How to Prevent a Poor Birth Experience: Prenatal prevention of birth trauma

No one wants a poor birth experience, but there are things you can do during pregnancy that can help you prevent a poor birth experience.

Hi, I’m Hilary — I’ve been an L&D nurse for 20 years and honestly I am just now (in the last year or so) seeing stuff about birth trauma. I think it’s important to address these issues and talk about ways to prevent them (because nurses are all about prevention — yes, I’m looking at you vaccines). Come join me so we can talk about your pregnancy as you progress towards delivery:

Preventing Birth Trauma

Foster Good Communication With Your Providers

This is the #1. If you go into your labor trusting your provider, you are going to trust the choices they make as your labor and experience advances.

However, if you go into labor not trusting your clinician, you will not trust the choices they make. You’re making yourself both the provider and the patient. That’s just hard, and that’s not your job!

What to do if you don’t trust your provider?

If you are before 20 weeks, you will likely be able to switch to another one.

However, I realize that insurance makes it hard to pick who you’d prefer. It does always seem like the grass is greener for doctors that aren’t on your plan. Keep in mind that a lot of that is in your mind. I do believe that you will be able to find a competent physician on your plan.

Ask friends at work, at church and in other areas you socialize in. See who they used. I’d take reviews online with a grain of salt — most are written by one or two angry or very happy people… it’s hard to get medical reviews.

Call around, as you’re doing so — feel free to ask specific questions you have when your schedule an appointment. For instance, if you want to VBAC or something specific like that, they should be able to answer before you move to them.

How to Communicate with Your Doctor

No one wants to be met with aggression, especially a doctor who has spent years training for your case and thousands of others. Be respectful of that, they’ve earned that.

Train yourself to have positive feelings about him/her. When you find yourself having negative feelings about them, curb them back to positive and remind yourself that your doctor went into this profession for a reason.

Make a list of the questions you have (I always kept mine in the note app on my phone), and make sure you’re able to ask them at your appointment.

If your doctor is rushing you through your questions, tell them you have questions that you expect to have answered. Perhaps he has a nurse that can answer them if you have an extended list (or some informational pamphlets). I also recommend….

Learn The Truth About Labor

Doctors, in reality, just don’t have the time to go through the entire labor process — what you will experience and feel. That’s why a high quality prenatal class is important.

Yes, there are some small free ones that can give you a nibble of what you need… I recommend you start at about 20 weeks or so (but don’t worry if you’re later, there is still plenty of time to get prepared now!)

BUT, you really need to take a full class to learn the in’s and outs.

Why do you need a prenatal class?

1. It puts all the information in one spot, where you and your partner can review it all at once (instead of small nuggets of truth throughout your pregnancy)
2. It allows you to learn the “language” of the new place you’re at (the hospital) so that you understand. Just like if you were going to a foreign country
3. A lot of people call totally normal things birth trauma in the hospital (and I’m not saying that there aren’t things in the hospital that are scary all on their own). But, by knowing they are going to happen and what to expect — it just makes things easier.
4. It weeds out the lies, more on that coming-up…

I have to say, even before we went to Disneyland, I helped my kids learn the stories and even watched some rides on YouTube so they’d know what to expect.

That way, they weren’t taken off guard by how dark some of the rides were, or how some used flashing lights. They knew to expect it — and it truly was the happiest place on earth. 🙂

Yes, I’ve taught prenatal classes for my hospital (which I LOVED), and I now have an online class which I 100% believe is my best class yet.

It is created to simplify the birth process for busy couples so they can get prepared together. If that sounds good — I encourage you to check it out.

There are also hospital options (although, as I write this a lot are getting cancelled), some doulas offer them — but please be aware of your doula’s qualifications and mindset before you take their class. Try to find some reviews before you start.

Don’t Read Lies

Internet, I am looking at you.

I spend a lot of time on Pinterest, looking for great things to pin for my readers.

And I. see. a LOT. of lies.

Things like:

• Home Birth is Safer
• Things your physician is hiding from you
• You can prevent all tears
• How to go into labor on your own
• How Pitocin is the enemy (this one really gets me)
• How the epidural will ruin your body

Stop. Stop it! I mean, some of these might be amusing — but do. not. take these as knowledge.

Most of these are written by women who had a few births with no tears, or had a bad experience with physician communication. The internet somehow makes everyone an expert (which I whole-heartedly disagree with).

Most are not written by professionals (hello, 20 years) – and most are not written with huge, broad experience over many (even thousands) of births.

Many have people’s own bias about having or not having an epidural, or how it’s stronger to birth at home.

Stop it. At the very least, read these articles with your own bias that they are opinion pieces until proven otherwise.

Staying Open and Flexible

My #1 tip for labor and delivery (besides asking questions) is to stay open and flexible.

A lot of birth trauma is caused by wanting X, Y and Z — and then you being awe-struck that your birth team wasn’t able to provide you with those.

The reality is just true that things happen. X, Y and Z weren’t right for you or your baby. Maybe you didn’t want an epidural, but you got one — and you feel disappointment in yourself.

Maybe you didn’t want to use a vacuum, but the doctor decided it was in your baby’s best interest (along with your informed consent, I hope).

By telling yourself that sure, you’d prefer X, Y and Z (turns out most women have the same hopes, as does your labor team — I have a whole post on birth plans) — but you’re open to take things as they come and you’re ready to be flexible, you’ll flex.

And you most likely will have an amazing experience.

I am also a fan of positive birth affirmations — both about yourself and your team. Things like:

• My body was created to make this baby
• My birth team has the best of intentions for my birth
• I will make the right choices at my delivery
• My partner and I make a great team
• I am so excited to meet my baby

Whatever it is that you find yourself concerned about, turn it around as a postive and write it on a post-it that you see frequently, repeat it to yourself. By focusing on the positive I find that things just tend to work out. It might be woo-woo, but it seems to work in every area of my life.

Postpartum Tip: Talk About it Afterwards

Something I have put into my own practice is talking to patients about their birth, and opening communication about it afterwards.

Explaining why we performed any particular interventions.

Telling them how normal it is to have a tear, and how they can take care of it to heal.

Asking them if they have questions — this is especially important if something “out of the norm” (like an emergency cesarean ) happens.

I remind them that they can always talk to their postpartum nurse about it, and they can always ask a labor nurse why something happened, so you can get answers instead of letting questions linger or fester in your mind.

Ask questions. I feel like a lot of birth trauma happens when you don’t ask questions and you let things grow big in your mind…

It’s like a kid who thinks they have monsters in their room. Once they turn on the light, they realize it was just a shadow, or very explainable. I bet that could be true for you as well.

And nurses are always happy to answer questions. It’s our job (and we love it)!

The Truth About Birth Trauma

I am 100% not saying that birth trauma can be prevented.

There are crazy things that happen (I’v had severe anxiety after some devlieries), and the hospital can be a very scary space.

But I also feel like patients can do things to prevent it in many cases, and by doing that they can start their family on a happier foot.