Few things in life go to plan – which at best is annoying, but at worst can lead to us feeling hopeless and out of control.
Childbirth is one of those occasions. We’re encouraged to make ‘birth plans’, prep like we’re studying for a degree and are constantly asked “are you ready for your new arrival?”. So it can be extremely frustrating, and sometimes even devastating, when things don’t go according to plan.
For some new parents, this can lead to a whole host of complex feelings and symptoms, ranging from trauma to failure and disappointment. It’s something Victoria Warnes, 41, from Berkshire, knows all too well.
“My first birth experience expectation was heavily romanticised and biased towards one type of ‘natural’ birth and feeding experience,” says Warnes, who had her daughter in 2014.
“When Olivia arrived following an emergency C-section, following an undiagnosed breech position, I was traumatised – I thought I was going to die during labour and that we would lose her too.
“I felt utterly broken holding her in my arms. An extremely painful breastfeeding journey seemed to cement my entire experience: I was a complete failure.”
Sadly these feelings aren’t uncommon. In a study of birth experiences in Pennsylvania, US, roughly one in 10 women were found to experience feelings of disappointment after giving birth, while 15% reported feelings of sadness and 7% reported feeling like a failure.
What is birth disappointment?
Birth disappointment is a feeling of sadness and loss that your birth experience didn’t work out as you hoped it would.
Maybe you planned for a home birth, but ended up giving birth on a labour ward. Maybe your baby came early or late and you couldn’t have the birth you wanted, or perhaps you needed intervention like forceps or a C-section when you hoped for a vaginal birth.
It’s different to birth trauma, as Dr Kim Thomas, CEO of the Birth Trauma Association, explains: “Birth disappointment is a feeling of sadness that tends to fade. Birth trauma is a term that refers to psychological symptoms experienced as a result of having a traumatic birth.
“Those psychological symptoms can include feelings such as intense anxiety and fear, flashbacks to the birth, or a feeling of constantly being on high alert. Some women (about 4% of those who give birth) develop full-blown post-traumatic stress disorder (PTSD).”
“Birth disappointment is a feeling of sadness that tends to fade.”
- Dr Kim Thomas
The two issues are not mutually exclusive, however, and can exist on a spectrum – some women may experience both as a result of a difficult birth. And while birth disappointment may not have the same psychological effect as birth trauma, it’s still a very real experience when childbirth doesn’t go the way someone thought it would.
Zoe Ayre, 36, from West Yorkshire, planned to have a home birth in 2021 and had everything prepared including the pool, which had been set up downstairs. But her due date passed and there was no sign of her baby.
“I went two weeks overdue and so with every day that passed, I realised the home birth was becoming less and less likely,” she says.
The 36-year-old went into labour naturally and believed a home birth might be back on the cards, but when she experienced a bleed and was admitted to hospital, these hopes were dashed.
“I ended up having an epidural, an episiotomy and a pretty big haemorrhage after she was born which was really scary,” she says.
Why do we experience birth disappointment?
Expectation versus reality plays a big part when it comes to birth disappointment. Often, from the likes of antenatal classes, we’re given a best case scenario of childbirth – but the reality can be very different.
We’re encouraged to make birth plans, and these include the ‘nice’ things like what playlist we’d like to have in the background or whether we want the lights down low, but this can mean aspects like pain relief and interventions fall further down the list of priorities.
“There is increasing pressure to have a perfect birth,” says Dr Thomas, who notes that social media doesn’t help matters.
“If you see images, or read stories, of women getting through labour by doing breathing exercises and then giving birth naturally in a pool, it can feel like this is the best way to give birth and anything else is ‘failure’,” she says.
“The implication is that if you do everything right, then your birth experience will be smooth.”
Ayre, who runs @therespectfulmum, reflects that the courses she did throughout pregnancy gave her “a rose-tinted view of birth” and set her expectations at a level “which is really unachievable for many”.
“I had expected to be able to just breathe the baby out, using the techniques that I had learnt, and I went in clear that I wouldn’t have any medication or pain relief at all,” she says.
“When things started to go wrong, it felt like I had failed. That narrative that women have been doing this for millennia, and that it’s the most natural thing in the world, meant that when I couldn’t do it that way, I felt that it was a reflection on me and my abilities.”
She reflects that while antenatal courses can be “brilliant” for letting parents-to-be know what to expect during birth and help them make informed decisions, “it felt like interventions and pain relief were vilified by the courses and made to be something to fear and avoid at all costs”.
For Victoria Warnes, the lack of realistic expectations taught in antenatal classes led her to create her own alternative antenatal education business, Our Baby Club. “I don’t ever remember as a child, or adult even, watching on TV or reading anything remotely near to a realistic birth,” she says.
“And much less likely having realistic conversations around birth or parenthood. Sadly I know many people who have experienced birth disappointment.”
Of course, it’s not just antenatal classes and unrealistic social media posts that can lead new parents to experience birth disappointment; it can be the hospital care or even exhaustion that can lead these feelings to surface.
“I was just so tired after giving birth,” says freelance journalist Kat Romero, 34 from London who had her son in October 2021. Instead of the birth centre labour she hoped for, she ended up needing an emergency C-section.
“I had been so sleep-deprived from the constant monitoring in hospital that by the time my son was born, I was too tired,” she says. “I just wanted someone to take care of him for a few hours so I could rest. My partner was there but I felt the pressure to try to breastfeed and bond. It was hard.”
“That narrative that women have been doing this for millennia, and that it’s the most natural thing in the world, meant that when I couldn’t do it that way, I felt that it was a reflection on me and my abilities."”
There’s not a lot in the way of studies looking into birth disappointment and how it affects new parents. But, a 2021 study published by BMC Pregnancy and Childbirth found that a mismatch between birth expectations and experiences is associated with reduced birth satisfaction – and it might even increase the risk of developing postnatal PTSD.
To ensure women’s expectations are met, and they experience a satisfying birth experience, researchers said maternity providers should provide sensitive care, which acknowledges women’s needs and preferences, and is based on open and clear communication.
Importantly, this should be delivered as early in pregnancy as possible, they said, and women should be able to make their own decisions about care.
What help and support is available for those navigating birth disappointment?
For those experiencing disappointment connected to a recent birth, Dr Thomas recommends asking for a birth debrief at your maternity unit.
“A midwife will go through your notes and explain why your birth happened the way it did,” she says. “This can be helpful in relieving yourself of some of the guilt you might feel for not having had a ‘perfect’ birth.”
If the feelings of disappointment are having an impact on your daily life or your relationships, you might be able to get help from the perinatal mental health team too, suggests Dr Thomas. She also recommends speaking to friends and family about your experience, or finding support groups online.
In an article on the topic, psychologist Dr Sarah Allen shares some strategies that can help with healing from a difficult birth, including writing out your birth story and asking for your birth partner’s input, so they can offer a fuller perspective of events; trying not to avoid how you are feeling; and focusing on all the things you did right as a parent on the day your child was born.
She also stresses it’s important to remember it can take time to fall in love with your baby, no matter what your labour experience is – and instant bonding is “rare”.
It’s one thing Kat Romero wishes she’d been told before giving birth. “That’s what hit me the most – that I didn’t have that instant bond,” she reflects.
“But, once I started reaching out to fellow mum friends, I felt like most of them were let down. It seemed like only a small handful of women get their dream birth experience. Many of us suffer complications or stress.”
Ayre believes we need wider discussions on the topic in order to help create awareness of birth disappointment.
“I don’t think it’s spoken about very often, particularly not in the mainstream. It’s one of those topics where when you open the floodgates, you realise how many people feel the same way,” she says.
“I really think it’s important for us all to reassure ourselves that no matter how our birth went, we didn’t fail in any way.”