse or a caesarean. At no point though had anyone actually given further details on exactly what went on during those procedures, or the risks, how they might make you feel, what actually happens as a result, what support you might need after.
So, when I actually ended up needing a forceps delivery because my son was stuck (I couldn’t actually push him out myself, and at 40 hours in I was absolutely done in), I didn’t really know what I was agreeing to when I was told I need a forceps delivery.
Studies shows that two in five women feel they have not had consent for the procedures that were done to them during labour. For me, I remember being told at the time what needed to happen to get the baby out, which obviously I went along with because the health professionals did have my best interests at heart and my baby’s. However, it was a big rush for obvious reasons. They just want to get your baby out and you sorted, so I was very quickly told what they needed to do, but I wasn’t aware of how the procedures would take place.
I vaguely remember signing my name on a piece of paper to give consent for forceps delivery and for a possible emergency caesarean, but I certainly didn’t understand the implications of what those procedures meant. So, when I did have a forceps delivery, I felt that I just wasn’t present in my body. I was a piece of meat on the table and as they pulled the baby out of me, I just remember thinking, ‘Oh my god, what is happening to me?’ I didn’t understand the severity of an episiotomy either. In reality, these are major procedures that had been mentioned probably in once months before. I don’t think this counts as informed consent.
During my labour, I sustained a very large haemorrhage, so the whole experience really was one of the most terrifying moments of my life. I very genuinely felt like I was going to die. The trauma I experienced post-birth was associated with that feeling and experience. It was life-changing, and it’s something that will stay with me forever.
I felt desperately, desperately numb after. What should have been love and bonding was taken over by fear, anger, frustration, and silence. I very quickly spiralled into post-natal depression, post-natal anxiety. I couldn’t eat, I couldn’t sleep. I was hallucinating and having intrusive thoughts. I was struggling to feed my baby. I just couldn’t bear how I was feeling. It was like I was trapped in a black hole of hell. I didn’t know how to get out of it. I was angry with my body and felt like it had let me down.
I felt like my body just wasn’t mine anymore.
I didn’t understand what had happened to me, I didn’t understand why the forceps had damaged me so badly, and I didn’t understand why for several months afterwards my clitoris was so bruised and sore. I couldn’t bare my husband or myself to even touch my private parts because of the physical damage due to the forceps. Nobody had told me that, and I didn’t know that was a thing or would happen and the whole experience left me really questioning whether I could ever be ‘normal’ ever again. I felt like my body just wasn’t mine anymore and I felt like I would never enjoy sex again. The whole experience was so physically, mentally and emotionally damaging that you wouldn’t wish it on your worst enemy.
The community midwives were lovely, and they asked the right questions, but I did that classic thing of putting a mask on and pretending I was fine when I was anything but. I was worried someone might take my baby away or think I was an unfit mother, and so my mental health was in a shocking state after I’d given birth. I really didn’t feel particularly supported by anybody - my family tried, my husband tried, they did their very best, but they had very minimal knowledge on how to help me.
I do remember my community midwife sign post me to the Birth Trauma Association, of which I am now the very proud ambassador and spokesperson for. It really was a lifeline for me and made me realise that I wasn’t on my own with my very challenging birth. Thousands of women are suffering and something needs to be done to really step up the mental health side of care for women in pregnancy, labour, and birth, as well as the physical side.
A week after giving birth I went back to my GP saying, ‘I feel like my anxiety is back’, which led to me being put on a bog-standard SSRI (which wasn’t compatible with me and made me feel even more depressed, giving me even more suicidal thoughts). People were concerned, but nobody noticed how badly I was suffering. In hindsight, I definitely had borderline post-partum psychosis, and I remember desperately wishing that I could go to a Mother Baby Unit because I just needed this hell to stop for me. I didn’t feel fit and well enough to look after my baby or well enough to look after myself, and I desperately needed someone to come help me look after my baby because I felt so deeply unwell.
There was no what I would call ‘proper’ intervention with my mental health, and the only reason I got better was because I contacted my psychiatrist, who had helped me several years prior when I first developed generalised anxiety disorder. He was able to help me and very quickly put me on some medication. We came up with a compromise that I needed to stop breast feeding. I wasn’t producing milk anyway, because I was so ill, and I needed emergency medication to help me sleep and to start to address the intense panic attacks and fear I was experiencing.
Time did heal, and my bond with my son went from zero to 100 in months.
I’ve had loads of support since. I accessed a lot of private therapy which really helped to deal with flashbacks. Obviously, this is a privilege and something that isn’t open to anyone, which I’d like to help change. I found accessing my birth notes (through birth reflections at the hospital) really helpful to fill in the blanks. I was able to ask questions about why certain decisions had been made for my birth and that was cathartic in understanding why certain choices had been made and why the procedures had happened. That really helped me move past the trauma of giving birth. I’m pleased to say time did heal, and my bond with my son went from zero to 100 very quickly in a few months. Now seven and a half years later, he’s the apple of my eye. But, I still feel so desperately sad that the start of our life together was so deeply affected and marred by the horrendous birth I had and subsequently the lack of post-natal care that followed.
My second pregnancy was completely different, because, by design and having experienced birth trauma and perinatal and post-natal anxiety, the health care professionals recognised I really needed extra help and support. I actually took my daughter coming along for me to actually feel like I’m a good enough mother. I call my first-born, my son, my ‘warrior baby’ because of everything that happened. I call my daughter my ‘medicine baby’ because by design, I wanted to have a very medicalised birth. I opted for an elected caesarean before I even got pregnant.
I was well-supported psychologically by the peri-natal community and the mental health team on the NHS. They helped make sure I had all the support I needed for the second pregnancy. I’m delighted to say the planned c-section was the best thing that ever happened to me and really gave me the confidence I needed and the reassurance I needed that I was a good mother. I love both my babies equally; I think I’m a really good mum and I wouldn’t change any of it. I would love, by speaking out, for other women to not have to go through what I went through and to have more support.
That’s why I’m also supporting Grazia’s campaign for mandatory mental health checks during pregnancy and most importantly, post-partum. Giving birth is trivialised. So many women are left to just fend for themselves and ‘get on with it’ after they’ve had a baby. I think we would have a much lower statistic around birth trauma and post-natal depression if proper care and attention was taken in that post-natal period, and all the very intense emotions that happen after birth were considered. The fact that women are just left to fend for themselves means a lot of women just feel silenced.
We need to remember that everyone who gives birth is doing it uniquely. It’s the biggest thing that they will ever do in life, and no one size fits all. Everybody deserves care, respect, and support to be honest and open about their pregnancy, labour, birth and post-natal period within the time they need it to feel healthy and well, so there’s a happy mum and a happy baby.