My birth was, now I'm sure, a traumatic experience. It took me years to be able to tell it completely and to express my feelings, although, finally, I was able to fit it into my life and overcome what I lived by empowering myself and making myself stronger. But there are still things to cure, wounds to close. That's why this is interview with Gabriella Bianco It has reached me so deeply and I think it is essential that pregnant mothers and those who have gone through a traumatic birth know what this wonderful woman has explained to us, who is also a specialist in these matters.
In this third and last part of the Babies interview and more to the psychologist Gabriella Bianco let's talk about the traumatic births and of the strategies to avoid them, and, of course, also, of the proper approach to healing.
When a woman who has suffered a traumatic birth should receive psychological help or psychotherapy?
When we experience one or more traumatic experiences in our life and experience them as such, not only is an aid indicated, but an accurate diagnosis and a specific psychological and psychotherapeutic intervention. And the sooner, the better.
The psychological trauma is not erased, it is not forgotten (forever), we are not free of it as much as we would like. In about 2-9% of women the experience of childbirth (or childbirth as retraumatization of an old trauma) generates postpartum PTSD (Post-traumatic Stress Disorder). Today, the latest research from the area of psychoneuroimmuno-endocrinology suggests that the hormones generated by the mother in a situation of psychic trauma produce an epigenetic imprint through which the trauma is transmitted from one generation to the next (from mother / father to children). These findings clearly suggest the importance of seeking trauma repair. However, it is essential to know when, how and with whom to start a trauma repair job. Experienced trauma professionals know the damage that can occur in addressing the trauma at the wrong time or in the wrong way, causing unnecessary re-trauma and even harmful to the affected person.
And when is the right time?
Personally I do not usually recommend psychotherapy in case of traumatic births immediately after delivery. I consider it more appropriate to plan a small number of individual consultations to assess more deeply the immediate consequences on the mood and general maternal and child welfare, stabilize and set coping strategies in favor of a better mother-baby bond. The (immediate) postpartum is a priority to ensure the stability of the maternal-filial relationship, care for psychosocial support (starting with the couple).
I suggest treating the aftermath of a traumatic / cesarean delivery at 9 months or one year after the baby or, at the latest, before a new pregnancy.
What benefits does psychotherapy offer in these cases?
The benefits of a specific psychotherapy consist of processing the traumatic experience, accessing our internal resources, creating new resources, creating resilience as a tool for growth and overcoming the adverse effects generated by the trauma. In this way we can recover health and, sometimes, achieve post-traumatic empowerment. Responsibility for our health acquires in these circumstances a broader and more extensible sense of responsibility for the health of our children. It is possible to integrate the traumatic experience in our biography when we manage to elaborate it on a psychological level thanks to a psychotherapeutic process. This is usually more complicated as time passes or several experiences of trauma add up in our lives.
What aspects favor a woman suffering post-traumatic stress or living her birth as a trauma?
Perhaps at this point in our interview you can intuit that both the history of Primal Health of the (future) mother, as well as the presence of previous traumas throughout her biography (especially those linked to her sexual life and / or the hospital experience, if the woman decides to give birth in a hospital) can be triggers of a traumatic birth experience. To these “predisposing” factors, we can add the treatment received by women at the time of delivery: an accompaniment that is not respectful of their person and their intimacy, an unequal, indifferent or even negligent treatment by health professionals can lead to the traumatic experience (or trigger a retraumatization, in case of previous traumas) of an event as transcendent in the sexual life of women such as childbirth.
Do the laws and the Spanish health organization offer sufficient guarantees of prevention and help to mothers of puerperal women?
We have valuable documents and clinical practice guides (Normal delivery care strategy in the National Health System, 2008. Ministry of Health and Consumer Affairs) in which the latest scientific evidence is collected with indicators of good practice and the necessary recommendations for promote both a respected birth (for the parturient), and a healthy and dignified birth (for the child). There is also a new National Sexual and Reproductive Health Strategy prepared by a large group of experts in 2011 and published by the Ministry of Health, Social Policies and Equality. The Strategy includes a section dedicated to the attention to mental health problems in the puerperium, indicating how to prevent and early identify postpartum psychopathology, facilitating specific attention to the needs of the puerpera woman. Good birth / birth care certainly represents a protective factor for mental health throughout the postpartum period.
Are these recommendations fulfilled?
Despite the efforts at the state and regional level by professionals and women's user associations in this regard, I feel that it is necessary to continue renewing and optimizing global attention to maternal and child health, introducing prevention and policy strategies promotion of perinatal (mental) health that are innovative, as well as laws that protect the mother-baby dyad and the health of the young family by equating the period of maternity leave to other EU countries and improving the conciliation policies of the family and work life. I also consider the training of all professionals in all Primary Health sciences essential, including perinatal psychology as one of the emerging areas in this field. Every day more psychologists require and request preparation in perinatal psychology and participation in the clinical and research areas of the country's university hospitals.
It has been a privilege to be able interview the psychologist Gabriella Bianco for Babies and more. I hope, I am sure, that knowing these issues in depth is essential so that mothers and their children can enjoy greater physical and emotional health, so that traumatic births are avoided and so that, if they do, healing is safe. Thanks Gabriella.
