Birth Trauma Awareness Week (BTAW) is held in July each year with a special focus on informed consent as the 2024 theme. In the UK, an estimated 30,000 women a year develop PTSD after birth, and so the recognition and understanding of the signs, symptoms and potential preventions is increasingly important.
What is consent and informed consent?
In the most basic terms, consent is the permission for something to happen or agreement to do something. In medical practice, consent is required for any medical procedure other than in exceptional circumstances as outlined by the Mental Health Act 1983. Consent can be verbal or written. Your consent should always be required, and you can withdraw your consent at any time. If you decide to withdraw your consent, the practitioner should inform you of the risks and benefits of doing so.
“For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.” Informed consent includes being presented with all relevant information regarding the treatment and what this involves alongside all reasonable options and alternatives. It is important that all risks and benefits, including the risks of refusing treatment, are provided to make an informed decision. The 2024 parliamentary inquiry into birth trauma has sparked a debate amongst maternity experts, families and the government surrounding prenatal and birthing care and preventing avoidable birth trauma.
What is birth trauma?
Birth trauma can include any experience throughout the journey to parenthood which impacts your mental, or physical wellbeing. This is often during the birth itself however this can also include reproductive trauma, Hyperemesis Gravidarum (HG) or breastfeeding trauma. Reproductive trauma includes the inability to reproduce such as infertility diagnosis, or pregnancy loss and any injuries caused by fertility treatments. HG is a condition of severe nausea, vomiting, weight loss or dehydration during pregnancy. Breastfeeding trauma surrounds the inability to breastfeed when wishing to do so, or having to stop sooner than the mother feels that they are ready.
Experiences during, or after, childbirth may cause trauma to the mother, baby, or any witnesses can cause postnatal PTSD. Examples of common causes include:
- Difficult labour with a long and painful delivery
- An unplanned caesarean section
- Emergency treatment for the mother or baby
- Other shocking, unexpected and traumatic experiences during birth
- Physical birth injuries, to the mother or baby
Choices, risks and alternatives which hospitals must provide and accommodate during childbirth:
As no pregnancy, or birth, is exactly alike, personalised maternity care and support planning is vital to making informed choices during birth and pregnancy. This covers antenatal care, labour and birth as well as postnatal care. An important consideration is deciding where to give birth, the below are options of where you can give birth:
Home births
Home births can be arranged for a straightforward pregnancy, and support can be provided by a midwife. When deciding to have a home birth it is important to consider that epidurals are not available, however other pain relief such as gas and air is still available. Doctors or midwives will provide recommendations on the safety of a home birth.
Birthing units
Midwifery centres and birthing units may be within a hospital or a separate unit. If the unit is entirely separate, transfer to hospital may be required during the birth and pain relief such as epidurals are unavailable.
Hospital births
Hospital births are the most common birthing place and include specialist access to neonatologists and special care for the baby if there are any complications. With hospital births, care may be provided to a different midwife than during the pregnancy. Epidurals, episiotomy or the use of forceps during delivery are more common in hospital births.
Unassisted births
Unassisted births are home births without the presence of medical professionals. Midwives can still be contacted for support and advice during labour to advise on the health of the mother and baby. Midwives can recommend and arrange, transfer to hospital if there are health concerns.
This plan can be changed at any time during the pregnancy and may need to be changed during labour. Requests for the birthing method will also be considered. Based on the complexity of the pregnancy, a recommendation will be formed by the medical professionals for a vaginal or caesarean birth however all risks and benefits of each option should be discussed. Caesarean births can be requested against recommendation and one in four women have a caesarean birth in the UK. With a caesarean birth it is important to note that the risks of surgery such as infection, blood clots, excessive bleeding and damage to the surrounding organs are at a higher risk than a vaginal birth. Vaginal birth complications, such as episiotomy, are at a lower risk than caesarean births.
A birthing and pregnancy plan cannot always be adhered to and where emergency situations arise and the plan needs changing, such as an emergency caesarean, professionals should provide all the relevant information to make an informed decision before consent is provided to change a plan.
The effects of birth trauma can severely impact a person’s life and so it is important to recognise the relevant issues and take all reasonable steps to prevent birth trauma. One in 25 women suffer from post-natal PTSD and 25% of women find some aspect of their birth traumatic. This is why it is important to recognise the effects of birth trauma and raise awareness for the support networks which are available to anyone suffering from birth trauma. “For those suffering from any element of birth trauma, your feelings are valid and your experiences matter.“
If you need urgent help with your mental health:
- Contact your GP surgery
- Visit accident and emergency at the local hospital
- Contact Mental Health crisis helpline 0800 9530110 24 hrs/7 days a week
- Call Samaritans directly on 116123
- Text SHOUT to 85258 to start a confidential conversation with a trained shout volunteer
- Contact CALM on their national helpline: 0800 58 58 58 (5pm - midnight)
If you or a loved one has suffered an injury due to the negligence of a medical or health professional, including a birth injury, then we may be able to help you pursue a claim for compensation. Our leading team of experts are on hand to offer advice, so please get in touch with us on 0161 696 6165 or complete our online enquiry form and we will contact you directly.
By Abigail Worden, new business advisor
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