Hot Topic Blog - Parenting
SUPPORTING FAMILIES WITH BIRTH TRAUMA: AN INTEGRATED APPROACHBy Kate White, Massage and Craniosacral Therapist in Charlottesville, Virginia, USA
A young woman recently called me about helping her with her birth experience. Someone she knew told her about my approach to healing difficult births. Her story was familiar: the birth did not go as planned; the pain was too much; the staff at the hospital were not attentive; many interventions were used; the baby had to be resuscitated, then would not sleep for months; and the story of this difficult birth kept swirling in her head. Yes, of course, I would help her I said, and I laid out a plan for her, an integrated approach of somatic skills, touch, awareness, and working with autonomic states in the body to help her, her husband, and their baby.
There is a rising tide of practitioners trained to help families who experience birth trauma. A true definition of this kind of trauma is “when the individual (mother, father, or other witness) believes the mother’s or her baby’s life was in danger, or that a serious threat to the mother’s or her baby’s physical or emotional integrity existed” (Simkin, 2016). In addition, research into the birth experience reveals that one-in-four women exhibit symptoms of posttraumatic stress disorder (Kendall-Tackett, 2016). It is no wonder families seek support for babies who cry; as well as have difficulty feeding, sleeping, and other issues. As a bodyworker who specializes in helping families with birth trauma, the most frequent reasons mothers bring their babies to me are difficulty feeding and sleeping. Many also report inconsolable crying.
Assessment of the families begins with listening to the birth story. The quality of presence and listening is an important skill and can settle the mom in particular. We are trained in nervous system regulation and help families understand the range of sensations and responses to autonomic nervous system states related to overwhelming events. For example, each person has what we call a functional range, where his or her nervous system will rise and fall in energy and experience based on functional need. These needs include the energy to go out into the world to work; to get things done; and then to rest, eat, and sleep when needed. This translates easily into understanding the baby’s experience to eat, sleep, and play. When events are overwhelming, we can go out of this range into symptoms related to fight, flight, and freeze. These are all normal responses to overwhelming events, boundary breaches, pain, abandonment, and traumatic births.
Treatment protocols for the family include helping parents sort out their experiences and what they notice inside their own bodies. Working with sensation and feeling states, a trained practitioner can create enough safety and coherency (or good feelings) in the body so more difficult, dysregulated, or frozen states can be addressed and released. I also spend a lot of time normalizing difficult experiences from birth. These can range from really fast births to very long births and near death experiences. They also include severe pain and overwhelm from hospital interventions. Overall, I have found three large patterns in birth trauma for mothers: feeling unseen (“I was in so much pain, how could the staff not see?”), feeling betrayed (“Why didn’t anyone tell me?”), and feeling confusion or when two things were happening at once, (“It was right but so wrong, wrong but so right.”). I have worked with Pitocin, Cesarean section, hemorrhages, shoulder dystocia, near death experiences, as well as placenta retention and manual removal, just to name a few of the difficult births families have experienced. Treating the whole family is best. My approaches use touch, bodywork, Somatic Experiencing®, as well as prenatal and perinatal trauma healing (see castellinotraining.com).
Babies communicate very directly about their experiences with crying, autonomic signals such as skin color (flushed to pale on a continuum, including mottled), posture (floppy or rigid), eye gaze or lack of eye contact, movement (none to jerky), and specific ways they hold their bodies (in a c-curve, extension, or compression) from their in utero or birth experiences. Most often, babies who don’t recover after birth are carrying an imprint from an in utero experience or severe issues from the birth process. The somatic practitioner’s job is to relieve compression, restore full function of the body if needed, hear the story of the baby through the baby’s way of speaking (cry, gaze, movement, gesture), and teach the parents how to do this at home with their baby.
I use a large range of skills I have learned over time. These include craniosacral therapy, myofascial approaches, social engagement, recognition of autonomic nervous system states (a key to healing the mother-baby dyad), supported attachment (crawl to breast), postural approaches, timing, intensity, and presence. I teach about sequencing, or how a baby completes an action or activity, and sleep states. Frequently, I get asked to assess fascial constraints that limit breastfeeding latch and tongue function. Additionally, the mother may report an amazing birth experience, but it was not that way for the baby.
Most of the time, I relieve compression that is still in the baby’s body and experience related to pregnancy and birth. As I relieve this compression, the baby may touch back into the overwhelming feelings he or she felt during birth. Treatment is rhythmic, titrated, and we pendulate back and forth from the present (“You made it! You are safe now. That was then, this is now.”) to the experience that caused the physical state (“You were stuck then, but not now. Yes, that was overwhelming, you can go slowly now, you don’t have to speed up. You can do it differently now, but yes, that was scary back then.”) Many babies look relieved when I understand their story and can help them feel better in their bodies. Families learn how to help their babies at home by listening for key moments in their babies’ stories. Sometimes, we make repair or reflect back to the baby how sorry we are for their hurts, and how we didn’t want that to happen for them.
Human development starts before conception, not after birth. If we bring our conscious awareness to our family patterns, stress levels, and healthy habits, we can conceive, carry, and birth babies optimally. If we can provide quality care that includes stress management, levels of support for the pregnant woman and her partner, and education about the baby’s experience, we will improve birth outcomes. As a complementary therapy to traditional medical practices for families, a skilled bodyworker can make a huge difference during this early time, so families get off to the best possible start. Osteopathy, or a genre of physical medicine, provides this quote: “As the twig is bent, so grows the tree.” Let’s help our birthing families with their birth experiences, so their trees grow optimally.
Kendall-Tackett, K. (2016). Healing birth trauma: A two-day online conference for birth and behavioral health professionals. Prevention and Treatment of Traumatic Childbirth. Retrieved from: http://pattch.org/trauma-conference/
Simkin, P. (2016). Resource guide: Prevention and treatment of traumatic childbirth. Prevention and Treatment of Traumatic Childbirth. Retrieved from: http://pattch.org/resource-guide/traumatic-births-and-ptsd-definition-and-statistics/
About the Author
Kate White, MA, CMT, CEIM, SEP is a massage and craniosacral therapist who specializes in working with babies and their families. She has extensive training in working with families during the childbearing year, especially prenatal and perinatal health, trauma resolution, birth, breastfeeding, and bonding/attachment. She is currently the Director of Education at APPPAH, Director of the Center for Prenatal and Perinatal Programs, and owns a private bodywork practice in Charlottesville, VA. She is married with two children. You can see more about her at belvederearts.com or ppncenter.com, and about her educational program for APPPAH at birthpsychology.com. Email: firstname.lastname@example.org