Transformation after “Seismic Trauma” in Childbirth

“We must never forget that we may also find meaning in life even when confronted with a hopeless situation, when facing a fate that cannot be changed. For what then matters is to bear witness to the uniquely human potential at its best, which is to transform a personal tragedy into a triumph, to turn one’s predicament into a human achievement.

—Viktor Frankl, Holocaust survivor and author of Man’s Search for Meaning 1

Many writers and podcasters perpetuate an urban myth that a difficult, disappointing birth experience will follow you to your grave. Not so; many resilient parents overcome disillusions, resolve inner conflicts, and feel stable again within months or a few years. However, a great shock and trauma may require more time to sort out; those storytellers may need to be witnessed, supported, or mentored through their process. (Without a map or mentor, it took me eight years to slowly find my way, rebuild my belief system and embody a new story.) This article offers you hope if you are still early postpartum and in the crucial but awful phase of chaotic thoughts, negative feelings, and ruminating about what happened.  

30 to 70 percent of people report positive changes following trauma2

In the mid-1980s, Richard Tedeschi and Lawrence Calhoun began researching personal transformation after traumatic events, such as a natural disaster, loss of a loved one, or debilitating illness. They observed personal growth resulted from a storyteller’s psychological struggle to cope with a traumatic event and find meaning in their adversity, not from the traumatic event itself.3 Tedeschi and Calhoun coined a term for this experience “posttraumatic growth.” 

In their book, Posttraumatic Growth: Positive Changes in the Aftermath of Crisis, Calhoun, Park, and Tedeschi drew an analogy between the aftermath of psychological trauma and an earthquake in the following passage:

“Posttraumatic growth is both a process and an outcome. The events that initiate posttraumatic growth have the quality of “seismic events” on a psychological level. Consider that earthquakes produce a significant threat to existing structures and leave little but the poorly functioning rubble of a community in their wake. The remains of old structures must be removed so that new, stronger structures can be built. But a period of confusion and mourning precedes this rebuilding, and there may be worry that it is no use, the task is too great, and aftershocks or future disasters [future births] will wipe out all constructive efforts.”4

The aftershocks of birth shock and traumatic or life-threatening events in childbirth can crumble old assumptions and belief systems;  what you were sure was true is now in doubt. You may doubt your capacity as a parent, partner, and decision-maker; you may worry about, over-plan, delay, or avoid altogether another pregnancy to forestall the possibility of another traumatic experience.

Tedeschi and Calhoun recognized the necessity of seismic strength traumatic events to precipitate lasting posttraumatic growth.5 Unwished-for and unexpected events, including lack of empathic care from providers, set the stage for a seismic shattering and shaking of long-held beliefs about yourself, your sense of autonomy and self-worth, as well as assumptions and expectations regarding childbirth, birthplace, caregivers, choices, and influence.  

At some point after the traumatic event, you may wonder why what happened-happened, and how you arrived at this place of confusion, blame, regret, and so on. To pass through the Third, Fifth, and Sixth Story Gates on your Return, you have to complete specific tasks, such as examining old rules and beliefs before you can begin to build new ones. Intrusive thoughts spin you in the Revolving Gate (Sixth Gate); it is the necessary phase of rumination.6. 

With the passage of time, self-reflection, and perhaps an empathic, wise listener, you will step out of the Sixth Gate and makes your way to the Seventh Gate where another part of you, your Huntress,* becomes active and begins tracking the story you are telling yourself about yourself. At this Gate, it’s possible to begin a new narration about what happened.7  Eventually, you will reach the Ninth Story Gate and your heroic journey will be complete. Like the first Gate, the last Gate is a Gate of no story; it will be so thoroughly composted and integrated, you’ll have no need to “process” it again. When you, the hero, completes your journey, you will receive a hidden healing, a Gift to carry with you into the future. You will realize some (maybe all) of the seven possible transformation markers described by Tedeschi and Calhoun:

  • Greater appreciation of life; change in priorities; enjoy the simple things in life
  • Greater appreciation and strengthening of close relationships; accepting help
  • Increased compassion and altruism
  • The identification of new possibilities or a purpose in life; new awareness of their vulnerability and mortality
  • Greater awareness and utilization of personal strengths
  • Enhanced spiritual development; new philosophical outlook
  • Creative growth.8,9

“That which does not kill us makes us stronger.”

—Friedrich Nietzsche

Ancient myths, literature, history, and religious texts tell tales of many a hero’s inner battle for truth in the face of adversity that led to radical, lasting transformation. If emotional birth shock and trauma made you stronger, tell us about it on Facebook (I’ll post invite in a few days). Why does Nietzsche’s saying seem to be true for some people some of the time but not hold universally? Because not everyone who experiences a traumatic event will experience a posttraumatic transformation. (A note to birth story mentors: It is better for you to watch for signs of posttraumatic personal growth in storytellers rather than to prescribe or suggest  they ought to be experiencing this growth—already.10)

Who is likely to experience post-traumatic growth? 

  • Age is a factor: Children under eight years of age are less likely to have the cognitive capacity needed to process a traumatic experience in a way that leads to PTG. However, people in late adolescence and early adulthood are open-minded and still forming their worldviews—so, they are more likely to experience PTG.11  In two studies, younger mothers reported more posttraumatic growth after perinatal trauma; conversely, the older mothers were, the less posttraumatic stress they reported.12,13
  • Cesarean mothers experienced significantly more posttraumatic growth than women who gave birth vaginally. It is easy to understand how unexpected cesarean birth, especially emergency cesarean for fetal distress—would create a seismic crisis powerful enough to shake the foundations of a mother’s core beliefs and assumptions.14
  • The greater the passage of time since the traumatic birth occurred—the greater the possibility for posttraumatic growth;  over time there is a natural decrease in intrusive thoughts, which allows the storyteller to rebuild their belief system and new narration.15
  • Another factor that positively influences posttraumatic growth is the degree of self-disclosure and sharing of emotions.16

“When more meaning is sought, more meaning can be found.

—Noonan and Tennstedt17

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*  Read about the nine birth story Gates in my book, Ancient Map for Modern Birth. 

GLOSSARYTerms Defining & Distinguishing Resilience, Recovery, and Posttraumatic Growth 

Resilience is the ability to experience a life-threatening or traumatic event and be able to adapt in the face of crisis or tragedy, and to maintain relatively stable, healthy levels of psychological and physical functioning. 

Kanako Taku, Ph.D., a survivor of the 1995 Kobe earthquake in Japan and associate professor of psychology at Oakland University, defines resiliency as “the personal attribute or ability to bounce back.” 18

   When resilient people face unexpected events, they aren’t emotionally shattered. So, they won’t have to seek a new belief system; therefore, they won’t experience PTG. On the other hand, less resilient people are more confused and experience more distress when their worldview crashes.19

Recovery suggests a trajectory in which normal functioning temporarily gives way to symptoms of depression or posttraumatic stress disorder for at least several months and then gradually returns to pre-event levels. Complete recovery may be relatively rapid or may take as long as one or two years.20

Posttraumatic growth refers to positive personal changes or transformation following a struggle to find meaning after experiencing adversity or a life-altering crisis that shattered assumptions about the world, their place in it, and the importance of life.

Citations
  1. Victor Frankl (1959). Man’s Search for Meaning, Boston: Beacon Press. p. 112
  2. S. Joseph ( 2014). What doesn’t kill us: The new psychology of post traumatic growth. Psychology Today. Retrieved from: http://www.psychologytoday.com/blog/what-doesnt-kill-us/201402/posttraumatic-growth                                                          
  3. Tedeschi and Lawrence Calhoun (1996) The Posttraumatic Growth Inventory:  Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. 10.1002/jts.2490090305 

4.  Richard Tedeschi., Crystal Park, and Lawrence Calhoun (1998). Posttraumatic Growth: Positive Changes in the Aftermath of Crisis.Mahwah, New Jersey: Lawrence Ehrlbaum Associates. P. 2.  216

5.   Ibid, p. 216.

6.   Pam England (2017), Ancient Map for Modern Birth. Santa Fe, NM: Seven Gates Media. pp.375-380

7.  Ibid. p. 380.

8.   Tedeschi & Calhoun, 1996       

9.   Scott Barry Kaufman (2020, April). https://blogs.scientificamerican.com/beautiful-minds/post-traumatic-growth-finding-meaning-and-creativity-in-adversity/

10.   Meeta Malhotra , Suma Chebiyan , Posttraumatic Growth: Positive Changes Following Adversity – An Overview, International Journal of Psychology and Behavioral Sciences, Vol. 6 No. 3, 2016, pp. 109-118. doi:10.5923/j.ijpbs.20160603.03.

11.  Lorna Collier. (2016, November). Growth after trauma: Why are some people more resilient than others—and can it be taught? 47(10).  Retrieved from: https://www.apa.org/monitor/2016/11/growth-trauma

12.  Sawyer & Ayers (2009). Post-traumatic growth in women after childbirth. Psychology & Health, 24(4), 457–471. 10.1080/08870440701864520

13.  Sawyer, et. al. (2015) Sawyer, Nakić Radoš, S., Ayers, S., & Burn, E. (2015). Personal growth in UK and Croatian women following childbirth: A preliminary study. Journal of Reproductive and Infant Psychology, 33(3), 294–307. 10.1080/02646838.2014.981801

 14.  Sawyer, A., Ayers, S., Young, D., Bradley, R., & Smith, H. (2012). Posttraumatic growth after childbirth: A prospective study. Psychology & Health, 27(3), 362–377.  doi: 10.1080/08870446.2011.578745

 15.  Cheryl Tatano Beck, Sue Watson, and Robert Gable (2018, June). Traumatic Childbirth and Its Aftermath: Is there anything positive? Journal of Perinatal Education 17(3): 175-184. Doi: 10.1891/1058-1243.27.3.175

 16. Calhoun, L. G., Cann, A., & Tedeschi, R. G. (2010). The posttraumatic growth model: Sociocultural considerations Weiss, T & Berger, R (Eds.), Posttraumatic growth and culturally competent practice: Lessons learned from around the globe. Hoboken, NJ: Wiley.

17.  Noonan, A. E., & Tennstedt, S. L. (1997). Meaning in caregiving and its contribution to caregiver wellbeing. The Gerontologists, 37, 785-794.

 18. Lorna Collier (2016, November). Growth after trauma: Why are some people more resilient than others—and can it be taught?  47(10).  Retrieved from: https://www.apa.org/monitor/2016/11/growth-trauma)

 19.         Ibid.

20.   George Bonanno (2004, January). Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events? American Psychologist.

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