I was at a very stressful birth yesterday. The labour and delivery were 36 hours long. I was with the family for 18 hours and 16 of them were spent in the hospital.

When mom was finally complete, she was told to push when she felt an urge to. She didn’t. She never did during the four hours of pushing she endured. Shortly after she started, it was obvious there was meconium in the fluid. By the time the baby was crowning, the meconium was so thick that it turned the baby’s scalp green like a little Incredible Hulk.

Even before stage 2, mum was desperately tired. After a few hours of pushing she was tired, demoralized and starting to feel she’d landed herself smack into a Dantean ring of hell. It seemed as if it were her fate to attempt to push her son out for the rest of eternity.

Around the three hour mark, she was given some pitocin that would strengthen her never very strong and waning contractions. As the resident explained the risks and benefits and ended with an open ended comment that seemed to imply that baby may be in jeapordy and mom may end up in emergency surgery, dad had reached his breaking point and had to step away from his fragile wife.

As their doula, my heart broke that this couple who’d been so ready to roll with the punches and eager to embark on the great unknown of first time parenting was now facing constant challenges.

Mother had a horrible amount of physical birth trauma I found difficult to see. She was inadequately anesthetized for the repair and the resident who’d been left to do the work didn’t listen when she complained of severe pain. It seemed a miracle that the baby got away from his experience with little more than deep suctioning, but he was born strong and healthy. The poor mother could barely remain awake and had no energy or patience to attempt to breastfeed. At one point she said she was upset because she felt not one little bit of bonding feeling; that she just wasn’t interested in the baby at that time because of the traumatic birth.

While the nurses were really wonderful, she went through three different resident changes and had to endure introductions from 6 different interns throughout the day. The family never once met an actual OB, who only walked in as the head was delivered, remained for the delivery of the placenta and left. All actual medical care was performed by students and nurses. Aside from the nursing care, the family vented that they felt deeply let down by the obstetric staff.

When I got home last night and gratefully ate half a pizza, ravenously making up for not eating for an entire day (OK, I had a couple of butterscotch candies), I thought to myself that I should probably spend more time postpartum with this family than I normally do. A birth like this is far more likely to cause postpartum depression disorders than a less traumatic one.

So, yes, I’m pretty darned sure that birth can cause PTSD. After leaving the hospital, I felt like I’d been fighting a war. And I was only the doula! It’s not like there was conflict or horrible mismanagement of the labour and delivery, but all of the circumstances of a long, tiring, difficult labour really stress a family, particularly a mom.

Birth in it’s most joyous is never an easy journey. When it’s difficult it can leave lasting emotional damage.

When my therapist told me I was suffering from Post Traumatic Stress nearly a year after the birth of my twins, I was taken aback. But she explained how my birth experience fully met the criteria for PTSD. I spent the next 6 months in therapy (talk therapy and EMDR) and it made a huge difference in my quality of life.

Still, nearly 7 years later, the thought of getting pregnant and giving birth terrifies me. I won’t put myself in that position ever again.

I could list all the horrible things I went through, but it shouldn’t matter. I had a licensed therapist diagnose and treat me. It doesn’t mean motherhood is a “pathology.” It simply means that life-threatening complications exist, severe pain exists, and emotions and hormones can amplify and intensify the trauma. And with premature newborn twins to care for, I didn’t take the time initially to “deal with” the trauma. I just had babies to take care of. I was in survival mode.

And for what it’s worth, I had excellent health care, from caring doctors and nurses, and the support of my family. But sometimes, REALLY bad stuff happens anyway.

I’ve never considered that birth could cause such a terrible disorder, but it makes sense! I’ve fortunately had two very “normal” deliveries, but I’ve thought to myself, “wow! I just came through something unreal!” It’s somewhat traumatic, despite it happening all the time all over the world, even in the best circumstances.

I think I had PTS after an officially labeled “traumatic” childbirth. I had flashbacks for months. And of course, I did almost die, like a lot of women would (it used to be 10% not long ago) if it were not for modern medicine. What is it in warfare that causes PTS? Isn’t it the risk of your life?

I am absolutely sure that birthing can be traumatic, and although I wasn’t treated for it, I know I had some amount of PTSD. The labor/birth itself wasn’t bad. I only pushed about five times before my daughter came out. But afterwards, I hemorrhaged and my doctor had to reach up inside and clear my uterus with no anesthesia. I was scared out of my wits; it was the most painful thing I’ve ever experienced. (Even more painful and scary than crushing my right hand in an electric dough roller.) I made it through, and went home with my beautiful daughter. But I couldn’t stop thinking about it. I kept replaying it, vividly reliving it even. Then about three weeks after the birth, I hemorrhaged again. I nearly died, and had to have emergency surgery. Afterwards, I again couldn’t stop reliving it. Most vividly, I kept feeling the sliding pop of the clots coming out and literally covering the bathroom floor. Having a normal period freaked me out for two months.

I was not upset because my “birth plan” got scuttled. I am profoundly grateful that I was in a medical situation so that my life could be saved. The experience was not easy to get over. It interfered with my ability to enjoy my daughter, who happens to be a wonderful, tiny zen master. It took time for the images and feelings to stop intruding into my thoughts. I am better now, but I can’t help but feel that the dismissive tone here comes from a place of privilege.