Don’t tell women to “forget” their traumatic births

One of the worst things you can say to a woman who has had a traumatic birth is: “Forget it and enjoy your baby”. It diminishes the trauma the woman has experienced, and displays a very basic failure to understand how the mind works: it’s the equivalent of saying “Just snap out of it” to a person who is depressed.

It’s rather dispiriting, therefore, to see an obstetrician express exactly that sentiment. Jim Thornton’s blogpost is headed: “Best try to forget it and enjoy the baby”. After receiving numerous comments, he’s now amended it to read “Immediately after the event best try to forget it and enjoy the baby” – perhaps unaware of the advice made famous by Denis Healey: “When in a hole, stop digging.”

Thornton’s argument is that if a woman has had a traumatic birth, then immediate counselling after the event is unlikely to help. In fact, he’s probably right about this, and this isn’t just true about traumatic births, it’s true of many other traumatic events. Immediate counselling after the event can harm rather than help the sufferer’s recovery. It seems to be the case that the brain moves distressing events from short-term memory into long-term memory quite quickly and that immediate counselling can hinder this process by forcing the person to recall the event. Post-traumatic stress disorder occurs when the event isn’t shelved into long-term memory and the person relives it over and over again through flashbacks and nightmares.

So the problem with Thornton’s post isn’t that he’s wrong about counselling, it’s that he has fundamentally misunderstood the impact a traumatic birth can have on a woman. He writes:

“Parents who have experienced traumatic birth should be encouraged to get on with their lives and avoid special counselling. For most of them putting the birth behind them and enjoying the baby is good therapy.”

The assumption here is that you can tell a person how they should react to a terrible experience when in fact how we react to something bad happening is rarely in our control. Many service personnel returning from combat do not suffer from PTSD; some do. Is the best advice to give to servicemen who have witnessed people being killed: “Put it all behind you, and enjoy your life”? It should be pretty obvious that it isn’t. Some sympathy, some kindness, some recognition of what a woman has been through after a traumatic birth would actually go some way to helping a woman at risk from PTSD. Sympathy and kindness while a woman is giving birth would go even further: many women who suffer PTSD after giving birth say that the lack of care from medical professionals while they were in labour was a contributing factor.

As for the patronising injunction to “enjoy your baby”, one woman points out under Thornton’s post that she was too busy performing physiotherapy on the baby’s paralysed right arm at every nappy change, dealing with his projectile vomiting from his phrenic nerve injury and taking him to regular appointments with a paediatrician, orthopaedic surgeon, opthalmologist and dietician, all as a result of damage caused during the birth – as well as “caring for my husband who suffered PTSD from watching the trauma and supporting him through losing his job as a firefighter because he could no long cope in stressful situations.”

Until obstetricians like Thorton can acknowledge the damage a traumatic birth can cause, we’ve got a long way to go.