What a Pelvic Health Physio really wants you to know about birth trauma

Birth. What do you think when you hear this word? 

Is it visions of the most incredible day of your life, primal, beautiful, where you transition into motherhood with the deepest sense of accomplishment you will ever experience? Or are you overcome by feelings of fear, sadness or disappointment? If it is the later, sadly you are not alone. 

But despite one third of all birthing mothers in Australia describing their birth as traumatic, there are far too many going into birth ill-prepared, unaware of what might lie ahead, coming out the other side with the same sentiment, ‘I wish I had known’.

This week is birth trauma awareness week. As a health professional, who has spent over 18 years of my career helping women to recover from birth injuries, I feel I have a responsibility to use my voice. So what does this birth trauma researcher and pelvic floor physiotherapist want you to know? 

Read more on healing from a traumatic birth here

1.The female body is built to birth

When diving into the harsher realities of birth, it is important first and foremost to remember the female body at its most primal function it is designed to birth, and for every negative experience, there are at least three positive experiences.

There is an intuition in the female body, and if a woman can trust her body and those around her, the patho-physiology of birth in most cases takes over. The oxytocin is released, the uterus contracts, the cervix thins, the pelvis widens, the sacrum shifts, the pelvic floor lengthens, and the fetus knows how to twist down the birth canal. And the most incredible part is this all happens without any cognitive control, it is inherent, the body at work in its finest hour. Pure magic. However, if a woman is scared, ill-prepared and doesn’t trust those around her, this magic is far less likely to prevail, and birth may change course.

2. Knowledge is power

Whilst many pregnant women may enter childbirth, knowing an episiotomy may be a possibility, there would be very few knowing there was a 15% chance of an emergency caesarean and an even higher chance that instruments will be required.  Few would know that there is a 70% chance of a perineal tear, a 3-5% chance of an anal sphincter tear and a 20-30% chance of a pelvic floor avulsion (a deep tear where the pelvic floor muscle tears from the bone).  

And even fewer would realise the impacts run far beyond the birthing suite, with 30% of women experiencing lifelong urinary incontinence, 20-30% experiencing pelvic organ prolapse and many others suffering vaginal pain years later. The even less spoken are the stats surrounding anal incontinence, with 30-40% having difficulty in controlling wind and 5-10% with faecal incontinence.  

And of course, the impacts run deeper than simply the physical, with 20-30% of women experiencing post-natal depression, anxiety or post-traumatic stress.

3. There are ways you can prepare

Knowing the statistics and physiology is one thing, however, true empowerment comes from processing the information and using it to make truly informed choices. Essentially the preparation you do physically, emotionally, and mentally can go a long way to your birth experience. 

Mental preparation

The focus of birth education in the current system is based on educating women on the physiology of natural vaginal birth, with very little or no focus if the birth doesn’t go to plan, how to make choices and the reality of the statistics. This is leaving women ill-prepared, and as scary as it may be to discuss these things prior to birth if women are hearing things for the first time during labour, they are not able to make an educated decision for their body.

The EMP Birth Preparation Program is designed to help you heal safely and gently from birth whilst understanding all that you are going through as a new parent. Led by Women’s Health experts it’s designed to be started from birth with gentle movement, pelvic floor and core activation and education.

I've designed this program to work with your body’s natural healing processes. So that you can start to heal and strengthen your pelvic floor and core as soon as you feel ready. Choose either our vaginal birth recovery program or Caesarean birth recovery program. With specialised content for back pain, c-section wound recovery, pelvic organ prolapse and mental health.

We filmed this during our own postnatal recoveries, so you know that we completely understand what you are going through. We want to help you to feel stronger, more confident in your body and more prepared for motherhood. 

Start your free trial here as part of our Pregnancy Program.

Physical preparation

Just as you wouldn’t dive straight into a marathon without preparing your body, women shouldn’t be going into labour without preparation, especially the pelvic floor. The pelvic floor needs to stretch beyond 3 times its normal length, and if women haven’t learnt how to open their pelvic floor it is no surprise that during labour the muscles struggle to lengthen adequately, leading to a greater chance of obstructed labour, tears and episiotomies.

4. You are your best advocate

I would encourage women to start by asking to have a very open conversation with their birth provider about the slightly scarier elements of birth, as well as seek out a pelvic floor physiotherapist to help get the pelvic floor birth ready during the third trimester. These two things can be a significant game changer for a birth experience.

5. You can recover better

The physical changes to a woman’s body are possibly the most significant in her lifetime, and recovery needs to be prioritised. In Australia, currently, there is no government-funded support to help women heal post-birth, so it is up to women to seek support themselves. At a minimal level, women should be seeing a pelvic health physiotherapist at six to 12 weeks post-birth to have a thorough examination of their pelvic floor to identify any underlying issues and rehabilitate safely back to exercise.

I would encourage women to participate in the Empowered Motherhood Postnatal Program. Our postnatal program includes both vaginal and c-section recovery programs alongside specialised programs for abdominal separation, prolapse and even return to running. It supports women through the post-natal year with expert-led exercise and education.

Finally, please know if you have experienced birth trauma or ongoing symptoms there are many health professionals and organisations here to support you. You just need to take the first step: use your voice and reach out for the support you deserve.

Written by Lyz Evans. Titled Women's Health Physio and EMP Founder.