Processing Your Birth Story with Dr. Alyssa Berlin, Perinatal Psychologist
In this episode, we chat with Dr. Berlin, a perinatal psychologist, on how we can begin to approach processing our birth story if it was not the positive experience we had been preparing for.
With Gina and Alyssa
Welcome to the MamasteFit Podcast. In this week’s episode, we’ll be discussing how to process your birth story if maybe it wasn’t what you had expected, practical tips for overcoming trauma, and how to move towards healing.
We have the privilege of having Dr. Alyssa Berlin with us, a perinatal psychologist based out of LA, California.
I actually did my own postpartum therapy with Dr. Berlin after the birth of my son when I was dealing with a lot of postpartum OCD and anxiety.
Dr. Berlin specializes in perinatal mental health, and was a great resource to me. And so I’m really excited to have her here to talk about how we can process our birth because this is a common question that we get from a lot of our followers.
But before we start…
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Let’s continue…
Dr. Berlin:
Gina and Roxanne, thank you for having me. Thank you for doing this podcast and really showcasing such an important idea and experience because I think one of the biggest problems that we deal with in the world of mental health as a whole and definitely around birth and pregnancy and parenting is that we’re afraid to talk.
And a lot of us kind of live in silence out of fear of how people will perceive us or bigger consequences that, again, a lot of this goes unspoken. And so sharing your birth stories and really, again, showcasing this topic and making it okay, giving women permission is tremendous. So really, ladies, thank you for doing that.
I kind of reached the point where I realized what I was feeling was not normal. And so I reached out to Dr. Berlin and she helped me a ton with processing this and continues to be an amazing resource for us to this day.
And so my first birth story was definitely a more traumatic experience that was really the result of being treated pretty poorly in the later part of my pregnancy and during my birth. And I shared my first birth story in episode two of our podcast.
I ultimately had a birth that I was not expecting or preparing for. And my biggest issue was that I was trying to sort through this disappointing experience and mourning the birth that I had been preparing for while also being really excited that my baby was here. And so, I was scared that if I was disappointed in her birth and that it meant our story started off with trauma. And so, I told myself that it was fine and that my birth was fine.
I almost was looking at my second birth as my redemption shot what I wanted the first time around. And so it took me years to really come to terms with her birth and finally accept that it was not a positive experience and that it was okay for me to accept that it was not a positive experience, but it didn’t mean that the way that I was treated was okay. And so understanding that I could accept the experience and acknowledge that what had happened was not okay.
How Can You Begin to Process Your Birth Story
Gina: For lot of my doula clients, where it’s their subsequent pregnancies, they’re reaching out and they’re like, hey, I want to do all of the things right this time because my previous birth was not what I was preparing for, not what I was expecting, and it always breaks my heart because I know what they’re feeling.
How would you recommend that someone begin to process their birth story? Whether it was traumatic, it was just not what they expected, or if they even just have negative experiences or emotions around their birth.
Instead of imposing or assuming what a mom's experience was, slowing down and asking and checking in and giving permission for the whole range of emotions and experiences around something, I think that's already kind of putting us down a certain path where we pick up these subliminal messages of what is and isn't okay.
Dr. Berlin: I want us to talk about first and foremost that when we talk about birth trauma, birth trauma is one of those things where it’s in the eyes of the beholder.
So people who have attended our births may be like, wow, that was beautiful, and we may not feel that way. By the way, one of the fastest ways to kind of shut up a woman who had a negative experience is having someone else be like, that was great before really being able to even check in with that mom and be like, how are you doing, right? How are you feeling? And so we can even start right then and there.
Instead of imposing or assuming what a mom’s experience was, slowing down and asking and checking in and giving permission for the whole range of emotions and experiences around something, I think that’s already kind of putting us down a certain path where we pick up these subliminal messages of what is and isn’t okay. So that’s, I think, a really important starting point.
Another thing that I think really worth mentioning and talking about as we talk about what it is to be able to create that space to process a birth story is that society really does us a tremendous disservice where I think there’s a lot of times that assumption that the ends justify the means.
And Gina, you kind of were talking a little bit about that in terms of being in these two places. Like, I’m so happy she’s here, and I’m so happy she’s healthy, but what was that experience?
And is it okay to even be like, gosh, it’s not what I wanted, and I don’t like the way I was treated, right. But how often I’ll hear women in my practice say, like, oh, but I know that I should just be focused and be grateful that a healthy baby is here, or I should just be grateful that it went a certain way. And again, a lot of imposed energy and expectation that will very quickly quiet down a mom who maybe is wanting to share something else.
Birth Trauma can really impact ANYONE in that space
Dr. Berlin: So, one of the first things that we want to do is to really empower women and to empower families, right? We’re focusing more on the mom, but we know that birth trauma is something that could happen to mom as well as the non-birthing partner. And really, anyone in that space.
It’s not uncommon that I’ll have women reach out to me and say, hey, can you see my partner? I’m okay. Or I didn’t really know what was going on, so I’m not as impacted, but he’s really struggling, or she’s really struggling with what that experience was like. So, again, birth trauma can really impact anyone in that space.
And step one is, again, creating that permission to really speak up, that there’s no expectation of how you’re supposed to feel and whatever it is you have to say, we’re happy to listen. And so really empowering women to be able to talk and to share, and that’s the first step.
How can you let go of the guilt and blame?
Gina: Something that we have a lot of folks ask us, and it was something that I struggled with as well, was how can we let go of the guilt or the blame that we put on ourselves for our birth experience?
I am definitely in a place now where I truly believe that I did not deserve to be treated like that, that I did not do something to deserve that experience. And I have come to understand that I did the best I could with the knowledge that I had, and I prepared as best as I could. And there were things that were outside of my control. It wasn’t anything that I necessarily did that caused that experience. And I could totally go back and be in like, what is it? Hindsight 2020? And be like, oh, if I had done this differently and this differently, then maybe that wouldn’t have happened.
But at the end of the day, the provider that I had was just not having a good day. And the way that they treated me is what really caused a lot of the trauma.
How could you recommend that someone could let go of that guilt and the blame that we’re forcing onto ourselves?
Dr. Berlin: And it’s so hard. And even as you were talking initially, right, about the idea that women come to you for a second or third or subsequent birth, and like, we want our redemption birth, which I always bristle at that word, because no woman is likely in need of redemption in that she didn’t do anything wrong.
Now, that’s not to say we don’t want a very different birth experience, right? But the reason that women come in with that energy of I want to do it differently or I want to really different, I want a different experience is just astounding to me. It’s like there are very few places, if you will, where we go from novice to expert more than in this field, where we experience something.
And this is true postpartum also, right? It’s like being the parent of baby number one and then the parent of baby number two. It’s like, man, oh man, right. It’s night and day of what we know.
And so I think that that’s a lot of that experience. Also, when we go through a traumatic experience, first and foremost, we tend to do a lot of soul searching and research, and it really does inform then where things could have been different. I’ll throw out this and then I’m going to get back to your question.
The idea is that a lot of times when I work with women, it’s reframing it’s not that mom failed, which is oftentimes the experience that somehow either they or their body failed to do what they thought or wanted or should have done.
But oftentimes I’ll reframe it to, you know, what, your team failed you, your birth team failed you. You didn’t fail. You did the best you could with what you had or you, you know, but your birth team failed you and failed to either treat you, right, like in your case, Gina, or to support you in the ways that you really want. And so as we even kind of go into picking our practitioners, I’m often really outspoken of like, you don’t want a doctor that’s going to tolerate you. You want a doctor that’s really invested in what you’re wanting, right?
So it’s not just like, yeah, sure, and we’ll see, but it’s like, no, they’re really in line with you. And philosophically, we’re wanting the same thing. Guilt is such a hard thing because I’m pretty sure that us moms more than dads, but us moms get in line about six times over when they’re handing out guilt, we ride and come to that maternal guilt so deeply. Because if ever there’s a role that we really want to get right, it’s being a mom. And that starts in that birthing process. And a lot of us go into it with expectations of what we want it to be and how we want it to go and really wanting to foster a certain experience.
Prevention: Can We Prevent Trauma?
First of all, on that prevention side, something else that we find that can be really helpful in the potential prevention is really slowing things down. So it's not always possible. But when it is and things are changing for a woman in that birth experience or things are deviating from what they want but slowing down and really talking to mom and talking to the nonbirthing partner and either giving them that chance to ask questions, giving them that chance to understand, giving them that chance to perhaps wrap their mind around what it is that their practitioner is wanting to do can really be a tremendous buffer in experiencing trauma.
So I kind of want to come at this question from two different perspectives, which is things that we can do to kind of prevent the potential of trauma, and that’s not always possible. And we know that there’s a lot and again, the two women sitting in front of me, you guys can tell me better than I can, right, about all the different things that we can’t possibly anticipate or prepare for, right?
And I’m sure you get a lot of women who are like, okay, so here’s how it’s going to go. And you’re like, wait a second. But having more accurate expectations going in, that ability to be flexible and to go through an openness to what might be can be really helpful.
First of all, on that prevention side, something else that we find that can be really helpful in the potential prevention is really slowing things down. So it’s not always possible. But when it is and things are changing for a woman in that birth experience or things are deviating from what they want but slowing down and really talking to mom and talking to the nonbirthing partner and either giving them that chance to ask questions, giving them that chance to understand, giving them that chance to perhaps wrap their mind around what it is that their practitioner is wanting to do can really be a tremendous buffer in experiencing trauma.
And I remember I moonlighted as a doula for a very short period of time, and our family learned that having two on-call parents was not a good idea. So I was very happy to give the mantle to my husband.
But I remember being a doula at a birth where things all of a sudden just took a turn, right? And all of a sudden couldn’t get baby on the monitor, and the room was stormed by people, and they’re manipulating mom this way and that way, and mom is freaking out. And I just slowed down, and I went to mom, and I’m like, how are you feeling? What’s going on? And every question she would ask or have, I would broadcast it to the room and then repeat it back to her quietly.
And just giving her that information of what’s going on, why it’s happening, hey, I know it feels really scary, but actually, in this situation, it was a good thing, right? The baby had sunk into the canal so deeply that that’s why the monitors were struggling. And actually, you’re getting closer to birth. Like, it’s okay. She’ll still talk about after the fact of like, oh, my gosh, what I would have been left with if I didn’t have that person to slow down and talk to me so I couldn’t make sense and process and feel comfortable and feel a part of it.
Right. Empower her to be a part of it. So those are just some of the things that we can do to kind of help either before or in the moment.
What about after the trauma has occurred? What tips would you share for overcoming trauma?
First of all, on that prevention side, something else that we find that can be really helpful in the potential prevention is really slowing things down. So it's not always possible. But when it is and things are changing for a woman in that birth experience or things are deviating from what they want but slowing down and really talking to mom and talking to the nonbirthing partner and either giving them that chance to ask questions, giving them that chance to understand, giving them that chance to perhaps wrap their mind around what it is that their practitioner is wanting to do can really be a tremendous buffer in experiencing trauma.
What do we do after?
An after is really hard. After when, again, whether a birth didn’t go the way we thought it would go or the way we wanted it to go. Maybe there was an intervention or again an emergency that happened that left mom either feeling scared or disempowered or something. It does. It’s really impactful. And I usually find a couple of different things.
One thing that can be helpful is, like we said, people willing to listen without judgment, without quieting mom, they’re really willing to listen to the experience. Women, at the end of the day, we’re verbal processors.
And so I’ll tell men all the time, right in my preparation for birth class, I’m like, guess what? Your job is going to be to listen to your partner tell your birth story over and over again. Like you didn’t have front-row seats for the experience and like you’ve never heard it before.
Because if she’s wanting to share it, guess what? You get to listen. Right? And it’s even priming the people around mom for what would be helpful and supportive. And maybe it is listening to her say it over and over and over again as she’s trying to digest and make sense of it. Now, in deference to our nonbirthing partners, you can suggest calling a mom a friend. But I’m like, but if at the end of the day, you’re the one she wants to talk to, buckle up and get ready to listen because that can be really helpful. And having people, again, not try to minimize, but listen right can be very helpful and cathartic.
Story Telling to Heal from Birth Trauma
Another thing that can be helpful is talking to other women who have had a traumatic birth. Being able to share your story is very powerful. And having other people who are like, you know what? I get it, right? I hear you and I get it and I'm right there with you can also be really helpful.
Another thing that can be helpful is talking to other women who have had a traumatic birth. Being able to share your story is very powerful. And having other people who are like, you know what? I get it, right? I hear you and I get it and I’m right there with you can also be really helpful. Things can be really difficult and impactful. They can have really impacted us deeply. And usually, again, talking to people around us will be helpful. When things hit that threshold of trauma, it often requires more professional help because the concept of trauma is that things are kind of getting stuck.
Talking about it has value, but somewhat limited value to really being able to address the trauma. And to me, guilt is a symptom of that trauma.
And so gratefully there are some wonderful techniques out there that are super helpful in processing and digesting and releasing that trauma from the body. And so those would probably be some of the more beneficial ways to address that guilt: EMDR, eye movement, desensitization, and reprocessing.
Francine Shapiro’s approach can be very helpful. It’s one of my main modalities when I’m working with trauma. And then Peter Levine’s approach of somatic experiencing, or SE, is also really helpful because we are helping to digest the experience using the body.
And at the end of the day, a lot of it is really stored in the body, right? A lot of times when people experience trauma, the ways that it’ll manifest is either a lot of thoughts, but the more somatic ways are shortness of breath, sweating, erasing heart, a feeling of electricity in the body, and things like that. And so we just know that we are much more effective dealing with it from a bottom-up, somatic-oriented perspective than just talk.
Talk is very helpful and I definitely like women to be able to reframe and to come at the experience from a different way, right? Like we were talking about even before, where it’s not that God forbid a woman or her body failed, but perhaps the team failed you or you didn’t have what you were expecting or wanting to have.
Gina: So it was definitely really helpful for me after my birth and then after my miscarriages to essentially just kind of repeat the story over and over again to other people as I was processing it and kind of accepting that they had experience had happened. And especially with my miscarriages, it was so helpful because a lot of other people have had pregnancy loss and so I felt so much less alone when I started sharing my story and then some of my other friends were like I actually have had a pregnancy loss too and I haven’t told anyone about it.
You’re the first person that I have told it to and so it became this very healing, we’re in this together kind of experience, which I found like the talking to other people to be super helpful and to be able to repeat the same story multiple times to be very helpful for me. And then of course, being able to speak to professional really helps when I was starting to have more issues that were definitely affecting my ability to live my life and I’m sure you’re familiar with my story.
One of the things that really triggered me to see Dr. Berlin was some of my postpartum OCD where I would almost have, or probably just have a panic attack where I would cease to function because I was afraid something’s going to happen to my son. And it was always some sort of like super irrational thing, I think what triggered it for me, I was in an aquarium and I thought someone was going to take him for me and throw him in the shark tank. And I had to sit down and I was breathing really hard and just panicking. And I was like, I think I should seek some professional help.
So hopefully people that are listening have not reached that point in their lives, but definitely talking to people and then talking to a professional to be like, hey, I think this is not normal for me, was definitely a game changer for me. It’s okay to seek additional support. And what’s really great is we have so much virtual options as well.
I’m on the other side of the country from Dr. Berlin and I was able to do therapy sessions with her for over a year and they were super beneficial for me. And so there’s so many online options too, because sometimes the barrier is, can I bring my baby with me or my baby’s going to cry the whole time and I’m going to be so distracted trying to seek help for myself.
Navigating the Unknown During Birth
Gina: One of the things that you talked about was your story as a doula where there was a potentially more emergent situation happening. And this is something that I encounter a lot too. And I kind of find myself like tiptoeing, where I don’t want to tell my client what is happening because I don’t want to potentially be wrong about what everyone is responding to.
Either a family who is potentially in a more emergent birth situation, which I find seems to result in more of a negative experience, is feeling really confused about what’s happening and kind of going down this rabbit hole of despair or feeling very confused about your options. So what would you recommend to a family if they find themselves in their birth and there seems to be a lot happening, but nobody is talking to them?
You're just trying to focus on the emergency, but having another nurse coming in there to be like, hey, this is what they found, this is why they're doing all of these techniques. Baby looks like whatever, or like, we saw this for you and whatever, these are the reasons we're doing this. We're doing the best we can. We will update you once you're stable. That is something that is talked about that needs to happen. And I think some hospitals are better at it than others, for sure.
Roxanne: Yes, this is definitely something that is talked about in the medical community, is that we in an emergent situation. Someone needs to also be talking to the patient and the family members because they have no idea what’s going on. And sometimes it’s not even necessarily a full on emergency, it’s just something that we need to address immediately. But having somebody kind of designated to tell them what’s happening. Even in code situations, I’ve never had to thankfully be a part of an adult code, but there’s usually a person that’s designated to be like, you’re in charge of the family. You go and update the family on things that are going on.
But in labor and delivery, this is sometimes the things that’s kind of thrown to the side in an emergency, like telling them what is happening and kind of like keeping them updated in the moment. So afterwards is sometimes a thing that kind of comes up. After the emergency, the provider and the nurses will sit down and kind of go over everything that happened, why they did what they did, and then kind of answer any questions that they had that came up. Because in the moment, it’s like you have blinders on.
You’re just trying to focus on the emergency, but having another nurse coming in there to be like, hey, this is what they found, this is why they’re doing all of these techniques. Baby looks like whatever, or like, we saw this for you and whatever, these are the reasons we’re doing this. We’re doing the best we can. We will update you once you’re stable. That is something that is talked about that needs to happen. And I think some hospitals are better at it than others, for sure.
Afterwards is usually that’s like a positive. If we’ve updated the family, which it should just be standard, but it is hard in an emergency situation, especially to remember to update everybody.
One thing that we had started was started just like calling out what was happening, like, hey, baby’s heart rate is down. We’re going to reposition to the left side. So, one, everyone on the medical team knows what interventions we’re doing, but also the family member knows as well. So it’s like you’re calling out. So, then the provider could be like, hey, I need her to have some IV fluids. And then the nurse will then, hey, I’m giving her some IV fluids now, or like, hey, I need this medication. Hey, this medication is drawn up. We’re giving this medication. And then someone else would be like, this is why we’re giving the medication to the patient. Like, do you consent to this medication?
Obviously, because we don’t want to give someone something that they don’t want. But in an emergency situation, usually it’s quick consents, but yeah, that’s definitely something that needs to for sure happen more. But I think hopefully it’s moving in the right direction where more people are going to be a little bit more verbal in just like the actual situation so that everybody can understand.
So then if they do have another family member or a doula, and they hear like, hey, baby’s heart rate is down, they know what that means and they can be like, yes, baby’s heart rate is down, they’re doing all of these interventions to bring baby’s heart rate back up. Nobody’s calling it out. Like, again, Gina could be like, I think this is what’s happening, but I have no idea. And then you don’t want to say like, oh, I think baby’s heart rate is down. It was really just like her blood pressure was down and that’s why we’re just trying to keep her blood pressure up and Baby was actually fine.
So, I understand where Gina is coming from, but definitely is a thing that we need to improve on in the medical community. Before, obviously, I haven’t been in the hospital for two years now, just from life, so maybe it could be a lot better now than it was when I left.
Like, someone needs to kind of be designated, but then it’s like you want to be involved and helpful in the action in an emergency of like, you feel like if I’m doing something to help bring the baby’s heart rate up, I’m more important than being the person that’s telling somebody. But that is an important part of an emergency situation and that’s it.
But we know that what we build up in our head is often so much bigger and so much worse. And to have the medical personnel, like you said, call out as they go, listen, having a designated emotional support person while these things happen, that's the dream. A minimum, to call it out so that mom and dad or mom and their non birthing partner also are informed, that's tremendous. And again, we appreciate the distinction.
Dr. Berlin: But I have to say, Roxanne, you should be in charge of [labor and delivery floors] everywhere, because that model would be a game changer. But we know that what we build up in our head is often so much bigger and so much worse. And to have the medical personnel, like you said, call out as they go, listen, having a designated emotional support person while these things happen, that’s the dream. A minimum, to call it out so that mom and dad or mom and their non birthing partner also are informed, that’s tremendous. And again, we appreciate the distinction.
Right. When COVID first started, we couldn’t give any real energy to the emotional because it was life and death. There was nothing to talk about. And between life and death, right. That’s what we have to focus on first. It was so upsetting to me, though. This was last year already, my son had an appendicitis, and thankfully, we were through a lot of the major initials of COVID where we weren’t dealing with that same level of danger.
And they still made him choose, do they want me or dad as he’s going down to surgery and doing all of these things? And I’m like, no. I said, when we’re past the immediate now, we do need to bring the emotional piece back in because we know it’s as impactful, if not more, in terms of what a person is experiencing. So I’m still voting for Roxanne for hospital reform.
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There is room for a happy mom.
And [my husband] was like, "it didn't trigger for me the way that you were being treated or the fact that you didn't get the birth that you wanted would somehow have been upsetting for you because our baby was healthy." Healthy mom, healthy baby. He's like, that's the standard. How could you possibly be upset and still processing your birth? Healthy mom, healthy baby is, like, the bare minimum. There is room for a happy mom. Like, a good experience, too.
Gina: Yeah, that was something that my husband just listened to our first birth story, and he came home, and he was talking about this story to me, and he’s like, I didn’t even recognize that you had had a negative experience until you started talking about it later. And he was like, it didn’t trigger for me the way that you were being treated or the fact that you didn’t get the birth that you wanted would somehow have been upsetting for you because our baby was healthy. Healthy mom, healthy baby. He’s like, that’s the standard.
How could you possibly be upset and still processing your birth? Healthy mom, healthy baby is, like, the bare minimum. There is room for a happy mom. Like, a good experience, too.
And just like Roxanne was saying, everyone’s focused on wanting to be the one to do all the things, and nobody wants to focus, I mean, there’s probably are people that do. A lot of people do not want to focus on, “am I emotionally taking care of this person in this very transformative experience of their lives? Can I help them with the emotional aspect of things?”
And so maybe it’s like our society has really downplayed the significance of pregnancy and birth and motherhood. It’s probably a huge aspect of it. And then maybe it’s more of the medical community that kind of downplays the emotional aspect of care, because we don’t have time. We’re running for patient to patient.
And so, yeah, he said he didn’t even know realized that I had had a negative or traumatic experience, because he was like, well, we have a healthy baby. What more could you have wanted? And then with our subsequent birth, he’s like, oh, I see what more you could have wanted. You wanted to feel empowered in your experience, too.
Roxanne: Yeah, I definitely think in the birth community that it is in the hospital sometimes that emotional portion of this is such a happy moment. And a monumental moment in people’s lives is the birth of their children. And, I mean, some of us only get one, two, or three, or some people get ten experiences, but it’s like we help people bring their babies in every day.
But I think that sometimes because we do it every day, we forget that it is this monumental moment for people and that it is something that they are not experiencing every day. But for us, it is like, a normal thing that we encounter every day is birth.
Yeah, it’s like we’ve come jaded to the experience for other people. And the past like five years since COVID I feel like I say five years, but it’s really been like three years, but I feel like the past five years nursing, there’s a nursing shortage. So in hospitals, the support on labor and deliveries, there’s just not enough staff to be able to provide the type of care that all of us want to provide.
The rate of nurse burnout is like incredibly high. I’m not saying that what is happening is okay, but that is one of the things the first thing that’s going to go in medical care is probably that emotional stuff because we just don’t have enough to be able to provide it all.
I mean, birth trauma can affect not just like the person experiencing it, but the other people that are experiencing it to include the birth partners, the family members. Even a doula like birth workers can also experience that trauma because of an experience that they witness that they blame themselves for. So, like, midwives, OBs, nurses could also experience that trauma because of traumatic experiences that they could blame themselves for.
Even so, mental health, everyone should see a therapist. I think everyone it’s just beneficial for everybody, but especially people in the birth working world, as well as family members who maybe just even if you feel like you had a really great birth, experiencing sometimes just talking it out with someone to be like, yeah, I’m good, I’m good mentally and that’s it.
Dr. Berlin: Right. And we would be so remiss if we didn’t recognize the massiveness of birth life altering experience.
Right. We’ve all heard the saying, and it’s really true that with every baby that’s born, there’s a new parent that’s born or parents that are born. And even when it’s baby two or three or four, right. It’s still a new iteration of those individuals as parents. And again, that’s massive. And our country, I think we know, can do a lot more to support new families and then yes, and then recognizing that no one leaves that room unscathed.
Everyone is impacted by the hormones and the oxytocin. Birthing and non birthing partners alike can experience some emotional upheaval and actually a full on perinatal mood or anxiety disorder, which I know we’re going to talk about at a different time, but it does. And I think where we get in trouble with partners is sometimes assuming that they had the same experience. And then we go to react in the same way versus slowing down and asking and creating space where it’s okay that we had different experiences. And instead of trying to make yours mine or vice versa.
How can I support you? How can I be open and listening to what yours was maybe similar or maybe different than mine? Right? And that can be tremendous.
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Overcoming Trauma
Anytime you're experiencing those flashbacks or those repeated experiences, those are indications that I want you to reach out for help, that I want you to seek a professional. And it's something that I like to tell non birth partners that a lot of times they may be the first one to really notice that their birthing partners are not quite okay. Because again, as women in particular, I feel like a lot of us, we power through. If it's the first time, we also often may have nothing to compare it to.
Gina: What would you recommend to somebody who’s stuck in their trauma so they’re having a hard time moving past their birth? They’re reliving it over and over again. Everything reminds them of the birth.
So not that having a cesarean birth is traumatic, but we definitely have more folks that reach out to us who have had a cesarean birth that found it to be a traumatic experience. And so every time they see their scar, they’re like, every time I see that, it makes me relive that story again.
What would you recommend to somebody who is stuck?
Dr. Berlin: I think that I would want to look at that as an indication of seeking some additional outside help, whether it’s in the form of support groups initially, because, Gina, even as you talked about it, there’s a catharsis to being with other people who have experienced something that we’ve experienced. And I like the play on words, so I’m going to say it here, but we need to figure out a better play on words, right? Which is to say, we’ve all heard the adage of misery loves company.
The reality is that misery loves miserable company. And not to say that anyone is in misery or miserable, that’s for each person to decide or navigate. But the notion of being with people who get it is a very different experience when you find yourself either having a hard time looking at the scar and every time you see it, it’s triggering flashbacks or memories.
Or for some women, if something happens at a certain time in the day, right, if the unexpected Csection happens at like 04:00 p.m., if you will, there can be a temporal trauma that comes where this woman is like, “gosh, every day at 04:00 p.m., I just start bawling and I don’t know why.”
Anytime you’re experiencing those flashbacks or those repeated experiences, those are indications that I want you to reach out for help, that I want you to seek a professional. And it’s something that I like to tell non birth partners that a lot of times they may be the first one to really notice that their birthing partners are not quite okay. Because again, as women in particular, I feel like a lot of us, we power through. If it’s the first time, we also often may have nothing to compare it to.
For some women, it’s like, I guess this is just what it is, and they’ll struggle or they’ll suffer because the assumption is there’s not another way. And so, I really like to clue in non birthing partners too. I want you to watch. And if you’re seeing something, right, maybe you’re the one who’s going to even start that conversation of like, hey, it seems like something’s going on, and maybe this is bigger than just you and I talking about it or addressing it together, but maybe we want to go talk to someone. And I am a big believer that birth trauma, no matter which partner is experiencing it, it’s a family issue. And so, we want to come at it from a family perspective.
Nothing feels more supportive than having your partner be there with you. Unfortunately, the antithesis is also true that little feels more devastating than to feel like your partner is not aligned with you or isn’t getting it right. And so having that team or having people come and do it together is really helpful. And we’re getting the one who’s struggling the help that they need. And then there’s a lot of psychoeducation for the one who’s maybe not directly struggling, but to help give them a context and an understanding of what their partner is going through. And I always like to be able to share with partners, like what are the things that you may want to say because you think they’re helpful, but they won’t be helpful, so stay away from those and what are the things to say that will actually be experienced as helpful and use those and when in doubt, ask.
So those are some of my thoughts about that.
Preparing for Birth After Birth Trauma
I like to share with women a lot that, again, when it comes to motherhood, we aspire to be the good enough mom. I think that's hard. We live in a society that doesn't really recognize middle of the line. It's always like, hey, I need the best. I'm going to the mall, what's the best white shirt I can find? Or I'm throwing a party, I need the best photographer out there. Sometimes the functional good guy or person who's going to get it done, it works. And I can make my piece and be happy. But there has to be an awareness of that that has value, that it's not the best or best, but that there's value in the good enough, right?
Gina: What would you recommend to somebody who’s getting ready for their second pregnancy and navigating a subsequent experience after their first potentially negative experience?
Usually what I’ll see for my clients is those who have had like a negative prior birth experience, they want to do all of the things. “I will eat this specific way. I will exercise every day. I will do all of the things because the reason why I had that experience was because I failed to do to check all my boxes.”
And then they’re like super anxious their whole pregnancy because their to-do list to guarantee a good birth is so long.
I find that if someone still if they have this long to-do list, they’re probably still holding on to something from their prior birth.
What would you recommend to that person who is preparing for a subsequent pregnancy and birth?
Dr Berlin: And so, first of all, I love that you know that. I love that you already know the warning signs of if you’re coming to me with the kitchen sink list, ding, ding, ding. That’s a warning sign, right? And it is true that for a lot of women, especially if they muddled through the first time around and didn’t really do work around it, that for a lot of women, it will come up as they do get pregnant again and are anticipating that next birth. And that can sometimes be that time, we’re like, whoa, now it’s hitting me.
Because here’s the thing. As we talk, we know that things can often become desensitized. Think about something good. You go on this fabulous family vacation, the first person, you’re telling it’s with vivid detail and we went here, and we went there and we ate this. And it’s amazing. And we give every last detail. By the 6th or 7th person, it was like, yeah, we went, it was good, we had fun. The energy tends to wane and wax out.
And the other thing is that for a lot of us, when we’re not in the thick of it, we don’t go back. And so, it’s like, well, I’m not feeling overwhelmed or traumatized in this moment, so I don’t need to deal with it. I’m okay. And I like to think about trauma as kind of like a bruise. Maybe you have a bruise on your arm because you walked into a doorknob. Not saying that I did that. I did it all the time, right? But let’s say you walked into a doorknob, right? We all do it, and you have that bruise. You’ll be very aware of it those first couple of hours or a couple of days that this big and throbbing and whatever.
And then usually we forget that it’s there and we go about our day and it kind of lays dormant until someone or something bumps up against it. And it’s like, oh, my gosh, that still hurts. It’s like, right. Just because I wasn’t aware of you then doesn’t mean you went away. You’re still there. And if, unfortunately, the quote unquote right thing hits it or we get triggered, it brings it back center stage.
What’s the first thing I would recommend is if you didn’t process and digest it and do work around it, then do work around it now. Because I love for women to be able to clear out whatever energy might still be lingering from a prior birth before segueing into the next one. So that’s one thing.
Another thing is I like to change some of the language for women. I like to kind of really address some of the expectations and then for good or for bad. I will often share, like, the standard of care. It’s not the best possible care you will ever have. They strive for what reasonable. What is a reasonable standard of care?
And so sometimes it’s even coming back to a woman and saying, like, hey, what feels reasonable? Or maybe it’s helping to not take a list where everything is a ten star of importance, but separating out what are the most important for you, that the things that you want us to really spend our time on, what maybe feels less imminent or important that it’s like, hey, this would be a nice cherry, but if it doesn’t happen, I’m okay.
I like to share with women a lot that, again, when it comes to motherhood, we aspire to be the good enough mom. I think that’s hard. We live in a society that doesn’t really recognize middle of the line. It’s always like, hey, I need the best. I’m going to the mall, what’s the best white shirt I can find? Or I’m throwing a party, I need the best photographer out there.
Sometimes the functional good guy or person who’s going to get it done, it works. And I can make my piece and be happy. But there has to be an awareness of that that has value, that it’s not the best or best, but that there’s value in the good enough, right?
Closing Tips on Navigating Birth After Trauma from Gina
Navigating Subsequent Pregnancies and Birth:
- Don’t overwhelm yourself with to-do lists! If your to-do list is TOO long and it is causing anxiety, shorten the list to what is manageable (and realistic) for you!
- Plan for how you want to FEEL during your birth, and how what actually happens may differ but still produce the same feeling.
- Examine your prior birth: what were the negative things and how can we mitigate them. And what were the positive things, and how can we enhance/replicate them?
Gina: And so usually what I’ll recommend to my clients is if you have this mile-long list of all of the things that you want to do to prepare for your next birth, whether it’s a VBAC or a vaginal, birth after a C-section or if it’s for another vaginal birth, but you want a more positive and empowering experience, only do the things that aren’t going to increase your level of stress.
And so if you have like eight things on your list that you want to do every single day, but trying to do all eight of those things is stressing you out and increasing your anxiety to the point where you’re like, “well, if I don’t do these eight things, then I’m going to have a bad birth.”
We need to decrease the amount of stuff that’s on that list. And so sometimes I’ll see where my clients are, like, “I need to see a chiropractor, I need to do massage therapy, I need to work out every day, I need to eat a certain way.” And then it becomes too overwhelming.
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And so just pick one or two things off the list of things that you would like to do and prioritize those and then add depending on how you’re feeling that day, if eating really well feels good for you that day, do so. If eating something that just is comforting for you is better for you, do that instead.
And so as you’re preparing for a subsequent birth, take a look at how many things you’re trying to do to prepare for that birth. And so that’s usually the biggest advice that I give to my clients that are really seeking a more positive experience.
The other thing that we can focus on as we prepare for a subsequent birth because we don’t know what is going to happen. There could be an emergent situation. We may develop a complication at the end of our pregnancy. We may not have the exact birth team that we’re hoping for with the medical team.
And so instead of focusing on the physical things that happen, focus on what you want to feel like during your birth. And sometimes focusing more on how we want to feel can help us navigate experiences within our birth that were maybe unexpected.
So, hey, I want to feel heard and respected the entire time is going to make a huge difference as opposed to what physically happens to me. And so focusing on what you want to feel can be a really helpful approach as well.
The other thing is, as you are reflecting on your prior birth experience, sometimes we’re really focused on the negative aspect of things. We can look to understand why did I perceive that as negative so that we could develop a course of action to prevent that or mitigate that in the future.
And then also, what are the things that I felt really good about? What were the things that made me feel good during my birth? And while there may be a lot of negative experiences, there are probably a few really positive ones that meant a lot to you. And can we replicate those or can we mimic those in a subsequent birth as well?
Those are usually the tips that I give to my birth clients who are looking to have a better subsequent pregnancy et experience.
Processing Your Birth Story with Dr. Alyssa Berlin, Perinatal Psychologist
In this episode, we chat with Dr. Berlin, a perinatal psychologist, on how we can begin to approach processing our birth story if it was not the positive experience we had been preparing for.