Labour and Birth

Support following complications and unexpected outcomes

Psychological distress following childbirth

It is natural for pregnant women and their families to wish to have a normal labour and birth. Giving birth is often a time of high expectations, excitement and joy. For some women and their partners, unfortunately, childbirth is not fulfilling and it can become one of the most traumatic experiences of their lives. As in life, complications and unexpected outcomes can and do occur during labour and childbirth.

Research shows that feeling traumatised by a birthing experience is not uncommon and that trauma symptoms can develop, even if there were no obvious complications. Feelings of powerlessness, fear and experience of pain, unfulfilled expectations, and dissatisfaction with the level of information or care provided, are all possible factors impacting on women’s and their families’ emotional and psychological wellbeing following childbirth.

The symptoms of psychological distress can vary greatly from feelings of anxiety and agitation to feeling withdrawn and depressed. A more serious form of psychological distress, called post traumatic stress disorder (PTSD), can manifest as nightmares, flash-backs, extreme anxiety or depression, feelings of worthlessness or emotional detachment, problems with bonding with the baby and a fear of future pregnancy and childbirth. These symptoms and unresolved grief may repeatedly resurface with certain triggers or reminders such as the anniversary of the child’s birthday, causing the woman to relive the birth trauma.

Can anything be done to avoid psychological distress following childbirth?

Unfortunately it is not possible to always predict who will feel traumatised by a birthing experience. Research shows that childbirth for women who have experienced past birth trauma can either have the potential to re-traumatise or to heal. Each pregnant woman and her partner perceives and reacts to the experience of labour and birth in an individual manner, depending on their past experiences, cultural and religious background, knowledge, attitudes and expectations of labour and childbirth. However, having a sense of control and support in labour and birth is associated with better outcomes and there are some ways that pregnant women and their birth partners can prepare themselves for childbirth:

  • If you have experienced birth trauma in the past and find you are again experiencing feelings of fear and dread, please seek help early in your pregnancy by discussing this with your obstetrician and/or an experienced counsellor or psychologist
  • Attend antenatal classes and facility tours; ask questions about not only the normal process of labour and birth, but also any possible complications and likely interventions. Try to develop a flexible, balanced view and develop skills and ways to manage your labour and birth
  • Choose a birth partner who you trust, who will support and comfort you during labour and childbirth, and who can communicate effectively with your Maternity Team
  • Ensure both you and your birth partner are well informed and know your options during your informed consent discussions with your obstetrician and midwife
  • Have a birth plan so your Maternity Team knows your preferences, but be flexible and prepared to keep your options open if and when any circumstances change
  • Communicate often and develop a partnership with your midwife and obstetrician during labour and birth; e.g. don’t be afraid to ask questions and ask for advice, support, and pain relief

What support is available?

There are a number of options for finding support when unexpected outcomes or complications arise during labour and childbirth. These include debriefing and counselling, formal and informal expressions of concerns or complaints and a process called Open Disclosure.

Discussing your feelings and expressing your perceptions of your birth experience with your midwife and obstetrician may provide you with new insights into your birth experience. Research suggests that being able to ask questions and discuss and make sense of your birth experience can strengthen you psychologically, by assisting you to:

  • Gain an understanding of the medical aspects of your care
  • Reconstruct or piece together the whole birth story by closing any memory gaps or misunderstandings
  • Discuss any unmet expectations
  • Acknowledge any grief or loss and identify those emotions
  • Decrease mental distress
  • Promote further education about labour and childbirth

If you feel distressed or traumatised by your labour and birth experience, your midwife and obstetrician can empathetically explain and discuss the events with you. Please approach them early so they can acknowledge and address your feelings, support you, and provide any other assistance. Some of our midwives are trained counsellors, such as the ‘Gidget’ midwives (see Emotional wellbeing in the Resources). If you feel you need additional professional assistance your Maternity Team can also refer you to appropriate services for counselling, support and therapy.

Under the Private Patients’ Hospital Charter, you have a right to raise concerns or complain about your treatment. If you are concerned about any aspect of your treatment you should initially raise this with the staff at your hospital. Raising a concern or making a complaint will in no way adversely affect your health care with us. Ramsay Health Care views all complaints as an opportunity to improve services and will deal with your complaint in a fair and timely manner. If you wish to make a complaint, there are several options. We would prefer to help while you are in hospital so please let us know. You may contact the following staff of your hospital:

  • Discuss matters with the Nursing Unit Manager or the Director of Clinical Services
  • Contact the After Hours Manager if outside business hours
  • Write to the CEO or Director of Clinical Services. All complaints received in writing receive a response within seven days

Additionally, you can contact the Health Care Complaints Commission of your State or Territory or the Australian Health Practitioner Regulatory Agency. Links to these sites are available in the Resources.