Birth Trauma Awareness Week 2024 - Informed Consent
Birth Trauma Awareness Week - 15 - 21 July 2024
For this year's Birth Trauma Awareness Week, specialists within our Perinatal Trauma and Loss Service (PETALS), talk about reasons why individuals may need our support.
This year's theme is 'Informed Consent'. Read on to find out more about trauma, reproductive trauma and what informed consent means.
What is trauma?
Trauma is an emotional response to an event (or a series of events) that was experienced by the individual as frightening, distressing, stressful and out of their control.
Trauma roots in the Greek meaning ‘wound’ and is when anything happened that felt too much, too soon or too quickly for your nervous system and body.
It can also be what didn’t happen, what should’ve happened, and what could’ve happened in the absence of care, connection and support that you needed at the time of your experience.
Regardless of how traumatic the event is viewed by others, we know it is the individual’s feelings and personal experience which is most important.
What is reproductive trauma?
Reproductive trauma (sometimes referred to as perinatal trauma or birth trauma) is a term that covers a range of traumatic and distressing experiences that can occur during the reproductive period including:
- Trying to conceive
- During a pregnancy
- When a pregnancy ends
- During birth
- Postnatally
These experiences may include:
- Infertility, secondary infertility and navigating fertility treatments.
- Pregnancy and baby loss
- Having a termination (for any reason)
- Other complications or health concerns during pregnancy (for mother, birthing person or baby)
- The premature birth of your baby
- Your baby requiring specialist care post birth (e.g., in NICU)
- A difficult, distressing or unexpected birthing experience
Not all of these events will lead to a post-traumatic stress response, however the impact can be significant and long lasting.
What is informed consent?
Informed consent means that you have the right to make your own decisions about your body and the medical treatments you receive in pregnancy and birth.
No intervention or treatment should happen without your agreement.
You should be given enough information to understand the suggested intervention and feel able to make an informed decision.
Symptoms of PTSD
People may describe re-experiencing symptoms such as flashbacks, intrusive thoughts/images and nightmares that leave them feeling like they are reliving the trauma.
People may become distressed by real or symbolic reminders of the trauma and physical sensations such as pain, sweating, nausea or trembling.
People might notice that they are more alert, on edge or hypervigilant and find it hard to settle or relax and feel panicked when reminded of the trauma.
Consent is...
- A two way flow of information, covering benefits, risks and alternatives and cannot rely on information leaflets alone.
- Material risks determined by what a person themselves considers significant, not only what the healthcare professional deems relevant.
- Checking again about comfort levels even after woman/birthing person has said yes.
- Dialogue and evidence of real understanding, not a form signed in a medical emergency.
The report by the All-Party Parliamentary Group (APPG) and the Birth Trauma Association follows the UK’s first-ever inquiry into birth trauma.
PETALS contributed, alongside other similar services across the country, highlighting the impact of traumatic births on women, birthing people and their families. This echoed the voices of people with lived experiences. It found that some people accessing maternity care experienced a lack of compassionate care, which has been exacerbated due to staff shortages and a lack of crucial training.
These more negative care experiences have a significant impact on the mental health of women and birthing people. This has led to some clear recommendations designed to improve how services are designed, led, and delivered.
One of the key movements within mental health care is the importance of trauma informed care and practice. This means that services are embedded from the top down and bottom up with principles and values designed to create feelings of safety.
Trauma informed care advocates for care and compassion, working with people, alongside people and collaboratively, giving people choice and control over their care, recognising people as individuals, supporting diversity, and facilitating recovery.
Simple acts such as having continuity of care, asking a woman/birthing person's permission to carry out an investigation, explaining what will happen next, and providing choices and options in their care, are all ways that help people feel safe and looked after.
A trauma informed approach recognises that the system and the staff are pivotal to this and the needs of both, and the care they receive, will support a parallel experience for clients and their families going through maternity.
To reduce birth trauma and improve the care experienced by birthing people and families, we need to look at changes to the system so everyone feels safe and cared for.
Find out more about PETALS, including details of how to self-refer into the service here: Perinatal Trauma and Loss Service (PETALS) | Greater Manchester Mental Health NHS FT (gmmh.nhs.uk)
