Too many mums dismiss their birth trauma because the 'baby is okay'

"My baby is okay, I had no physical damage, I should be happy with how the birth went."

That's something perinatal psychologist Ange Conn hears on a regular basis.

But birth trauma does not need to be connected to physical pain or medical intervention.

It can be anything from feelings of panic when being reminded of the birth; feeling easily upset, irritable or angry; feelings of inadequacy or like a failure; or flashbacks or preoccupation with the birth.

Birth trauma affects as many as one in three women and yet Ms Con said it still remains stigmatised.

Ms Conn has worked in mental health for more than 10 years. She's currently based at the Dubbo Health Hub in Central West NSW and has a specific focus on the psychological and emotional experience of women, infants and families during the perinatal period.

It covers from pre-conception to the first few years after birth.

"The perinatal period is often the most vulnerable time in women's life, a time when women can feel very isolated. I have always felt very strongly about the need to support women during this vulnerable time, long before even becoming a mother myself," Ms Conn said.

A mother who gave birth at Dubbo Hospital was among the 4000 submissions made to the recent inquiry into birth trauma across the state.

Her experience while giving birth has had lasting consequences.

"Unfortunately [it] made my husband and I think we probably don't want any more children as we don't want to have to go through anything like this again," she said.

The mother said she was sent home from the hospital when she was four centimetres dilated and told to return "when she could no longer stand the pain".

She returned at 1am, and was forced to wait outside before entering the hospital through the ambulance entry while fully dilated.

She gave birth quickly, but then staff attempted to manually remove her placenta.

"I was in so much pain and asked her three times to stop before I could feel myself passing out," she told the inquiry.

She was then left to sit in "soiled sheets" until 8am that morning.

A mother from Parkes, NSW, wrote about how giving birth 10 years ago left her with post-traumatic stress disorder, and postnatal depression and anxiety.

The inquiry was established by the state government in June after the Maternity Consumer Network filed a complaint with the Health Care Complaints Commission. The complaint was filed on behalf of dozens of women alleging poor maternity care at Wagga Base Hospital.

The findings were handed down in May. They included 43 recommendations that the committee said "would go a long way towards addressing preventable birth trauma".

"The evidence highlighted a number of factors contributing to avoidable birth trauma which the committee believes must be urgently addressed, such as lack of continuity of care, lack of trauma-informed practices, inadequate antenatal education, inadequate informed consent practices, a lack of respect for women's birthing choices and experiences, and a lack of inclusivity and culturally-appropriate services within in maternity care," committee chair Emma Hurst said.

"We also heard that some of these issues are exacerbated by maternity workforce shortages and resource constraints."

Ms Conn said birth trauma often remained unspoken due to the stigma surrounding it.

She said there was a societal expectation childbirth should be a joyous event which could make women unlikely to share their negative birth experience.

"Feeling okay about your birth is much more than the delivery of a healthy baby, it's about feeling safe, supported, listened to and in control of what is happening to your body. Many people, including healthcare providers may not fully recognise or understand the psychological impact of a traumatic birth," Ms Conn said.

"Women may also feel isolated or unsupported in their experiences, believing they are alone in their trauma."

Ms Conn said birth trauma could result from:

While it may affect the birth mother, it can also be quite difficult for fathers or birthing partners. They may experience anxiety, helplessness, depression and symptoms of PTSD.

"Often healthcare providers will focus on the physical aspects of a birth to determine how a mother is recovering. It's important that health care providers assess a mother's emotional adjustment after the birth and not just in the days afterwards, often it's in the weeks and months after birth, when women are still experiencing symptoms, that these conversations need to happen," Ms Conn said.

July 15 to 21 was Birth Trauma Awareness Week. This year's theme was informed consent.

Feeling informed is about more than just having access to information, the Australasian Birth Trauma Association chief executive officer Amy Dawes says.

"It's about feeling heard, listened to, and empowered to ask all the questions needed to make informed decisions to navigate childbirth with confidence and clarity. Without this, there is a threat of emotional and physical injury," she said.

Ms Dawes said the organisation's findings and experience showed a direct correlation between the lack of informed consent and birth-related trauma.

However, for anyone impacted by a negative birthing experience, Ms Conn said help and support was always available.

"It's important to let someone you trust know you may be struggling to process the emotional experience of birth trauma, reaching out to your GP, child and family health nurse, or other trusted health professional is so important," she said.

"A GP can provide you with access to Medicare rebateable sessions where you can be referred to a psychologist, who can help you to make sense of birth trauma and find a way forward."

Information and resources are also available through PANDA - Perinatal Anxiety and Depression Australia. It supports the mental health of parents and families during pregnancy and in their first year of parenthood.