Supporting and Healing Birth Trauma: An Interview with Renee Groenemann

Renee Groenemann, www.spiritedgrowth.com

Renee Groenemann, www.spiritedgrowth.com

First of all, tell me about your work. What do you specialize in?

I wear a variety of hats. I am a mental health counselor, and also an experienced and registered yoga teacher at the 500 hour level, which is the highest level of registration and certification. I am a yoga therapist, and have been practicing yoga therapy since 2002. I also received my license in counseling 2002. I mainly work with people who are dealing with trauma related symptoms including anxiety, depression, PTSD, obsessive compulsive behaviors, and more. What I am looking at is, "What was the rough point in life?" Then we work to smooth that rough point out by processing it in such a way that they can integrate it into their life. The result is a change in their healing story, and all I mean by healing story is: we all have our paths, our journeys, and those significant moments that really cause us to pause and reconsider life. We suddenly look at life through new eyes, and perhaps with new beliefs about how to do life most effectively. I see my role as helping people in that part of their journey. 

What I specialize in is trauma recovery, and while I work with people who have gone through a variety of traumas, one of my favorite groups to work with is pregnant and postpartum mamas. When we go through the birthing and mothering process, it makes us pause, notice things with fresh eyes, and often experience life in a new way because we have discovered that we are creative beings. All of a sudden we are reevaluating and experiencing life in relation to this new being. 

The name of your business is Spirited Growth. Can you tell me a little bit about why you chose that name?

The name has to do with the spunky, spirited, and can-do nature that I see in many of my clients. It takes a lot of spirit to create a change and face some of these challenges. My focus is really around empowering individuals to explore their own life and realize that they actually have the answers. They are the best expert in their life, and I give them the forum and the opportunity to self-explore and self-heal, along with some guidelines and some tools. I teach mind-body tools such as relaxation methods, and quick turn around methods to shift out of anxiety. I help clients to hack the body and mind to heal.

What led you into this line of work?

I personally went through some issues with childbirth. First, I had some struggles getting pregnant and maintaining a pregnancy. Then I chose to do natural childbirth when we did have our first child. In the preparation for natural childbirth I took Sharon Said's Hypnobirthing class. That process of preparing was so informative. I really got on an even deeper level the connection between mind and body.

When I went through my first child's birth, I experienced back labor, and it was intense. I felt empowered at the end, but I also spent 32 hours feeling some extreme sensations without an epidural, and I really had to draw on the reserves.

With my second pregnancy, my child had issues afterwards with breastfeeding and sleeping because he was having breathing issues. My son was waking every 10 minutes trying to catch his breath. I was pumping every 20 minutes in the end to combat mastitis and clogged ducts. I ended up developing PTSD due to the threat to the life of my child and the lack of sleep I was experiencing. It's one of the worst combinations: trauma and sleep deprivation.

What I discovered was that while childbirth can be and is an empowering experience, it can also be a traumatic experience, and often there is a range in between. Childbirth is unique that way. The body-mind is in one of its most vulnerable states, and it can be a very trauma sensitive time. Childbirth is a weaving together of strong emotions and strong body reactions. I wanted to help women to experience their power in that moment of childbirth.

What are some of the reasons that women come to see you while pregnant?

I get a variety of clients referred to me. Sometimes there will be a trauma history for the individual, ranging from sexual abuse, rape, or one of the more invasive urinary tract procedures that are sometimes done to young girls. Some of my clients have just had some bad hospital experiences and there is a white coat syndrome going on, and some are second or third time moms who maybe have had previous birth experiences that were not so good.  The lack of control with childbirth can trigger an old trauma.

Women come to me preparing for birth because they recognize this anxiety and they want to be in the best emotional state for their birth. They want to be able to follow their birth plan, and they know that being relaxed and feeling empowered to make the choices that they need to rather than functioning from an emotional or a previously traumatized state can help them.

A guideline that I might offer is that if there is some anxiety about an upcoming birth, and a woman wants to prepare for the birth, we can examine it together and figure out what is going on. What might be being triggered from the past?The anxiety is often subconsciously linked to some former experience, and we work on resolving emotions around that former experience. Then I help the mom move forward into the birth: What is the best possible scenario with this birth? What are some of the most challenging scenarios? How can you feel empowered  even if the worst possible thing does happen? Working through the underlying emotions allows the woman to make those empowered choices no matter how unpredictable the birth might become.

What about postpartum? What are some of the reasons women come to see you after they have given birth?

Often I see women after they give birth because they have had a traumatic birth experience. When I say traumatic birth experience, I want to be very clear that nobody gets to define what that is except for the individual. So when I say traumatic birth experience, often times it is that the mom did not get the birth plan that she was hoping for and that maybe she even felt pushed in some way. Whether that intention was there or not does not matter, what matters is what was received by the mom in that moment.  

Sometimes women come to me because of anxiety, or maybe they are wanting to bond more effectively with the child. Maybe the bonding has been limited in some way because of what happened after the birth. There will also be times when the mom says, "I'm suffering from postpartum depression," and what we discover is that it it is not a classically hormonally based depression, but a combination of the sleep deprivation that comes with those first months with a new baby, and a traumatic experience with the birth. When we surround the mom with proper support and work through what happened in the birth, then all of a sudden the depression lifts for these women. Now there are definitely times when it is hormonally based, but for some women, sometimes just talking will shift things.

We explore the story of the birth and if we do that process early enough, sometimes it can just be as simple as allowing the mom to tell the story in a safe place where nobody is judging her or saying, "Oh well at least the baby is healthy," or some of the other negative feedback we sometimes get from people that limit our ability to process our challenges and our feelings. Sometimes it gets more complicated, and can move into things like Post Traumatic Stress Disorder (PTSD). Childbirth certainly has ripe conditions for PTSD.

 

What do you see as some of the biggest obstacles women giving birth today face mentally?

The way we do childbirth in the United States has become medicalized. Women who wish to experience that sense of empowerment at birth often have to assert themselves at a time when they are very internally focused, and that can become very challenging, both for the mom and for the health professional in the room. My goal in the coming years is to get out and educate as many childbirth professionals as possible about what the trauma process looks like, why childbirth is such a unique time where trauma can happen, and how they can minimize the chances of that happening to a woman. 

In terms of obstacles that women face, there is just a lack of understanding of the trauma process. Trauma is this point that we get to when we perceive a sense of threat to the wellbeing of ourself or others, and that perception puts us in a different state of mind. Literally, certain areas of the brain are shut down. I really feel that helping women prenatally, the way that you do as a doula, and helping the professionals in the room to understand how to create a more trauma informed birthing environment will help to limit the number of women who have these traumatic experiences.

If a woman is hoping to avoid experiencing birth trauma, what are some tips you might give her? Are there any ways women can prepare prenatally so that if they are presented with a potentially traumatic event during the pregnancy or birth, they can minimize the effects?

I suggest having open conversations with all of the people who will be in the room around the woman's plans for birth, her fears around birth, and what her needs are ahead of time. Those conversations should include childbirth professionals and family members so that it is a very team oriented experience.  I am not saying that all professionals are going to be open to this, but I think it is important that women advocate for themselves beforehand.

When we are going into something that feels very unknown, we often manage that anxiety by creating a lot of really specific expectations to try to control the environment. It ends up looking like, "If I get A, B, C, and D, then I will get the birth I want." I encourage women step toward that, and then take a step back from it and get a broader perspective.

Here is what I mean by that. Let's say a woman has a sense of what her ideal birth plan looks like. When she develops that plan, I would have her imagine that she got everything exactly as she wished on the birth plan. Everything turned out perfectly. I want her to imagine the sights, the sounds, the people around, the sensations in her body. What does it feel like in her body to have this perfect experience she has visualized for herself?

When she goes into that space of having pictured that perfect experience, can she tune into her body? Where does she feel it the most? Our feelings are felt states inside our body. So when she tunes into her body and says, "Oh I can feel my baby in my arms, " or,  "I feel very light," or "I feel like I can do anything," I want her to tune into that feeling on a physical level.

Then I invite her to recognize that it's not A, B, C, and D that they are after. It is actually that feeling right there. In the end, we think that we want A, B, C, and D, but what we really want is the feeling that we believe A, B, C, and D will produce. When we can tune into that feeling, and really know it well, then we can start becoming more flexible. We don't know how life is going to progress at any time, whether it's during childbirth or any other time, so we can't even know that A, B, C, and D are even going to be options for us, but what we do know is the felt state we are hoping to create. And if we can tune into that felt state, we can make decisions according to that feeling.

During birth, we are in our animal brain. Our logical brain is largely checked out, and we are relying mostly on those feelings and instincts. By tuning into how we want to feel at the end, a variety of options opens up, and it is not so rigid anymore. This creates a more fluid dynamic within the individual, and a greater possibility that she will be able to find multiple choices to get her to that end feeling.

The other thing I would suggest is to really practice the skills of staying calm relaxed as possible and also to stay present to the moment, including breathing techniques.

What are some of the signs that there might be a problem, and someone might consider coming to see you for help either prenatally or postpartum?

One of the signs would be any sort of extreme anxiety. Sometimes that anxiety is very obvious, and sometimes it manifests itself as checking out and not even acknowledging that there is a birth coming at the end of this pregnancy. 

Postpartum some of the things to look for would be inability to connect with the child, postpartum depression, anxiety, difficulty concentrating, nightmares or recurring memories, especially when it was a challenging birth.

In the early weeks after a trauma, just telling the story can be very helpful, and that is something that a mom can be doing on her own. Writing the story, telling the story, getting that communication center in the brain kicked back in around the trauma. In later months, things like mind-body explorations might be helpful. Because our bodies are a part of the trauma, our bodies are also a part of the healing process. The same sensations that have created the trauma are also the sensations that we have to calm our emotions around by exploring them in a safe place so that they do not become triggered in the future.

Sometimes when we have a very big emotional response to something that seems out of proportion, it is because some trauma from our past is actually being triggered and we are reacting to that trauma, not the present experience. We have good instincts, and if our emotions are seeming very out of proportion, we need to investigate it. We don't do this trashcan diagnoses of "Oh it's just your hormones." We look at the full emotional context of what happened, and sometimes our gut tells us, "Hey, this is bigger than hormones. I had this really bad experience and I am having a hard time moving past it." I don't want to see women minimizing their experience because we know something about hormones and because society says you are just emotional because you just had a baby. It really minimizes the woman's experience. If we are trying to shove it aside and say, "It's just hormones," and our minds keep going back to it over and over, it's probably more than just hormones.

If it's gone into full fledged PTSD or other acute anxiety, things people might notice include bad dreams, a sense of hyper vigilance, avoiding or having a strong emotional response to something that reminds us of the trauma. Panic attacks or extreme anxiety symptoms that may seem either random, or occur after being around a trigger. Sleep issues including a very shallow sleep pattern, which can be very hard to discern with new moms.

It can be difficult to discern which of these are just normal life with a newborn, and what is truly an issue, so if you are wondering about it, go ahead and get it checked out! I give a free half hour consultation to all new clients, so you can tell me about what's going on, and I can tell you whether I think it is something to visit together or if it might be in the range of normal. It gives women an opportunity to just check in and see what about this is just an experience of being a new mom and I've just never been a new mom before, and what of this is potentially trauma related.

Do you have any recommended resources to share with pregnant or postpartum women?

The book Birthing from Within can help women explore some of the emotions around birth. There are also some great classes being led by local doulas and midwives to help you prepare for birth as well, including one targeted specifically toward families who have experienced traumatic childbirth. Some doulas and midwives have trained with me around talking about what you want your birth to look like as well, and implementing some of the strategies we talked about earlier.

If people want to learn more or connect with you, where can they find you?

The best place is my website: www.SpiritedGrowth.com

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