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Every birth is unique. And for some, a birth experience can be deeply troubling and even cause post traumatic stress disorder (PTSD).


After giving birth, many women share a sense of disappointment, anger or fear. And this may have happened to you. Despite your best efforts, your birth did not turn out the way you planned. You may be angry. And you may think about your birth—a lot.

Fortunately, if you have had a troubling, difficult, or traumatic birth, there are some positive steps you can take.

What makes a birth experience difficult?

Some births seem really bad to outside observers, and yet mothers feel positive about them. Other mothers have births that appear perfect on paper, yet they are deeply troubled. Some births are life threatening and affect mothers for years.

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There is an assumption underlying much of the research on birth experiences that vaginal deliveries are usually positive, which is not always the case, and that cesareans are usually negative, also not always the case.

So what determines how a mother will feel? Researchers have previously defined good and bad birth experiences in terms of objective characteristics:

  • length of labor
  • use of pain medications
  • medical interventions
  • type of delivery

When considering women’s reactions to their births, I have found it more useful to consider the subjective characteristics. Trauma psychologist Charles Figley describes these subjective aspects in his classic book, Trauma and Its Wake. In looking at the range of traumatic events, he notes that an experience will be troubling to the extent that it is sudden, overwhelming and dangerous.

Let’s examine these in relation to birth:

  • Sudden: Did things happen quickly? Did your birth change from “fine” too dangerous in a short time? Did anyone have time to explain what was happening to you?
  • Overwhelming: Did you feel swept away by the hospital routine? Were you physically restrained? Did you feel disconnected from what was happening? Did you have general anesthetic?
  • Dangerous: Was your delivery a medical emergency? Did you have failed anesthesia? Did you develop a life-threatening complication? Was the baby in danger? Did you think you or your baby would die?

These three aspects can occur in vaginal or cesarean deliveries. In terms of understanding your reactions, the objective factors of your birth are less important than your subjective experience of it.

Some other risk factors for traumatic birth include your own history of depression, anxiety disorders, or trauma. Having a preterm baby can also be frightening and can lead to a negative reaction.

Relationships

Not surprisingly, your birth experience can impact your relationships with other people. You might be angry or disappointed that people who were there to support you during labor weren’t able to protect you. When you try to talk about your experience, others may not want you to.

Not being able to talk about your birth can compound your negative feelings. In the research literature on psychological trauma, this is known as sanctuary trauma. Sanctuary trauma occurs when a person has experienced a traumatic event and turns to those whom he or she usually counts on for support. Instead of offering support, these people either ignore or dismiss the issue, further contributing to a victim’s sense of isolation and trauma.

Unfortunately, a difficult birth can also influence another important relationship: your relationship with your baby.

After your baby’s birth, you may have felt numb. Even weeks later, you may feel disconnected from your baby. This effect can be compounded if your baby had health problems and needed to stay in the hospital, away from you.

Breastfeeding

Breastfeeding may have also gotten off to a very rough start. The stress of your birth may have delayed when your milk came in by several days. You may have needed to supplement your baby with formula to get through this time. And if breastfeeding didn’t work out, for whatever reason, you may have experienced this as another significant loss—or even failure.

In our study of 6,410 new mothers, women who had any type of birth intervention were less likely to be exclusively breastfeeding. However, even after a very difficult beginning, exclusive breastfeeding is possible.

Fear and pain

Below, are two birth stories from a woman named Kathy. Each birth was difficult for different reasons. The subjective factors I described above are important themes in both stories. There is fear of dying, overwhelming pain, and feeling trapped. There was also a replaying of events after these births.

When Peter was born, the birth itself was pain-free. He was small, especially his head and shoulders, and it truly didn’t hurt at all. I kept insisting I wasn’t really in labor up until two minutes before he was born when the doctor told me to lie down and push! He was born at 9:30, they told us he had Down syndrome at noon, and by 4 p.m., I was hemorrhaging so badly that I came within two minutes of death. I had to have an emergency D & C with no anesthesia and a big blood transfusion.

That night, they told us Peter needed immediate surgery and had to go to a hospital in another city. A very traumatic day, to say the least. And then they sent me home the next day with no mention at all that I might want to talk to somebody about any of this—the Down syndrome, the near-death experience, nothing.

I can still call up those memories with crystal clarity. And whenever we hear about another couple, I have to re-process those feelings. Interestingly, most of them relate to the hemorrhaging and D & C, not to the Down syndrome news. They’re all tied up together. Maybe it’s good to remind myself every so often of how precious life is.

My third birth was excruciatingly painful—baby was 9 lb 3 ounces, with severe shoulder dystocia. I had some Stadol right before transition, but that’s all the pain relief I had. I thought I was going to die and lost all perspective on the fact that I was having a baby. I just tried to live through each contraction. I was flat on my back, with my feet up in stirrups, and watching the fetal monitor as I charted each contraction. I know now that if I had been squatting, or on my hands and knees, I probably could have gotten him out much easier.

That night, after Alex was born, I could not sleep at all because every time I tried to go to sleep, my brain would start re-running the tape of labor, and I would feel the pain and the fright and the fears of dying all over again. I stayed up all that night and the next day and didn’t sleep until I was home in my own bed.

In Kathy’s stories, we see some classic symptoms of a posttraumatic stress response:

  • the fear of dying
  • the re-experiencing of her birth
  • the sleeplessness.

She did eventually come to a place of peace over her experiences, but the memories of those two births have remained vivid.

Road to recovery

If you had a difficult birth experience, you cannot change that. There are, however, a number of positive steps that you can take to help you resolve your experience and heal from it. Coming to terms with a negative birth experience is a process that can take months. Don’t be discouraged if it doesn’t happen overnight. You can overcome this.

Here are some things that other mothers have found helpful:

1) Process your experience

You may find it helpful to contact one of the support organizations to talk to someone who can validate your feelings and help you come to terms with your experience. Peer support, in person or online, can also be helpful. Some women find short term therapy helpful.

Another option is to write about your experience. Some find that writing in a journal is very therapeutic, and they’re not imagining this effect. Researchers have found that writing can help you heal from trauma. If you’d like to try it, I’d encourage you to get the book, Writing to Heal, to get the most out of this activity.

2) Learn as much as you can about your experience

I always encourage mothers to get copies of their medical records. If possible, talk with your healthcare provider or someone else who can help you understand the events that occurred during your birth. It is also helpful to read books that might put your birth experience in a broader perspective. Reading will do much to validate your experience and help you understand it.

You may still be angry, or you may get angry for the first time, but eventually the experience will not dominate your thoughts. If you plan to have another baby, the information you gain during this stage will make you a wiser consumer.

3) Give yourself time to get to know your baby

Your baby’s entry into the world was far from ideal. You may feel disconnected from her. Some mothers report that their baby doesn’t feel like their own. Fortunately, you can do something about this. Spend as much time as you can with your baby skin-to-skin, if it doesn’t feel too overwhelming. If skin-to-skin contact feels like too much, which can happen sometimes following trauma, ease into it gradually. You can get a lot of the same effects if you and your baby are lightly clothed.

You might also try infant massage. That can be a great way to get to know your baby and start to feel connected to each other. Babywearing is another helpful strategy.

4) Breastfeed

Following a traumatic birth, breastfeeding can also be difficult. Holding your baby skin-to-skin, or in light clothing, can also reactivate your baby’s feeding instincts and help your baby find and latch onto the breast, sometimes even weeks after birth. That reconnection can be healing for both of you. But mostly, you need to see that your baby prefers you to all others, even if, at the moment, you are having problems learning to breastfeed.

Get as much help and support as you can. Your stress hormone levels are likely high. Any activity you can do to bring them down will help. So accept all offers of household help. Relax as much as you can. Do things you enjoy. And spend as much time as you can with your baby. The two of you have been through a lot.

If your milk production is delayed by a few days, you may need to briefly supplement. This can be really disappointing. But remember, this is a short term strategy to get breastfeeding back on track. Things really will get easier.

5) Realize your partner may have also been traumatized

A negative birth experience can create problems between you and your partner. Like you, your partner may have felt powerless and swept away by the experience. Your partner might feel guilty because he or she could not protect you, and they may react to their bad feelings by being angry with you.

Because of those negative feelings, your partner may be unable to offer you emotional support. In this case, the most effective thing you can do is to be honest about your feelings with one another and try to find outside support together. If, however, your partner is not willing to work with you to resolve your birth experience, you must seek help alone.

6) Resist the temptation to rush into another pregnancy just to do it “right”

I often meet mothers who were unhappy with their birth experiences, who quickly become pregnant again in order to make it a better experience “this time.” You need some time in order to put your experience into perspective, get to know the baby you already have, and physically recover. Adding another pregnancy to the equation makes things much more complicated and may not give you sufficient time to consider all of your options.

7) Resist making hasty decisions about not becoming pregnant again

This is not the time to make a decision about permanent birth control. Some women make this decision only to regret it later. Understandably, you never want to repeat what you’ve been through. However, it is much better to make a deliberate decision rather than simply immediately reacting to a negative birth experience.

8) Make a conscious effort to forgive yourself

At first, you might balk at this suggestion: “I have nothing to forgive myself about.” If you still feel this way after you’ve thought about it, great! However, I’ve talked with many women who blame themselves and feel like they somehow failed. “If only I had been stronger…” “If only I had checked out the doctor/hospital more carefully….” “If only I had gone to a different prenatal class…”

The “if only’s” are endless. Recognize that you did the best you could under the circumstances and with the knowledge you had at the time, and let yourself off the hook!

10) Recognize that birth is only the beginning of a life long relationship with your baby

Motherhood is a role you gradually grow in to. A difficult beginning does not need to be the blueprint for the rest of your mothering career. It is important to realize that a negative birth experience can affect your relationship with your baby, but it does not have to. This is why it is vital for you to get the support you need as soon as possible.

I have seen mothers who have had difficult births try to make up for it by being supermom—to everyone’s detriment. It is difficult for anyone to be responsive and giving toward an infant or child when she is hurting inside.

In conclusion, I would encourage you to take good care of yourself and actively search for support. Many mothers and babies have overcome difficult beginnings. I am confident that you can, too.

Original article by Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA

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As a mid-Spring holiday, we never knew exactly what to expect from the weather on Easter when I was growing up in Michigan: Would we get to wear our new Sunday dresses without coats? Or would we be hunting for eggs while wearing snowsuits?

Although what the temperature had in store was really anyone's guess, there were a few special traditions my sister and I could always depend on—and it won't come as a surprise to anyone who knows me that my favorite memories revolved around food. After all, experts say memories are strongest when they tie senses together, which certainly seems to be true when it comes to holiday meals that involve the sounds of laughter and the taste of amazing food.

Now that I'm a parent, I'm experiencing Easter anew as my children discover the small delights of chocolate, pre-church brunch and a multi-generational dinner. While I still look forward to the treats and feasting, I'm realizing now that the sweetest thing of all is how these traditions bring our family together around one table.

For us, the build-up to Easter eats is an extended event. Last year's prep work began weeks in advance when my 3-year-old and I sat down to plan the brunch menu, which involved the interesting suggestion of "green eggs and ham." When the big morning rolled around, his eyes grew to the size of Easter eggs out of pure joy when the dish was placed on the table.

This year, rather than letting the day come and go in a flash, we are creating traditions that span weeks and allow even the littlest members of the family to feel involved.

Still, as much as I love enlisting my children's help, I also relish the opportunity to create some magic of my own with their Easter baskets—even if the Easter Bunny gets the credit. This year, I'm excited to really personalize the baskets by getting an "adoptable" plush unicorn for my daughter and the Kinder Chocolate Mini Eggs that my son hasn't stopped talking about since seeing at the store. (You can bet this mama is stocking up on some for herself, too.)

At the same time, Easter as a parent has opened my eyes to how much effort can be required...

There is the selection of the right Easter outfits for picture-perfect moments.

There is the styling of custom Easter baskets.

There is the filling of plastic eggs and strategic placement of them throughout the yard.

But when the cameras are put away and we all join together around the table for the family dinner at the end of the day, I can finally take a deep breath and really enjoy—especially with the knowledge that doing the dishes is my husband's job.

This article was sponsored by Kinder. Thank you for supporting the brands that support Motherly and mamas.


Our Partners

On Friday President Trump announced that the Centers for Disease Control is now advising people to wear a cloth mask if they need to go out in public. It's not a rule, he says, but a recommendation.

"It's really going to be a voluntary thing," President Trump told reporters. "I'm not choosing to do it."

First Lady Melania Trump is urging others to do it, tweeting, "As the weekend approaches I ask that everyone take social distancing & wearing a mask/face covering seriously. #COVID19 is a virus that can spread to anyone—we can stop this together."

What the CDC says about cloth face masks:

The CDC says it's recommending cloth face masks because recent studies show that people can have COVID-19 while asymptomatic, meaning they feel fine and because they don't know they are sick they might still be going about their daily routine in their community.

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Basically, masks don't protect the wearer as much as they protect people from the wearer (who might not know they are sick) by blocking respiratory droplets

"So it's not going to protect you, but it is going to protect your neighbor," Dr. Daniel Griffin at Columbia University, an expert on infectious diseases, tells NPR.

CDC experts are "advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure."

They say if you're going somewhere where it's hard to maintain the proper social distance of six feet, like a grocery store or a pharmacy, then it's a good idea to wear a simple cloth mask.

"The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance," the CDC states.

"You may need to improvise a cloth face covering using a scarf or bandana," the agency notes on its website.

A DIY cloth mask is an extra layer of protection:

The CDC still says that staying home and practicing good hand hygiene is the best protection against COVID-19, but a cloth mask would be an extra layer of protection if you must go out to get food or unavoidable medical care.

According to Dr. Scott Segal, chair of anesthesiology at Wake Forest Baptist Health in Winston-Salem, North Carolina, certain types of fabric are better than others when it comes to making a mask. While he CDC says improvised bandanas or scarfs are better than nothing, Segal says DIY mask makers should aim a little higher for the masks to be effective.

"You have to use relatively high-quality cloth," Dr.Segal, who is researching this topic, tells NBC News.

According to Segal you don't want to use a knit fabric (like an old T-shirt) but rather a woven fabric. He suggests a double layer of heavyweight cotton with a thread count of at least 180 (like quilters cotton). If you don't have a cotton with that high of a thread count, line it with flannel.

For more tips on how to sew a fabric face mask, check out these instructions from Kaiser Permanente.

No-sew methods:

If you're not a sewer you can still fashion a mask, and there are plenty of no-sew tutorials online showing you how. Use heavyweight woven fabric like Segal suggests and make one of these without a sewing machine.

How To Make a Pleated Face Mask // Washable, Reusable, No-Sewing Required youtu.be

Should kids wear masks? Talk to your doctor.

The CDC is not recommending masks if you're just going for a walk around the block or playing in the backyard (which is the extent of most kids' outings these days). The masks are more for grocery runs, which many parents are opting to do alone these days.

But solo parents and those with partners who are in the military know that leaving the kids behind isn't always an option if you're the only adult in the home. If that's your circumstance, choose delivery options when possible to avoid taking your children to public places like grocery stores and pharmacies (the kinds of places the CDC recommends masks for).

If you are concerned that you may need to take your child somewhere where a mask would be required, call your pediatrician for advice on whether a mask is appropriate for your child's age and circumstances. Babies' faces should not be covered.

If you have no one to watch your children while you get groceries and cannot get them delivered try contacting your local government, community groups and churches for leads on grocery delivery help. They may be able to put you in touch with someone who can fetch groceries for you so that you don't have to take your children to the store with you.

News

Lizzie climbed up the playground stairs on all fours, walked across the small suspension bridge and slid down the big red slide at our neighborhood park. I followed just inches behind my 4-year-old daughter ready to catch her.

I had become her shadow by necessity. Her actions were often unpredictable and sometimes dangerous so my arms became her safety net. Her big brown eyes and unruly curly brown hair encapsulated her carefree spirit, and I adored her with a love I never thought myself capable of.

She walked over to the swings and stood there, stiff, her eyes glazed over. She didn't look to me for help. She didn't point, raise her arms up or ask me to place her in the swing. But I knew what she wanted—I sensed it.

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"Do you want to swing, Lizzie?" I asked in a gentle voice. She remained silent.

I didn't expect an answer, but I always asked in hopes today was the day she would choose to use her voice to form a word for the sake of communicating with me. I placed her in the swing anyway and pushed her to the exact height I knew she preferred.

A look of contentment came across her face and a giant smile curled her lips. She was in her happy place. This place was a place I wasn't allowed in—not yet anyway. She lived in an alternative universe inside her head, and after the park, we would spend the rest of the day inside using therapy techniques to pull her from this place into the real world. I missed my daughter and the connection we once had.

There were so many quirks I thought were hers alone, when in fact they were symptoms of autism spectrum disorder.

Here are five possible signs of autism parents should know about. If you notice something that concerns you, please reach out to your pediatrician.

1. Change in language

As a baby, Lizzie's language gradually changed from babbling to gibberish. "With typically developing language skills, infants will babble often as early as two to three months indicating first instances of intentional and social communication," says licensed clinical speech language pathologist Julie Liberman. "An early sign of autism may be seen in infants creating nonsense syllables without added social-communicative behaviors."

Lizzie lost her social-communicative sounds and began to mimic noises from her environment such as screeching sounds or sirens. She also developed a few sounds such as "diddle diddle" that she would repeat all day long. The transition was subtle and slow—enough that at first I didn't recognize that it was happening. .

2. Sensory processing issues

"Sensory processing is how our brain and body organize and respond to sensory information. Issues develop when we are over or under-responsive to sensory information which impacts the body's ability to organize it, or modulate it and so responses range outside of typical parameters and dysregulation is observed," writes licensed occupational therapist Rachel Wolverton.

Lizzie walked on her tiptoes, flapped her arms when she was excited and ran full speed into the couch cushions over and over again. Many toddlers do similar behaviors, and we thought she was just being quirky and adorable. As part of her diagnosis, though, we came to understand that these repeated behaviors were signals that her processing was under-stimulated. She needed these movements to help her body and brain function. This also works the opposite way, too. Many kids are over-sensitive to lights, sounds and/or touch, so they become easily overstimulated. They might cover their ears, melt down when clothes are put on their bodies or withdraw from crowds.

3. Lack of response to name

Lizzie displayed what I call "selective hearing." I would stand in front of her, saying her name with a raised voice and she wouldn't respond or look up. She appeared to be deaf, but as soon as the theme song from her favorite Dora the Explorer TV show came on, she would run from the other room to watch.

As autistic teen advocate Matteo Musso explains, "Because we hear your voice so much, we don't usually respond to our name. It's that you say our name the same way all the time. A TV is more auditorily complex. One-word, same voice, can get lost in our thoughts and in our brain."

4. Repetitive behavior

My daughter began lining up her toys by color and her green peas at the dinner table. We thought she was brilliant! She is brilliant, but as it turns out, not because of her repetitive behavior.

While many children love repetition—as any parent who's got their child's favorite bedtime story memorized knows—what I learned is that the kind of repetitive behavior we saw in Lizzie is one of the core symptoms of autism.

"Individuals with autism typically find much comfort in repetitive behaviors, giving them a sense of control over their environment in a quite unruly world," says Dr. Caroline W. Ford, clinical psychologist and director of the Fairhill School and Diagnostic Assessment Center in Dallas. As she explains, autistic children experience real difficulty when their repetitive behaviors are interrupted: "When asked to change or alter the repetitive behavior, many autistic children become overly anxious."

5. Loss of connection

One of the most beautiful moments between mother and child is the first time her baby looks into her mom's eyes. It was in that moment with Lizzie, the connection formed was so strong I knew I would be willing to do anything for her.

Slowly over the course of months, she became more and more distant. She wandered around the house aimlessly and didn't seem to need me at all. As long as there was food and drink available, she was content to be all alone. It was hard to measure because it was a feeling, a distancing, a loss of connection. I second-guessed my feelings regularly. Mothers have a built-in intuition with their children, which should never be underestimated.

After my daughter's diagnosis with autism at the age of two, we researched and implemented a 30-hours-a-week home therapy program (although it's important to know that early intervention supports can also be found through community organizations and school systems—you don't have to do this alone). Now, I'm happy to say, Lizzie has made good progress, and I've found (and offered) support in the generous community of parents of autistic children like mine. I even started a non-profit, United in Autism, which partners with local charities to bring community-building, emotional-support events to special needs moms all over the country.

My daughter continues to be a source of joy and amazement. Most importantly, I know now that my daughter and I are not alone—and we never were.

Learn + Play

Starting this weekend Target and Walmart will be limiting the number of people allowed in its stores to give shoppers and staff more space to spread out and adhere to social distancing recommendations during the coronavirus pandemic.

"Beginning April 4, Target will actively monitor and, when needed, limit the total number of people inside based on the store's specific square footage," Target notes in a news release.

Walmart's corporate message is similar: "Starting Saturday, we will limit the number of customers who can be in a store at once. Stores will now allow no more than five customers for each 1,000 square feet at a given time, roughly 20 percent of a store's capacity."

FEATURED VIDEO

At Target you will also notice staff wearing gloves and masks over the next two weeks as the company steps up its coronavirus protection measures.

Many people are choosing to stay home and order groceries online, but that's not an option for everyone as long lines at some Target's prove.

"We're incredibly proud of the commitment our more than 350,000 frontline team members have demonstrated to ensure millions of guests can count on Target, and we'll continue to focus our efforts on supporting them," says Target's Executive Vice President and Chief Operating Officer, John Mulligan.

Target is open this weekend but—along with Costco, Aldi, Publix and Trader Joe's—Target stores will be closed on Easter Sunday to give the essential employees in these stores a much-deserved break.

News

I was blissfully asleep on the couch while my little one was occupied elsewhere with toys, books and my partner. She got bored with what they were doing, escaped from his watch and, sensing my absence, set about looking for me. Finding me on the couch, nose-level, she peeled back my one available eyelid, singing, "Mama? Mama? ...You there? Wake UP!"

Sound familiar? Nothing limits sleep more than parenthood. And nothing is more sought after as a parent than a nap, if not a good night's rest.

But Mother Nature practically guarantees that you are likely to be woken up by a toddler—they're hardwired to find you (and get your attention) when you're "away."

FEATURED VIDEO

According to attachment theory, when you respond to the needs of your child, a strong bond is formed and woven into their personality, serving as a basis for all future emotional ties. So your kids love and depend on you. And they can feel anxious when involuntarily separated from you, like when you are asleep.

Child psychologist Esther Cohen suggests that it is fairly universal that infants and toddlers try to open the eyes of their sleeping parents. Her theory is that when you are present, but with your eyes shut, you are not responsive, and on some level this causes your child a form of "emotional distress." So the best and easiest way for them to feel better is to wake you up.

Cohen believes that reestablishing eye contact bridges the gap between your physical presence and your emotional presence, making the situation feel normal again. Your kids are relieved that you are alert and there to interact with them—and that you are available to protect them.

Kids are hardwired to seek our attention all the time.

At birth, your brain is only about 25% of its adult volume. Born particularly vulnerable, you depend on years of loving care. This prolonged helplessness has resulted in the evolution of certain behaviors—like baby coos, smiles and crying—that increase your odds of survival within your family.

By the time you are a toddler, you've developed a sense of who you are and what you can do in relation to people and things. You also know that you are a separate person from your parents. Toddlers also have the sense of what's called object permanence—the ability to understand who or what is, or is not, present. That means you can search for objects and people. (And wake them up when you find them.)

Bottom line: When you sneak off for a nap and your toddler looks for you, know that this is a natural instinct for them, and they will grow out of it. But for now, when you are asleep, you are not there, so your kids must. wake. you. up.

And for an extra fun fact: Research indicates that this also could be why it's so hard for you to ignore your partner when working from home. They are there, but technically not available, so you

continually find reasons to interact with them—just like waking them up from a nap. 😉
Life
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