Birth trauma refers to a wide variety of medical conditions – ranging from physical and emotional damage to the mother during labour to damage to the tissues and organs of a newly delivered child.

Physical birth trauma following vaginal delivery

Physical birth trauma is classified as major, permanent damage to pelvic floor structures.

Pelvic floor dysfunction, in the form of pelvic organ prolapse (including cystocele, rectocele, and/or uterine prolapse) and urinary and faecal incontinence are considered inevitable sequelae for some women who experience injuries during birth. Vaginal delivery is considered the single most important risk factor for developing stress urinary incontinence.

According to urogynaecological experts, only about 25 per cent of women get a non-traumatic normal vaginal delivery that did not do serious damage to their pelvic floor or their anal sphincter.

Some of the common injuries are:

• Pelvic Organ Prolapse – affects 40% of adult women and involves the pushing of nearby structures (bladder, uterus and rectum) down into the vagina. A difficult vaginal delivery can be associated with increased occurrence of prolapse: forceps delivery, a prolonged second stage of labour, and large infant birth weight.
• Urinary Incontinence –  is a term used to describe poor bladder control – stress or urge incontinence, incontinence associated with chronic retention and functional incontinence.
• Faecal Incontinence – is a term used to describe leakage from the bowel due to poor bowel control – see www.continence.org.au

Psychological trauma following vaginal delivery

When we talk of psychological birth trauma, we mean Post Traumatic Stress Disorder (PTSD) that can occur after childbirth. This can include those women who may not meet the clinical criteria for PTSD but who have some of the symptoms of the disorder. Some of the factors that can lead to psychological birth trauma include: a lengthy labour or short and very painful labour, induction, feelings of loss of control, traumatic or emergency deliveries, neonatal death or stillbirth amongst others. Men who witness their partner’s traumatic childbirth experience may also feel traumatised as a result – see www.birthtrauma.org.au

What can be done?

A good starting place is a review with a trusted GP. It is sometimes a good idea to take a support person, if you are feeling worried about discussing your feelings or symptoms. Your GP may refer you to the appropriate health professional – a pelvic floor physiotherapist, gynaecologist or urogynaecologist.

Psychological birth trauma

• Before specific treatment for PTSD or another trauma-related disorder is approved you will require a comprehensive health assessment from your chosen health care professional.
• Treatments include an array of psychological therapies and/or medication.
• According to new research findings, both exercise and self-help therapies like ‘mindfulness’ can also be beneficial in the treatment of trauma. These activities can be safely used in conjunction with psychological therapies and medication.
• Exercise is also beneficial in addressing factors such as sleep difficulties, anxiety, depression and weight gain.

Your GP may consider you need further treatment and refer you to an appropriate health professional including a specialist – any one of the following :

• Counsellor or social worker.
• Psychologist or psychiatrist (if medication is required).

A Mental Health Care plan organised by your GP will help with the cost of treatment.

Legal options

There are increasing numbers of women who choose to explore legal options given the significant birth trauma issues they have experienced. Cases have been successfully run in the UK, Canada, the US, Australia and even recently in New Zealand where there is a no fault system of medical compensation.

Catherine Henry Lawyers has conducted numbers of cases for women who have experienced birth trauma and have recovered compensation for injuries to themselves and/or their child. For further information, get in touch with our experienced Health Law Team to discuss your legal options.