The Interrelationship Between Prenatal Experience,

Labor and Birth, and Post Birth Interventions

MEDICALLY INDUCED BIRTH TRAUMA

Not all birth traumas are medically induced. Birth trauma is viewed as a recapitulation of physical, emotional, or psychological prenatal traumas. Even a baby’s own journey through the mother’s pelvis (i.e., positioning, cord) are thought to be a result (recapitulations) of prenatal events and relationships. 

When a prenate is unable to navigate the birth canal for any reason and becomes stuck (stalled labor), the baby’s emotional state and memory is fear, anger, frustration, helplessness. Often, because the mother is also in distress, she is not “present” for the baby who needs mom’s presence, her reassurance, and her comfort even more so in the womb, in the birth process, and in the first moments and hours after birth. When a laboring mother requires oxygen support, without a doubt the baby is experiencing the emotional as well as physical symptoms of lack of oxygen. It is suggested that experiences such as this can be the root cause of physical illnesses of the lungs and breathing, such as asthma, bronchitis, etc.

Because the only way a prenate knows him or herself is through the experience of the mother, this is how a baby comes to know and to “believe” about her or himself. A baby only knows her or himself through the experiences, emotions, thoughts, and relationships with others, including how his mother feels about him and his existence. The people in her mother’s life become part of the outer womb, including the medical attendants at the time of birth. On a prenatal level, consider the differences of a pregnant mother who works as a librarian with those of a mother who works in a drug treatment facility or a pregnant mother in the military during these times or a mother who is being physically abused by her spouse or a woman who is in a loving, supportive relationship.

At the birth, consider the impact of the actions and words spoken by others present at birth as these create birth imprints…are they loving and supportive or are they cold, objective, medical, and controlled? Does the mother feel supported or intruded upon? Does she feel her body and her needs are valued or that they are being abused? Does she feel safe? Does she feel like she has to meet the needs of or “take care of” the needs and feelings of those in attendance who might be upset or scared? Or is SHE being supported and cared for? (i.e., is she able to ask her mother, doula, or nursing staff for space or time alone, or to refuse interventions?) 

All of this she does in control of her birth, her body, etc. is being transferred to the baby just as the baby is making his or her way into this world. Are medical interventions imposing upon the little one? Is the baby receiving her first dose of drugs (an imprint for future use) along with mother? Are the medical staff rushing or stalling the birth for their needs? This is standard care in medical birth and is creating a society with serious imprints about control, authority, and their own momentum in life. Is the baby unable to move through the pelvis because of articulation with the mother’s bony structure so that the intense contractions (which are fierce when because of Pitocin induction) only forces her head more intensely into the obstacle? Will this child perhaps look for outside forces or drugs throughout life in order to accomplish her activities? Will she be able to trust herself or to trust others to support her and what she needs?

Consider the fact that it is fairly common for babies to be born with the cord wrapped around their neck and that mothers are not routinely informed of this. Cord trauma is considered to be of no consequence by medical attendants; yet, it is known in pre- and perinatal psychology to create significant and serious lifelong psychological imprinting. William Emerson discusses the emotional and psychological impact of cord and other traumas in detail.

The mother and baby are one until birth. The mother is the “outer womb” and the baby is the “inner womb.” All of these people who are present at birth become a part of a newborns “outer womb”…the first experience of life in this world. The actions and words, energetically and literally, are imprinted upon the nervous system of the little one making her or his way into the world. Are they supportive, happy, scared, disagreeing, controlling? Is the mother being “talked into” interventions she has stated she does not want — no drugs, vaginal checks, etc.?  Is she being confined to a bed when her body tells her to walk, move positions, squat?  Is the environment noisy, cold, sterile, and is she treated objectively? Is she scared, disappointed? Is the physician she chose and trusted unavailable and so she has a “stranger” as her physician or a parade of medical students and residents? Is her chosen attendant available but managing many other time commitments, professional or personal, like trying to get a bite to eat? Are her support persons also fearful, disappointed, controlling, etc. and so unable to really support her? 

Unfortunately, these scenarios above represent “NORMAL BIRTH” in our society today. What society continues to accept as “normal birth” creates lifelong emotional and psychological trauma. A newborn baby cries, grimaces, flounders, shivers, and flings her arms as if in panic, terror, helplessness, and pain. This is the baby’s expression of his or her experiencing of trauma, shock, the immediate separation from her mother, with rough interventions done solely for the needs of medical staff (cleaning, weighing, shots, etc.). Rather than these interventions, a baby needs uninterrupted, loving, quiet, physical contact with her mother and father. This allows the naturally occurring experience of hormones that promote attachment. Body language that we can easily see and respond to in children and adults is unacknowledged in newborns at birth.

In the book, Birth Without Violence, (an almost poetic book that describes how beautiful and sacred birth is and can be expressed), Dr. Fredrick LeBoyer says that everything we do to newborns at birth says “welcome, to the mean, cruel world.”  It is crucial for mothers and medical staff to understand that babies are communicating their experience of fear and anxiety. Unacknowledged and untreated, these experiences become lifelong imprints that create personality and social issues seen in our society today. The good news is that these can be mediated even within the medical environment WHEN MEDICAL PERSONNEL ARE TRAINED IN AND UNDERSTAND PRE- and PERINATAL PSYCHOLOGY.

The timing of most interventions to facilitate birth and those done immediately after birth benefit the hospital staff, not necessarily babies and mothers. Most are not necessary within the first few hours of life and they are usually done extremely roughly. For example, weighing, scrubbing the baby with rough cloths, eye ointment, and PKU tests can all be postponed for the sake of facilitating attachment and bonding. The vernix on the baby’s skin is known to be a natural lubricant. It is best rubbed into the baby’s skin as it would be if a mother is allowed to hold her newborn immediately and for an extended amount of time. Meanwhile, baby is looking at mom, smelling her, feeling her. When ointment is placed in the baby’s eyes he is not able to see her. It is frightening, as any adult who has undergone surgery can attest to. Babies should not be removed from their parents for any procedures without the parents present. Doing so is known to create significant bonding and attachment issues. Newborns are terrified, feel abandoned and alone, and they are often mishandled. I have observed many times that at birth, and in the nursery, the nursing staff are extremely rough with newborns.

For example, my eight year-old daughter and I watched through the nursery window as a newborn, less than an hour old, was being checked out by a nurse. The baby was terrified, floundering, and screaming to the point of gasping as the nurse roughly checked her reflexes. The nurse paid no attention to the baby as she spoke loudly to someone else across the room. I was unable to speak as I watched. I was aware of and feeling the terror of this little one. My daughter finally said, “Mom, it looks like she’s just fixin’ a chicken.” My daughter was exactly right — the nurse paid as much regard to this newborn as she would to a chicken she was plucking and stuffing for dinner.

None of us in our adult bodies would wish to be treated in this manner by a medical provider or anyone…so disregarded, so unheard and unseen. Nor would we allow anyone to treat our children this way.  Yet, we all allow it to be done to our newborns (by trusting medical staff who take the baby away) under the belief that what they are doing and how they approach the baby has no impact or consequence. WHEN does a human begin to feel, remember and register pain and violence? If not at conception, if not prenatally, if not at birth, when?

The timing of post-birth interventions is one of the simple changes hospitals and medical professionals can make in their hospital policies that would promote and facilitate immediate improvement in attachment and bonding of newborns and parents. The research does not bear out the need for these immediate interventions. Policies are in place because of history and tradition (“it’s always been done this way”), in spite of the current research on the negative impact of post-birth interventions on newborns and on parent-child attachment and bonding.

A newborn, when birth is unmedicated, without interventions, and is left in the mothers arms, has the capability to be fully alert, to clearly recognize her mother, and within an hour of birth will crawl to her mother’s breast without assistance attaching herself and completing a significant sequence in her nervous system. In the first half hour, she will seek her mother’s face and they will gaze into each other’s eyes, creating a biological cascade of hormonal responses that create and support attachment and bonding. A newborn baby will respond to both her parent’s voices and to others whom she might already know from her time in the womb, such as siblings and grandparents. 

There are times when babies are unable to be born without drugs and interventions.  Leaders in the field report that the greater the degree of stress or trauma during the prenatal period, the greater the likelihood of birth complications and obstetrical interventions. When the baby is unable to navigate the birth canal and becomes stuck, the baby’s emotional state and memory is fear, anger, frustration, helplessness. Often, because the mother is also in distress or is drugged, she is not “present” for the baby who needs mom’s presence, her reassurance, and her comfort even more so in the womb, in the birth process, and in the first moments and hours after birth. When mothers are unable to be emotionally present with their babies in labor and at birth (because of fear, drugs, etc.) there is greater potential for difficulty in birth. When mothers are unable to recognize and empathize with the baby’s experience at birth, the consequence is that bonding is further impaired and a lack of trust develops. When parents are supported to support their infant’s experience, healing occurs. 

This is has been my experience in working with mother-baby dyads where epidural pain relief was used. While mother is expressing a good experience or how she felt so little pain, the baby might be thrashing and crying or limp and distant. Both are telling her story about her experience. The emotional quality of the infant ranges from anger to disappointment, distrust, or sadness about the mother’s detachment and unknowing.

MEDICAL INTERVENTIONS

Midwifery and homebirth eliminate these potentially traumatic medical events but are not without trauma. Midwives understand and are trained in and are experts in natural birth. Even so, regardless of the birthplace and attendants, the mother’s unresolved prenatal and birth experiences are triggered, as well as the baby’s prenatal experiences, and these experiences are expressed in birth. It is crucial that anyone who attends birth be trained in the consciousness of a prenate and the psychological effects of birth trauma.

Obstetricians are taught in their training that using medical interventions minimizes pain and suffering, but pain and trauma-free birth is rarely the outcome BECAUSE of the interventions meant to help. Birth accentuates what is already present. Women who are already feeling powerless, who are abused, who are in emotional pain, who are “suffering” or “in pain” re-experience birth as traumatic and violent. It is often later that the emotional impact comes into their awareness. The lack of consciousness and compassion in relationship with women and the disruption of the natural birthing and attachment process with their babies deepens their emotional pain. 

Women’s bodies and their souls are being hurt by the violence and the lack of regard for them and by the disruption of their bodies’ biologically programmed process to give birth in a certain way. As a result, many women feel they are betrayed and abused again in their births. This is a difficult mix of her own prenatal traumas over the period of her life AND the experience of being a woman whose body and birth are being managed by others. The resolution of this involves women doing their healing work with their babies and letting medical caregivers know their needs. It involves medical caregivers in honoring their own inner wisdom, taking time to listen to and engage with women in partnership in the health care of women and babies.  

Current obstetric practices often co-create with women a retraumatization of the prenatal period in the birthing experience. Unresolved prenatal traumas (that are obviously out of the control of the obstetrician) predispose babies to the use of interventions and birth trauma. (click here for examples from my infant and adult session.) So, while medical caregivers use technology to save lives and to make birth less traumatic and to ease pain, but do it without regard for the baby’s perspective, the facts are that: 1) when the interventions are done without regard for the baby’s emotions, 2) when they are used routinely, hurriedly, objectively, without discussion with the woman, 3) done without consciousness about birth as being sacred, 4) without regard for the impact of intervention, and 5) without referral to follow-up healing treatment, the consequence is that baby and mother (as well as the medical staff doing the procedure) are all retraumatized. (See the work of Dr. William Emerson for extensive thirty year observation of the psychological impact of obstetric intervention).

Meanwhile, no one is winning, and most significantly, babies are losing. Women and physicians each feel victimized; sometimes by each other, sometimes by the “system.” We need to see birth from the perspective of the baby. Our own inner baby is the place to start. What does your little one want to experience?