Wednesday, 13 April 2016

Debrief on Birth Grief

I wrote last year about my fears about L's delivery. I wrote about how the scars of her caesarean were more than physical.

After writing that post I had a debrief with a wonderful midwife at the hospital where L was born. This was something I had been thinking of doing for a while and something which I was only ready to do when L was nearly 2 years old. It became more urgent for me to address as I realised my continued fears and anxieties following L's delivery were preventing me from wanting to expand our family, were making me fear pregnancy.

Midwife R was really understanding of our experience, I was already upset and on edge walking into the hospital and being in the Green Zone had reduced me to tears before we even started talking through my notes.

My tombs of notes is large! 24 hours on delivery ward and continuous monitoring will result in a large folder of notes. But Midwife R talked me through the notes step by step and explained anything and everything.

My main trigger for the labour trauma was a five minute procedure, a five minute intervention for which no consent had been given and which was not explained to me or Daddy Morkus. This Artificial Rupture of Membranes at just 2cm dilated changed the course of my labour and took control and stole my focus away from myself. It reduced me to a screaming terrified woman who didn't understand what was happening. Still my first thought of my labour with L is screaming in pain asking J what was happening. 

Midwife R explained that that shouldn't have happened, they wanted to rupture my membranes to speed up labour, something which I would now argue for more time to establish, but that they should have explained what they were doing, why, that it might hurt.

Midwife R also said she had never read notes of someone who had turned the labour around so much. After pethadine and a mobile epidural being finally sited I was up on all fours, I was up standing to try and help L get into the right position. Midwife R said I was brave and I had courage and was strong to do that. I was back in the driving seat of my labour as I had always wanted to be, focused on the task of getting out baby.

Unfortunately not only was L coming out face up, but she had her neck flexed and not safely tucked with chin on the chest. The baby was not for turning.

I've always said its not birth trauma but labour trauma which scared me in more ways than one. The caesarean wasn't my favourite experience, and I would want things to be different if we went down that route again. But really that didn't bother me, I knew there was only one way for L to get safely out. 

The debrief helped me to understand what had happened and why. It also reassured me that such an intervention wouldn't happen again and we were apologised to because of it. It also showed me that I was stronger than I realised, what I thought was normal, for those with mobile epidurals to get up and move, was actually unusual and showed my strength.

It also helped Daddy Morkus to talk about it, it helped him to hear that it was babies position that caused me extra pain and that steps can be taken in a next labour to hopefully head off the pain.

It also helped to heal the fear of pregnancy. I started to think that I could labour again using the strength I had shown in L's labour.

I would encourage anyone who has suffered any kind of labour or birth trauma to arrange a debrief to talk through the labour, it is really important to try and heal scars and often the best way to do that is by talking.


  1. I think everyone should get a debrief even a short discussion a day or two after birth and anyone that needs more detail can then ask for a further appointment. I had a debrief after my first child, I had to have an emergency section after not only did he get stuck during a long labour (10lb 1oz) but I also had preeclampsia. It really helped me as I think I was in shock I couldn't piece it together it was all jumbled up. The Midwife I spoke to was really good.

    1. I also think it should be standard practice. Maybe not with the senior midwives but at least with one of the community midwife team. And you're right, a few days after birth is the best time to ask these questions. glad it was helpful to you.