Dr Heather Mattner is a perinatal psychologist and a midwife. In her psychology practice, Heather sees approximately 80 to 100 women a month, with up to 90% of them experiencing birth trauma.
Speaking at a Better Births event, Heather revealed the conditions that prevent birth trauma and what to expect from respectful maternity care. We attended to share some highlights with you.
Birth trauma is preventable harm
My colleagues and I strongly believe that the incidence of birth trauma is increasing, not decreasing. So I think we’ve come to a point where we have to say this is enough and cannot go on anymore.
Why you can’t just get over it
Generally, women’s perinatal experiences are never meaningfully discussed or explored. Instead, we have historically encouraged women to get on with it after traumatic experiences. We’re told we shouldn’t worry about the past – but get on with the future.
In reality, we have two huge elements we need to think about at the level of the brain. One is at the front, called our executive brain. The other is the area deep inside the brain called the limbic system. And the limbic system holds on to every memory we never process.
So, please don’t tell a woman to get over it because they never will; we have to help them get through it.
These experiences do stay with women for life. Many women experience significant distress that remains with them forever. I’m going to reconnect next week with a woman in her 80s. She has two daughters. Before the daughters were born, she had stillbirths. She has been told all her life that the reason those babies died was her fault – she was either not a good mother or wasn’t good during her pregnancy. She has suffered all her life because of it.
I don’t care if the woman is 80 or 20. If we can do some little thing to make life better for her, it’s worth the effort.
Birth is not a trade-off – don’t accept being told that it is
You must not accept someone telling you to forget what happened. You actually can’t. As long as you have a limbic system in your brain, you cannot do that.
Never accept being told that you can always try again after a loss.
Never accept anyone telling you that ‘you have to expect that a difficult experience because that’s just what happens when you have a baby’.
And never accept anyone telling you to be thankful you have a healthy baby because birth is not a trade-off between mother and baby. If anything about the mother is not right, it will not be right for the baby.
Informed choice – what it is and isn’t
When I talk to women about decision-making, I speak about informed choice comprising three things.
- Women can choose to say ‘yes’, which is informed consent.
- Women can choose to say ‘no’, which is informed refusal.
- Or they can choose the power response to say ‘why?’.
They can keep asking ‘why’ until they genuinely believe that they are well-informed and understand [the issues] so well that they don’t have any doubt whether they’re making truly informed refusal or informed consent.
What matters most in maternity care
It is important and what matters is that you feel cared about, and know people care about you and for you.
What also matters is that people listen to you. You can see in their actions, responses and communication that they do not just hear you; they are listening to you. And because they respect you, what you want to happen will happen.
Being safe is also so critical. At any time, if you do not feel safe, please voice it. Please say, ‘I do not feel safe’. You don’t have to explain it. It’s pretty clear then that something’s wrong, and they must do something about it. It may be the thing that changes everything and prevents you from getting PTSD or birth trauma.
It is essential that at all times, you feel autonomous and self-determining. You never lose your right self-determine because you are pregnant, in labour, giving birth or postnatal.
Two people in this have value, and lives matter, and that’s the woman giving birth and the baby.
Dr Heather Mattner is a health psychologist with nearly ten years of experience, focusing on perinatal psychology. She has also been a midwife for several decades, with a background in paediatrics. In academia, Heather holds the title of Adjunct Associate Professor at the University of Adelaide.
The Better Births event was organised by the Maternity Consumer Network and funded by the Queensland Government.
Where to find help:
- Your GP, who can create a mental health care plan and psychologist referral
- PANDA – 1300 726 306
- Centre of Perinatal Excellence (COPE)
- Lifeline – 13 11 14 or text 0477 13 11 14
- Beyond Blue – 1300 224 636 or chat online
Published 30th August 2022
Thank you. Birth trauma is not just part of birth. Women should be respected and empowered in birth; making decisions about their own care truly alongside their caregiver. Birth should never be about coercion or feeling unsafe. Let’s listen to women’s voices and change the birthing culture into a place of respect.