Knowing what TO say to a woman who is feeling traumatized by aspects of her birthing experience can be trickier than knowing what NOT to say.
While we may have a deep and immediate desire to offer love and support, and to help ease her pain, the most imperative questions we ask must first be ones of self-inquiry…
“In this very moment, right where I’m at, am I able to truly listen and be present for her in her pain? Am I in a place and space to deeply listen to whatever she needs to express, without judgement or comparison to my own stories?”
The postpartum period can be tumultuous, regardless of how the birth unfolded. To an even greater extent, a trauma-affected woman in the postpartum period is in an incredibly vulnerable state. She must choose her listener wisely. She needs her listener to be a guardian of her vulnerability—a keeper of the sanctity of her pain.
If our answer to the above self-inquiry is “No”—for whatever reason—we must be honest with ourselves and with her. If we sense that something about what she might share could somehow trigger something that we’ve experienced; if we hold strong beliefs about right/wrong or best/worse ways to give birth and are unable to set those aside; or if there are things going on in our own lives that might keep us from being fully present with her, then we must love her enough to allow space for another listener to be there for her. If this is the case, we can find other ways that we can show our love and care for her for the time being.
If we can answer “Yes” to being available to be a sacred listener for her right now, here are a few things we need to keep in our awareness:
So. We’ve established the importance of how to listen in a way that will be most supportive. Is there anything we can say?
Here are a few ideas of what TO say to a woman who is dealing with birth trauma:
1. “I can hear your pain. I can see that you are really hurting and struggling with aspects of your experience and are needing to share what you are feeling…”
She needs to know two things: 1) that what she is feeling is ok; and 2) that she is not alone in feeling those things.
That first need is validation—“permission” of sorts, simply to feel what she is feeling. She needs to know that she is still loved and accepted as she faces the magnitude of processing her experience and her feelings—even if we can’t relate or it doesn’t make sense to us. Trauma can be highly subjective; what is traumatic for one person may hardly catch the attention of another. We need to honor her right where she’s at.
The second need is the normalization of her struggle. Generally in life, when things don’t happen as expected or hoped, when there is a sense of being powerless, or when there is potential threat to a life, there is a great risk of trauma…How much more so during such an intense and vulnerable experience as childbirth?!
Sadly, birth trauma is far from ab-normal. In fact, studies have shown that 25-34% of women describe some aspect of their birthing experience as traumatic. Yet despite these high rates, most trauma-affected women—at least initially—feel like the only ones in the world struggling with it. She needs to know that she’s not the only one.
NOTE: We must keep in mind that giving validation and helping to normalize what she’s feeling doesn’t mean agreeing with what she shares. What does that mean? Validation and normalization are about acknowledging and honoring her feelings. Agreeing is about judgements of right or wrong and can perpetuate the Inward/Outward cycle that was discussed in #4 of What NOT to Say to a Woman Struggling with Birth Trauma…
2. “How are you? How are you, really? What are you feeling? I’m listening…”
While it’s true that talking about her experience and how she’s feeling will be very emotional and painful for her, the fact is that keeping it in—feeling like she doesn’t have anyone with whom she can just be raw and real—is far more excruciating in the long run.
Maya Angelou said it so beautifully: “There is no greater agony than bearing an untold story inside you.”
We can give her the life-changing gift of expression. We can be that safe place for her, free of all judgement, free of dismissal, free of any belittling of her experience or her feelings. We can greet with compassion whatever she shares.
Her wound must be acknowledged. The beast must be looked in the eye. Each layer, each root, must be brought to the light in its own time.
But be cautious: while she needs to express what is swirling around within her, telling and re-telling her story over and over can do more harm than good— especially if those she’s telling aren’t in a place to be the kind of guardian and listener that she truly needs in order to move forward in her healing. If we sense that she is stuck in that Inward/Outward revolving door through telling her story repeatedly, we can use the gentle questions that follow to invite her to back to a path that will help facilitate the kind of self-inquiry that allows for healing.
3. “Where in your body do you feel the anger? Where do you feel the betrayal? The grief, the guilt, the sorrow?
Trauma and PTSD expert Bessel A. van der Kolk, speaks in his book ‘The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma’ of the importance of befriending the body:
“Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies… In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.
In my practice I begin the process by helping my patients to first notice and then describe the feelings in their bodies—not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on.”
Again, we need to remember our role as a listener is to hear, not fix. If she shares that she feels her anger as tightness in her throat and jaw, or her grief as an emptiness in her chest, then validate that. It’s not our job to try to make her feel better. But interestingly, simply her own acknowledgment of those sensations and her freedom to express them to someone safe and trusted can make a significant difference in their intensity.
4. “Tell me about a moment during the birth that brings gratitude, joy, strength, love… Where in your body do you feel that gratitude, joy, strength, love…?”
A question asked by first-responders in emergency situations that have a high likelihood of causing trauma is: “When was the moment that you knew you were going to be ok?”
These types of questions can be life-giving to a woman in the trenches of trauma. Even when the experience is shrouded in an overwhelming sense of fear, powerlessness, confusion, anger or despair, returning in her mind to a moment of reassurance, relief or peace can be a life-line for her to hold on to.
We can help her remember that there were sweet moments amongst the darkness, that there were moments and memories from her birthing experience worthy of being cherished as favorites.
Please note: the purpose of inviting the woman to recall a cherished memory from the traumatic experience is NOT to ignore the trauma that she feels. It’s not “just focus on the good things; let the bad stuff go…” (#3 in What NOT to Say…) The purpose here is to offer a thread of light to prevent the dark parts from taking over completely.
Bessel A. van der Kolk continues the previously quoted excerpt from ‘The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma’ with:
“I also work on identifying the sensations associated with relaxation or pleasure. I help them become aware of their breath, their gestures and movements.
The mind needs to be reeducated to feel physical sensations, and the body needs to be helped to tolerate and enjoy the comforts of touch. Individuals who lack emotional awareness are able, with practice, to connect their physical sensations to psychological events. Then they can slowly reconnect with themselves.”
5. “You’re not alone in this.”
Yes, this is a part of helping to normalize what she is going through, as already discussed. This statement can also be a commitment in addition to being a sacred listener for her. We can help her to know that she’s not alone as she continues to navigate the tumultuous road of healing from birth trauma, beyond the initial bearing of her soul. We can offer love and hope. And we can help her gather a support system around her, and remind her of those supportive people and places in the moments that she feels so hopeless and alone.
6. Say nothing. Just BE there and hold her as she weeps…
Perhaps this should have been at the top of the list… But may we never underestimate the healing power of touch and of presence. Such a seemingly simple act of love can truly make a world of difference.
There will be moments that there truly will be nothing to say to someone in their despair…and we have to learn to be ok with that. We have to learn to see it not as powerlessness, but as an opportunity to give the most powerful gift of all. Because in those moments, all that we can do is… BE LOVE…