Birth Debriefing – What Is It?

Birth Debriefing – What Is It?

The period of time after giving birth can be an upheaval.

Even for mamas who have been through birth before, every birth is a new experience.

There can be questions about what happened, confusion, or trauma and fear.

You might have experienced something unexpected, or perhaps the birth wasn’t what you thought it would be.

But there is also a tiny newborn baby to care for. A birth to physically heal from. Tiredness to live with. And all the daily pressures of life to focus on.

It can be easy to push your unasked questions or unsettling feelings to the back of your mind, and just get on with things.

After all, isn’t that what women have been doing for a long time? Having babies and just getting on with it?

Birth Debriefing – What Is It?

The past few generations of women gave birth in a system that ignored the emotional and mental benefits of positive birth. Women were subjected to horrific practices in an attempt to get them through birth painlessly.

Even today, women are taught to fear birth. We’re told to not trust our bodies. We aren’t educated and empowered to understand birth as a normal, physiological process.

We tend to get through birth, even in our medically advanced world, with a sigh of relief that we made it, physically alive and with a baby to take home. And that is all that matters.

Unanswered questions can lead to unresolved feelings about birth. This can have long term consequences for women and their families.

What Is A Birth Debrief?

Essentially, birth debriefing provides the birthing woman with the opportunity to talk about her birth experience.

Rhea Dempsey is one of Australia’s most well known birth educators, a birth attendant and counsellor, and the author of Birth With Confidence. She says, at its simplest, birth debriefing is “telling the story”.

Rhea explains: “Birth stories are a huge part of our life experience. It is the beginning of our child’s life. It is an intense physical and emotional experience, one we can’t imagine until we go through it.

“Telling our birth story is a way to make sense of it and integrate this event into our lives”.

The overall idea of birth debriefing is to give women a supportive space where they can fill in any gaps.

They might ask questions, talk about how they feel about their birth, or just talk generally about the experience.

Why Debrief Birth?

Birth debriefing tends to focus on those women who have had a negative birth experience.

Often, they have very uncomfortable feelings about their birth but aren’t given an opportunity to understand what happened. This lack of understanding compounds the negative feelings about birth and increases distress.

In this situation, Rhea says, a woman who isn’t able to integrate her birth experience is left with intense feelings of guilt, shame and failure.

“Often, a new story is created, without the facts, which compounds the ‘fault’ as being hers – i.e. my cervix didn’t dilate, my baby couldn’t fit, I couldn’t handle the pain. This internalising creates more trauma and she’s more likely to be fearful of trusting her body and birth in the future”.

Having the opportunity to understand what happened, in the context of the people involved, and the setting where birth occurs can help answer the very important question: ‘Why?’. Being able to process their experience with the facts provides women with the chance to tell their story in a new light.

Rhea says, “Birth debriefing can help women to reclaim their birth story in terms of what courage looked like for them in that situation”.

This perspective moves women away from feeling they have failed, and towards seeing themselves as protective mothers who did the best they could to birth their babies safely in the situation they were in.

But what about women who have positive birth experiences? Do they need to debrief birth too?

Possibly not in the way women with negative birth stories need to unpack their story. But there are still many benefits to telling a positive birth story.

Many pregnant women want to hear how amazing and challenging birth is. There are far too many negative stories that push out the positive ones. You can do your bit to encourage women and girls to embrace birth as a positive and normal experience.

Raising awareness that positive birth is possible and achievable counteracts the negative way birth is viewed in the medical world. Focusing on negative stories only increases the expectation birth will be a negative experience.

Often women feel they shouldn’t talk about their positive birth stories, in case they make others feel bad about their own experiences.

It’s important to be empathetic to those around us but telling a positive story doesn’t have to be a judgement or a put-down of those around us who made different choices or had different experiences.

How Do I Debrief Birth?

How you debrief your birth will depend on you and your feelings about what happened. It is a good idea to tell your care providers, ahead of the birth, you’d like to have an opportunity to debrief; this can be put into your birth plan. Ideally you should speak to the care providers who will be present during your labour and birth.

Women who have normal and positive experiences often like to talk about how the labour unfolded, and to fill in any gaps of memory. They usually integrate their birth story into their lives without any problems.

Women who have negative experiences might need to take a two-pronged approach to birth debriefing.

In the first moments after the birth of your baby, you are usually overwhelmed with meeting your baby or ensuring you are both safe.

In the first hours after birth, take the time to settle in, rest and get to know your new baby. Make it known to your midwife or doctor you’d like to have some time before you go home for a birth debrief.

This time allows you to gather together the pieces of information you have forgotten or missed, or to ask very specific questions about procedures and choices made by care providers.

Often at this stage, care providers are focused on the positive outcome of a healthy mother and baby, and might not understand your feelings, which can increase your distress. Have a support person with you, to listen and take note of what is being said.

The deeper work of debriefing will come a little later, particularly when you have practical support in place so you can focus on yourself. This can involve going over what happened, and creating a timeline to understand why the experience was negative for you.

You might wish to journal or write down the events you experienced, the questions you asked, and the answers you were given.

For some women, this is enough to allow them to reclaim their stories and move forward. Others might need further support to process the negative feelings associated with their birth stories. Do whatever is best for you.

Who Is It Best To Debrief To?

If you’ve made the decision to debrief your birth, who is it best to seek support from?

Ideally, in the first few days after birth, speak with the care providers who looked after you. Gather the information, fill any gaps in your memory, and write events down.

When you are ready to unpack your story further, there are a number of ways you can do this:

  • Some hospitals offer debriefing services, although this is unlikely to be with the care providers who were present at your birth. Not all women find this helpful, as the focus tends to be on the outcome (healthy baby and mother) rather than on acknowledging what in the birth system contributed to their distress.
  • Independent midwives can help you understand the facts about the birth process and the medical birth culture that affects outcomes. Midwifery has the social and emotional aspects of care that are missing from obstetric care; this translates into ‘being with’ women during birth. Having holistic support goes a long way to making sure you are heard, on a deeper level than just the health of baby and mother.
  •  Trauma psychologists are trained to recognise and acknowledge the effects of trauma. They can help women to process their experience in a safe and supported way. Some psychologists specialise in birth trauma, and they can be found on the Centre for Perinatal Psychology directory.
  • Organisations such as BirthTalk and PANDA can also provide support.
  • Some doulas and birth educators offer birth debriefing support and/or have perinatal counselling qualifications.

It can be most helpful to talk to someone who supports birth as a normal life event and who also has a clear understanding of how today’s birth culture influences birth outcomes.

Birth debriefing can be a very emotional experience and one in which you should feel supported at all times. It can help you to make sense of what happened, and why, and it can end the cycle of internalising your feelings and creating more distress.

Should Dads Debrief Too?

It’s only recently we’ve begun to understand and acknowledge the effects of birth trauma on women. But it’s becoming apparent what goes on in the birthing suite can deeply and adversely affect dads too. To witness their partners in pain, and to feel helpless to protect them can be distressing for men. Emergencies or even a lack of communication can leave dads feeling traumatised by what they’ve seen and experienced.

Men tend to align with the medical outcomes viewpoint – having a healthy baby and mother. They might not be traumatised but feel unable to empathise or acknowledge their partners have problems integrating their experience of their baby’s birth.

This lack of empathy can compound a woman’s feelings of distress. In this situation seeking support as a couple can help both partners understand and support each other more positively.

It’s common for men to feel they need to stay strong to support their partners and families, yet this can compound the problem. Dads who feel they need to offload their feelings about the birth experience can access the same support as their partners can.

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Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.

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