Reaching Out

Over the years, alongside caring for my growing family, I was a childbirth educator, and attended births from time to time as a volunteer doula. When a friend of mine turned to me in distress after her particularly traumatic birth, I didn’t know how to help her or where to turn for support. We realized that there were no specialized mental health resources for women after birth to turn to. London has a wonderful organization called Yad La’Em, which provides physical support — meals, night nurses, and cleaning help — but there was nothing for emotional and mental support.

A team of four of us, all passionate about supporting women’s perinatal mental health, founded MENUCHA, a nonprofit organization to help women suffering from mood disorders during and after pregnancy.

When you work with mental health, you can’t leave any loose ends. Even if your organization will serve just one client, everything has to be in place, because you can’t allow that one client to fall. So before we could open our doors, we had to have a full clinical team ready. We had to link up with statutory care in our area, create specialist training programs, and find funding sources for therapy subsidies. We also had to ensure that our remit didn’t overlap with other local organizations, as it’s unfair to use public funds for overlapping services. This took us three years, and then MENUCHA was up and running. Since our founding, we’ve supported hundreds of ladies, not letting any woman fall.

At one point, we spoke about the need to have someone train and join the team as a birth trauma practitioner. My ears pricked up, and I was immediately drawn; this was what I wanted to do. I had found my calling.

Treating Birth Trauma

Trauma is subjective, formed by perception. There may be an incident that involves many people, yet they will all react to it differently. Some will take it in stride, while others may be left with trauma symptoms. Although many women have beautiful birth experiences, others have a hard time giving birth. Usually after the experience, their natural resilience will kick in; they may need support, and opportunities to debrief, but they will regulate themselves.

But studies show that some 20 percent of women who’ve struggled at birth will suffer from birth trauma. This isn’t necessarily from the stress of the physical experience of birth; it can be triggered by a lack of feeling cared for, medical negligence, or from not being taken seriously. It can come from the grief of a miscarriage, or from something as simple as nasty comments or attitudes from the medical team.

“Too much for too long” also causes it, which is why I see a lot of women with trauma symptoms who have suffered from HG, or had previous babies who didn’t stop crying for months. What’s fascinating is that it’s not only women who suffer from birth trauma — sometimes the woman is okay, but it’s the husband, grandmother, sibling, or doula who’s witnessed a difficult emergency birth or seen a newborn coding, who is traumatized.

I’ve helped people who are carrying around birth trauma since they were kids and saw their mother gasping “Call Hatzalah!” or yelling “You watch the kids!” while being rushed into an ambulance.

Women experiencing birth trauma may be extremely teary, or unable to talk about their birth. Some of the symptoms a person might experience when suffering from trauma include:

Emotional

Blaming yourself or someone else, guilt, fear, shame, horror, anger, trouble experiencing positive feelings, trouble trusting

Physical

Feeling upset or racing heart when something reminds you of the experience, irritable behavior, angry outbursts, acting aggressively, being super alert or jumpy, trouble sleeping, trouble concentrating

Reliving or Avoiding

Repeating memories, disturbing dreams, reliving, avoiding memories, thoughts, feelings, or triggers, forgetting important aspects of the event.

Although I’m trained to practice trauma release, I’m not a therapist. In my clinic, I isolate the trauma, and if there are other issues like anxiety, depression etc., I send those on to other clinicians. In my North West London practice, I work both for MENUCHA and privately, and also support many women worldwide via Zoom.

The main technique I use is called the Rewind technique, which uses guided imagery and relaxation to target the trauma memory to change the way it’s stored in the brain — from an emotive memory to a simple memory without active negative association. It’s a nondisclosure therapeutic tool, meaning that the trauma details don’t need to be disclosed for effective treatment to happen. On average, three sessions is enough to treat birth trauma, when other problems are not present.

A non-Jewish woman once contacted me online. She said she’d had such a traumatic birth 20 years ago that she could never get over it and had not had another child since. The trauma had been in her system for 20 years!

The good news is that birth trauma isn’t a chronic mental health illness. It can be released in several sessions.

It would be really great if instead of treating trauma, we could lower the potential for it to develop in the first place. To all women, I’d say that great childbirth education classes, choosing the right hospital and team for you, and taking along someone who cares about you will help you feel comfortable and confident and lower the risk of trauma. If things start to feel overwhelming, try to stay grounded, using grounding techniques.

To help with prevention, I’ve created a course for doulas and care workers to help them understand trauma and notice the signs.

Quick Qs

Hobby

Painting. When I feel life becoming overwhelming, I pull out my paints, take myself off to an art shop for a canvas, and sit down to paint.

Secret dislike

I have an interesting dislike called “koumpounophobia,” which translates as “a fear of buttons.” While it’s not a fear for me, it’s an intense aversion to buttons. They’re as off-putting to me as nails on a blackboard are to most people. Uch. You’ll never catch me wearing a cardigan.

Best advice I’ve gotten

“Just because I can, doesn’t mean I should.” I have a proactive and creative nature. When an idea or opportunity comes my way, I am usually super enthusiastic. I have to pull back, remind myself of this advice, and work out whether it’s in sync with my family, work, and other commitments.

Bucket List

I love traveling, but don’t get to do it very often. It’s the immersion in a different culture, scenery, wildlife, etc. So anytime, anyplace, take me away!

Case Study

I once met with a client who was expecting her second child.

She told me that she has always been fearful of childbirth. Since her first birth two years ago, she’s been even more nervous and anxious. She tried to avoid thinking about the upcoming birth, couldn’t stay in the room when anyone started to tell their birth stories, got very teary when retelling her previous birth story, and was highly anxious before every checkup and appointment.

In her first pregnancy, shortly after she was due, she felt labor starting and stayed at home a while. When she finally felt that things were progressing, she called her doula and got ready to go to the hospital. Her doula told her to go ahead, be admitted, and then when the hospital determined she was close to giving birth, the doula would join her.

My client arrived at the hospital, feeling quite panicky. It was a busy day, and she had to wait a while to be checked, while in intense pain. She was finally checked and was rushed to a labor and delivery room as they felt the birth was imminent. She didn’t have time to call her doula and had to manage on her own. The staff were impatient and brusque.

Eventually the baby was born — and he didn’t cry. Medical staff resuscitated the baby in the room and after what felt like a lifetime, he started to cry and was rushed straight to the NICU.

Baruch Hashem, everything was fine. The baby only needed to stay in the NICU for the night and was back with her and well the next day. But a happy outcome doesn’t erase trauma. The fear of not knowing whether her baby would be well, seeing her baby being resuscitated in the room, and the staff’s impatience caused her to be extremely anxious and panicky for her upcoming birth.

I knew we’d need to do trauma release work to help her remove her negative emotions attached to the previous experience and approach her upcoming birth as a new and fresh journey. Then she threw the bombshell, which although didn’t seem that relevant to her, I knew was having a big impact on her attitude to birth: When she was seven years old, her married sister was staying in her house for her ninth month. One day she remembers a massive panic in the house, her sister hysterical and out of control, her brother-in-law extremely stressed and anxious, and her mother shouting over the phone at Hatzolah that they needed an ambulance.

She watched her sister being hurried into the ambulance as her mother yelled at her to take her younger sister and knock on the neighbor’s door. Sure that something very serious was happening to her sister, she grabbed her younger sister’s hand, knocked at a neighbor, who didn’t answer, then tried another neighbor, who opened the door and took them in.

A few hours later, her mother came home, smiling, telling her that she was an aunt and now had a gorgeous little niece. Looking back, it was the normal commotion of labor, but unexplained to a young child, it felt very scary.

I knew that unless I tapped in and worked through that childhood experience, too, we’d never fully release her fear of childbirth.

Once we completed our work together, the client felt so much lighter, more confident and able to be present and focused during her appointments. She stopped avoiding thinking of the upcoming birth and even felt safe and able to create a birth plan together with her husband.

Baruch Hashem, she has had more children and said that although she had normal nerves, her intense anxiety never featured again.

(Originally featured in Family First, Issue 938)