Guest Blog from Vicky Kavanagh-Masterson, who offers doula support in Dublin and surrounding counties.

What is Trauma?

Everyone experiences trauma differently and it can manifest as a singular event, multiple events, or long-lasting repetitive events. Birth trauma is a widely known form of trauma that affects the experience of birth and postpartum. However, unresolved trauma/PTSD can also have a direct impact on the birth and postpartum experience.

Trauma is defined as an incident that triggers a stress response, leading to physiological and emotional responses such as fight, flight, or freeze. The release of hormones, including epinephrine, cortisol, and beta-endorphins, during trauma can impact memory and ability to focus. If the trauma is not resolved, it can lead to chronic hyper-arousal and cause a lasting impact on the brain, including changes to the hippocampus, amygdala, and medial prefrontal cortex areas.

Trauma & Birth

During birth, hormones such as oxytocin, beta-endorphins, epinephrine/norepinephrine, and prolactin must be released in balance to enable a person to give birth. However, for someone with unresolved trauma/PTSD, instead of helping the birthing process, the release of these hormones can illicit a stress response and severely compromise the body’s ability to create oxytocin.

The importance of Oxytocin during the birth process is massive. The onset of labour, the progression of labour and the initial stages of breastfeeding are all driven by the release and utilization of oxytocin throughout the body. It’s why the importance of oxytocin is repeatedly drilled into pregnant people, along with ways to release and maintain it, throughout labour.

Stress can have a significant impact on the birthing process and can trigger the release of additional beta-endorphins and adrenaline, which can interfere with the delicate hormonal balance needed for a successful birth. Studies have shown that stress during labor can lead to longer and more painful labor, higher rates of medical interventions, and an increased risk of complications for both the mother and baby.

In the context of birth and postpartum, we are only beginning to understand the impact that trauma or unresolved PTSD may have on this process. Scientists are currently investigating the role of oxytocin in PTSD and trauma, but it does appear that women/birthing people who have experienced trauma or have PTSD may be more sensitive to the release of natural stress hormones during labour and delivery. Certainly

if you’re stressed, it is possible that this will effect your labour. Depending on what’s a particular trigger for your unresolved trauma/PTSD, there could be aspects of the birthing process that may be a particular issue for you.

Trauma & Postpartum

It’s not just the birthing experience that can be affected by trauma, it’s the entire new experience of becoming a parent. I personally have been lucky enough to become a new mother twice, but as someone diagnosed with C-PTSD during their postpartum period, I know first hand how the very normal aspects of new motherhood can end up triggering you into a panic state.

Brain imaging studies have shown that unresolved trauma/PTSD create long-term alteration to the hippocampus, prefrontal cortex and amygdala. These changes can affect a person's ability to process emotions, regulate the nervous system, appropriately assess threats, memory, decision making, learning, decision making and cognitive functions.

New mothers brains literally change and adapt in order to best respond to the needs of their newborn baby. It’s a time of monumental change, with mothers and parents constantly learning new things, new skills, new ways to care for their baby, what that baby likes and dislikes, usually at a time of extreme sleep deprivation. And that's even before you add in huge hormonal changes in the weeks and months after birth! For someone with PTSD, these very normal (if intense) stressors can send them into a tailspin, putting them in place where they feel like their emotions are uncontrollable, and their problems insurmountable.

Without having coping strategies, a self-care plan or help and support, things can seem very overwhelming and unending. Trauma - when not addressed - is a thief, stealing your energy, focus and ability to adapt and if you're dealing with it during your postpartum period, it can severely impact your experience of that event.

Trauma & Parenting

The process of parenting by its nature makes us re-experience our own childhood and how we in turn were parented. Our parents are our first model of how to parent, and when this becomes a role we now step into, we have to decide what aspects of that parenting you’re going to bring with you and which ones you’re going to do differently.

For someone who is traumatised, their ability to make decisions and learn from experiences can be difficult if that trauma is still presenting in day-to-day life.

Additionally, for people who may have traumatic experiences from their own childhood, the act of parenting can become a highly-emotional experience, bringing up old feelings and hurts which in turn play out through interactions with their child. There is no easy period of parenting, but those early years of toddler meltdowns, sleep deprivation and constantly shifting sands can be particularly grueling, even for someone free of other complications (although I have yet to meet the person who has a completely uncomplicated life!).

If you’re not in control of your own emotional landscape, then it’s very difficult to help your child co-regulate and manage their emotions as they get older and look to you for their own example of parenting and development. So recognising any unresolved trauma you may have that needs addressing is a really proactive way of positively parenting.

So, what do I do?

If you think you might be experiencing unresolved trauma or PTSD, the first thing to do is take steps to deal with that trauma. For some people, talking to a trusted loved one, journalling or finding some outlet for the feelings is enough to help them move past it. But if you think that your trauma more aligns with the description of PTSD, making an appointment with your GP and then engaging a psychiatrist or psychotherapist you connect with to address those previous trauma’s is an excellent idea.

If you’re pregnant or postpartum, engaging the services of a Birth or Postpartum Doula (or both) could be really helpful support at a time when you most need it. The period of pregnancy and postpartum (the first 12 months after a baby’s birth) is a time of huge transformation and growth; for you as an individual, your relationships, your life. You need support, practical assistance, sound information and reassurance to get through this transition and it’s not always practical or possible to rely on family and friends to help with this heavy lifting. An experienced doula can really assist in preparing you for both birth and postpartum, making plans for both and helping you put in place supports and actions that can make both processes a positive experience for you.

Whether it’s helping you learn relaxation techniques or coping mechanisms for dealing with labour, to meal-prepping, sorting washing and baby rooms to simply minding the baby while you get some much needed rest, there’s a lot a doula can give in the time you have them for.

But whoever you go to, just remember: minding your child starts with minding you. You need to prioritise taking care of yourself, and the rest will follow.

*If you feel like you could benefit from additional support please do reach out to us on info@doulacare.ie and we can help you find the correct professionals