"Yes, he is still alive, but I'm not OK." The bloody truth about the delivery Life and style



Clare Cashion was 28 weeks pregnant and was about to go home in a plane after a family Christmas in Ireland when her waters broke.

She was rushed to the hospital in Dublin, where doctors were temporarily able to stop the birth. But there was no question of leaving the country safe, so while her partner and three older children flew back to England, Clare stayed behind in the hospital. Her son Cullan was finally born on New Year's Day by a Caesarean section, after a labor that was traumatic from the start.

It was only when surgeons started working, says Clare, that she realized that the epidural did not seem right. "I could feel everything." I screamed and they said: "No, you can not feel it, the spinal puncture has worked", and I screamed: "No, I can feel this, I can feel this. "Her son was eventually born under general anesthesia, with a body weight of only 12 kg (1.25 kg): it took two months before she could return to her family in England, and only then the entire impact hit her.

"I thought: I can do this, I am a mother of 4. Just put my face on it, drag the toddler to a mother-and-toddler group and take the baby, but inside I was a wreck, it's not something people talk about talk, you should just do it – the only thing you ever hear is: "You and the baby are ok at least." It is the most frustrating expression, you just want to scream and say: & # 39; Yes, he lives and I live, but I'm not OK, physically I'm OK, but mentally I'm not. "She still struggles with a deep anger about what happened, and with feelings of guilt about the impact it has had on her other children. She says she is almost robotic for a while: "I would do what I had to do, but I could not say that I was there." I would concentrate on crazy things, like the house had to be spotless, I would over-check things, because I had no control over what happened to me [in hospital]. "

Inside I was a wreck & Clare Cashion with her son Callun.



Inside I was a wreck & Clare Cashion with her son Cullan. Photo: Sam Frost for the Guardian

In the end she claims that posting her story on Facebook was the easiest way to tell friends what she was going through, while letting those who did not want to know what the bloody details were. But it was crucial for her, she says, that she could tell the truth. "If you have experienced something that is traumatic and do not talk about it, it is like putting a filter on life, and if you think you are the only one who has happened to it, you feel that you have failed."

These are stories like these that help explain why obstetric teacher Catriona Jones has unintentionally touched so much guts, when she suggested last week that sharing birth horror stories on social media can be a factor that feeds women's fear of childbirth. As Jones reportedly said: "You just have to give birth to Google and you've come across a tsunami of horror stories." "If you go to one of the Mumsnet forums, there are women who tell their stories about childbirth -" Oh, it was awful & # 39 ;, & # 39; It was a massacre & # 39; I think that can be very frightening for women. "

But among the headlines about women supposedly silenced – something that Jones is adamant – had a much more complicated, nuanced story about why birth trauma is so common in Britain and yet somehow manages to get involved in hide the full view.

For her part, Jones is clear that she never meant that new mothers should stop talking about their experiences. "I did not say," Oh, women have to stop sharing their stories. "I would not be able to raise my head again in a midwifery congress if I had said that," she explains from her office at Hull University. She argued rather for the opposite: better maternity services to support courageous expectant mothers, based on a mental health program developed in Hull to detect and refer anxious women early in pregnancy. Social media may, she says, be "one of the factors" involved in that fear, with recent research from Canada suggesting higher levels of nervousness among women who had read many birth stories, although it is unclear why (it is possible that women who are already anxious are more inclined to start looking, for example). But it helps women to deal with the fears that matter regardless of where they come from.

But the striking thing is that women were so willing to believe that an midwife expert might want to keep them silent. The story seems to have become a rough nerve, precisely because so many women are under pressure to keep troubling birth stories to themselves, a burden that for some reason is not placed on survivors of other medical traumas.

In the meantime, even at the other end of the spectrum, even women who have had a perfectly simple birth experience can feel inhibited to say this in case they sound complacent or insensitive. "You feel like it is almost something to be ashamed of, that you have to keep quiet about it, that you may banish other women or make them feel bad about themselves," says Clover Stroud, the author of a memoir about motherhood, Wild Other. , who has five children and happily admits that she has enjoyed all their births. "I think it's a shame because you generally hear the worst things, the line is that it's just a horrible, unworthy, violent and horrible experience, and actually it's a violent and unworthy experience – I was extremely painful, extremely violent births – but it is an extraordinary and human matter to go through. "The more women hear of both good and bad birth stories, she argues, the better. Yet so many women seem to have to consider the raw and bloody truth as their guilty little secret; something that must remain hidden, not only of women who have not had children yet, but sometimes also of other mothers.

The striking thing about research into fear of childbirth is that until recently it was so scarce. It was not until 2000, when psychiatrist Kristina Hofberg published an article about the serious and morbid fear of a birth known as tocophobia, that the term began to be recognized and examined; Until then, it seemed as if the terror of women had little interest. Definitions are blurred, even now – it is estimated that between 6% and 25% of women may be tocofobic, depending on how it is defined – and in extreme cases they may decide never to become pregnant, even if they are actively affecting a family want . Some double the contraception methods to ensure that this never happens; People who become pregnant themselves may become so anxious that they can not enjoy or plan after giving birth.

Jenny Shotton, who was diagnosed with PTSD after the birth of her second child.



Jenny Shotton, who was diagnosed with PTSD after the birth of her second child. Photo: Graeme Robertson for the Guardian

"It is becoming ubiquitous, so people can not think about it," says Julie Jomeen, a professor of obstetrics at the University of Hull. "One service user described it to us as surrounded by people who were all very excited about their pregnancy, going out and buying baby clothes, setting up their daycare centers, but they can not cope with it – their fear is at a level where they do not believe they are the delivery will actually survive. & # 39;

The causes of tocophobia are still not well understood, although Hofberg has made connections with sexual abuse in the past. But it is not surprising that it is also much more common in women who have already been traumatized by a previous birth.

For Jenny Shotton, eight months pregnant with her third child, even something as routine as going to the hospital for a prenatal appointment can be enough to bring her to tears. She was diagnosed with post-traumatic stress disorder (PTSD) after the birth of her second child, Eloise, three years ago; a very fast induced delivery left her daughter in an incubator and Jenny drifted in and out of consciousness. When she woke up beside her at an empty cradle, she was convinced that her baby had died. This time she hopes for a "peaceful" home birth with a midwife she trusts and who knows her history; yet she braces herself for what might come next. "I'm not worried about the birth: I trust that it will be whatever it is and I trust my midwife, but what I'm afraid of is how I'll be after birth, whether I'll have a depression again get, or that something will trigger me. "

PTSD is a condition that is more closely associated with combat stress or survivors of terrorist attacks. Yet as many as 20,000 women a year – about 4% of all new mothers – estimate it simply as a result of childbirth (by comparison, an estimated 9% of soldiers sent back to Iraq and Afghanistan). For some, the condition is caused by a clearly traumatic event, such as a bleeding or something with the baby. But in a surprising number of cases it follows what doctors would see as a perfectly normal birth. "There are a number of experiences that you would clinically view as traumatic, you would think," Oh, that's terrible, "but the woman will walk away," Jomeen says. "And there are other women for whom you would think it was simple, but something happened that is traumatizing them."

One explanation is that even safe, clinically boring deliveries are still a shockingly violent departure from women's expectations or everyday experiences. According to Office for National Statistics, 41.9% of the mothers who delivered last year experienced cracks. More than a quarter of the efforts ended in cesarean sections and about 12% in physicians using a forceps or ventouse (essentially a suction cup over the baby's head) to get the baby out. Inductions, when labor is artificially initiated rather than natural, have risen from 20% of births a decade ago to 29% last year and are associated with stronger contractions and faster efforts. What doctors regard as normal can feel anything but for the woman at the sharp end.

But the way in which medical personnel respond when something goes wrong can also be critical, according to the perinatal psychologist, who herself has experienced a traumatic delivery with her first child and now advises women who have had bad experiences. Research shows that the impact of trauma on women can be reduced by caregivers who feel safe, which means that they are not only treated kindly by midwives, but also get the chance to process and discuss their emotions afterwards – the only thing so many women feel reluctant to do.

Stacey Wilson was diagnosed with PTSD after a long, exhausting delivery that ended in a delivery of forceps. It took doctors almost an hour to resuscitate her daughter Adeline, now 15 months old, and the sight of her newborn daughter who was gray and silent stayed with her. Months later she still felt compelled to compulsorily check whether the baby was breathing and entering her room 40 times a night; she still has nightmares, flashbacks and feels compelled to experience the experience again and again in her head.

It was, she says, an intensely insulating time. "I did not go to the mother-and-baby groups because I called it" Ooh, how did you birth? "Missed conversation," she says. "What mothers attach to each other is that we have done it together, but you have put yourself a little on the sidelines, you do not want to say something that they just will not know what to respond to."

Her lifeline was the Facebook page of the Birth Trauma Association, an informal support group of about 6,000 members, where she was finally able to lift her; she continues to post there regularly, although she now reassures new members that they too will feel better over time.

Anonymity has liberated Mumsnet users to confess where women are ever ashamed to talk about, from sagging and incontinence to graphic stories about blood and blood and devastated meat. On the other side of the spectrum there are blissed "freebirthers" who make true-to-life YouTube videos of themselves without medical intervention (Simone Thurber & video's self-made video in a stream shot of 76 million YouTube views two years ago) .

Because it is the dramatic stories that tend to go viralize, the risk is that the type of birth displays that most women actually have – neither overwhelmingly horrible nor amazing, but somewhere in between – are quite lost in the crowd.

"It is also:" I gave birth in moonlight and it was orgasmic ", or:" It was the most horrible thing that ever happened to me, "says Rebecca Schiller, a doula and the CEO of Birth Rights, an organization that helps women do their right to choose how they deliver. "Both ends of the spectrum exist, but most women have something more in the middle."

But no matter how erroneous they are, the frank, candid conversations about the birth released by the internet can function very well as a safety valve.

"People need a way to process what happened to them and if you do not get that from society, from health services, from an overworked GP who has about 20 seconds to talk to you, you'll find a way" Fraser. Even in a society where women still can not easily express unspeakable truths about childbirth, there may be only so long that they can be curtailed.


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