The Birth Debrief: You Matter Too 

A birth debrief is an opportunity for you to reflect on your birth experience with a trained health professional, to feel heard and validated, and to hopefully find answers about any questions you may have. It’s an opportunity to get closure, and can be particularly helpful if you felt you lost control of your birth or if decisions were taken out of your hands.

Typically, a birth debrief is conducted in person at the hospital. Of course, this can be challenging if you feel traumatised by the experience and the location brings back tough memories. If this is the case for you, feel free to speak to your midwife about alternative options.

Debriefing is a powerful way for women to reclaim their voices following a stressful birth experience. It allows you to:

• Discuss your birth experience and your feelings about it
• Understand what happened to you and why
• Receive validation and resolve any lingering self-blame
• Express any negative feelings such as anger, frustration, or pain

A birth debrief should be accessible to anyone and everyone. Birth is a deeply personal experience, so only you can decide if you need a birth debrief. The experience can be traumatic for a whole spectrum of reasons, and your birth partner may also be seeking clarity or reassurance about certain things that took place. They are welcome to attend the birth debrief with you so they can provide you with moral support, and also to voice their own feelings where necessary.

If for any reason you don’t feel comfortable attending a formal birth debrief, it’s still a good idea to reflect on your birth in a less official capacity. Carving out some time and writing about your birth can be beneficial as you process the experience. Remember that your emotions about the birth may evolve as the weeks go by. It may take time for you to properly reckon with how your birth experience played out, and gauge how you actually feel about it.

The maternity team or unit where you gave birth should be able to organise a birth debrief for you. Most trusts will have a Maternity Voices Partnership (MVP) or a Patient Advice and Liaison Service (PALS) that can offer further pastoral care in this area. You can also choose to go private to see a therapist or another trained mental health professional. Many private midwives or doulas offer the ‘three-step rewind technique’, which is a therapeutic practice tailored especially to processing birth trauma.

It’s okay to feel that your birth was not what you imagined or hoped it would be, and it’s okay to spend time sitting with the disappointment or even grief that this can cause. You may find that people try to get you to focus on having a ‘healthy baby’, and although it’s likely that their intentions are to comfort you, this can actually end up rushing you through the processing stage. This really isn’t helpful for your mental health because you need closure in order to move on. The truth is that it’s possible to feel grateful for a healthy baby while also feeling sad or angry with your birth experience, or that you were failed by your support system. These two emotions are not mutually exclusive.

The effects of a difficult birth vary from parent to parent, with some reporting issues such as:

• Poor self-esteem
• Guilt
• Feelings of failure or inadequacy
• Difficulties bonding with their baby
• Relationship problems
• Anxiety
• Postnatal depression
• Fear of another pregnancy or birth

If this article is resonating with you, then be assured that you aren’t alone. Many women and their birth partners experience birth trauma, and you should be offered ongoing support from your maternity team as protocol. But please seek further, more specialised support if you feel the need to talk to someone. If left unchecked, birth trauma can develop into postnatal post-traumatic stress disorder (PTSD), a type of anxiety disorder. Witnessing traumatic events can also lead to PTSD symptoms, so partners can experience this too.

If you have concerns about your care at any stage of your birth experience, you can contact the Patient Advice and Liaison Service (PALS), the contact details of which should be featured on the website of your hospital or NHS trust. It might also be worth sending a copy of your complaint to the Head of Midwifery, the Director of Women’s Services, the Director of Nursing, and/or the consultant responsible for your care.

While writing your complaint, include as many details as possible about your birth experience. If you can, provide the names of the individuals who were involved in your care. Numbering the points in your complaint can be helpful too, as it allows you to ensure that each issue is addressed separately and properly by the care provider. Clearly state any reparations that you’re expecting as a result of your complaint. For instance, do you seek an apology, an explanation, a change in policy or procedure, or staff training? Listing any desired actions as bullet points at the beginning of your complaint can be beneficial in setting the tone.

Once you submit a complaint, the care provider is required to acknowledge it within three working days. This acknowledgment will confirm receipt of your communication and outline the next steps, including a timeline for their response. NHS bodies are legally obliged to investigate complaints swiftly and thoroughly, keeping you informed of the investigation’s progress.

You might be invited to discuss your complaint in a meeting, which can be held at a location of your choice; either the hospital or the clinic where your care was overseen, or a neutral location if you prefer. Bringing someone who wasn’t involved in your birth can provide additional support during this meeting, as they will be able to advocate for you and mediate where appropriate.

After the investigation, the NHS body should respond to your complaint in writing, usually within six months. If they cannot meet this deadline, they must inform you and be able to explain why. The response should detail how your complaint was examined, the conclusions that were reached, and any actions that have been planned as a result. If errors in your care are acknowledged then you should receive an apology, but be aware that the complaints process does not offer financial compensation.

For further information on NHS complaints policies and procedures, you can visit the NHS website​. You can also visit Birthrights for more personalised advice on writing your complaint, and you can request the notes from your birth through Birthrights, too.

Several organisations can provide you with mental health support:

• PANDAS Foundation: a pre- and postnatal depression charity with a free helpline and online support groups, including support for Dads.
• Birth Trauma Association: a charity founded and run by women who have experienced birth trauma themselves, dedicated to helping women and families access support.
• Counselling Directory: a trusted platform for accessing tailored online therapy with a mental health professional.

Planning another pregnancy after a difficult birth, or coming to terms with not wanting or being able to have more children, can be really hard. As you approach decision-making of this nature, it could be beneficial to access additional mental health support tailored to birth trauma, such as maternal counselling. Many trusts have mental health specialist midwives who are experienced in helping people navigate complex emotions. Exploring options like a planned c-section after a traumatic vaginal birth might also be beneficial. For more information, you can visit Tommy’s, a charity devoted to making pregnancy and birth safer, or Make Birth Better, a collective of birth trauma experts who offer personalised recovery support.