While pregnancy and childbirth are a beautiful time for many women, it can turn into a nightmare for others when they experience maternal trauma. When the pregnancy, labor, or delivery does not go as expected, the new mother can experience long-lasting physical and psychological symptoms. This can affect your ability to bond with your baby, work, and other parts of your life. If the trauma resulted from a healthcare provider’s negligence, you may be entitled to compensation under the law. An experienced New Mexico maternal injury attorney at Erin Marshall Law may be able to review your case and offer guidance for your next steps. Call (505) 218-9949 to book an appointment and discuss your legal rights and options.
What Is Maternal Trauma?
Maternal trauma is any physical or psychological injury sustained by a woman during pregnancy, childbirth, or the postpartum period. Mothers can experience a psychological injury without sustaining a physical one, and vice versa. They can also experience a physical injury that contributes to a psychological one. Both types of trauma can have a long-term impact on the mother and the entire family.
Physical Trauma
Physical trauma results in physical injury. This kind of trauma can result from motor vehicle accidents, falls, or being assaulted. Legally, maternal trauma results from obstetric complications, such as a placental abruption or uterine rupture, when caused by medical negligence. Even what seems like a “minor” complication can result in trauma for the mother, depending on how it is addressed and handled.
Psychological Trauma
Psychological trauma can be the result of physical trauma, such as when someone has post-traumatic stress disorder (PTSD) after experiencing domestic violence. However, psychological trauma can also be the result of simply witnessing a traumatic event, such as witnessing someone else being assaulted. Natural disasters, war, accidents, or assaults can also cause psychological trauma. When it is maternal trauma, it may also be referred to as birth trauma, and can be caused by experiencing childbirth as a frightening or overwhelming event. A woman might experience childbirth as frightening or overwhelming if her providers do not keep her informed of what is happening. For example, if they suddenly insist on giving her a C-section without any explanation and rush her into the operating room, or start screaming at her to push harder while she vaginally delivers.
Risk Factors for Experiencing Trauma
Many risk factors can increase the odds of someone experiencing maternal trauma, including a history of other trauma, domestic violence, motor vehicle accidents, falls, pre-existing mental health conditions, and obstetric complications that are beyond anyone’s control.
However, the Maternal Mental Health Leadership Alliance (MMHLA) has also found specific things during the childbirth process that led to new mothers experiencing trauma. While these particular quotes and statistics in their fact sheet are directly related to childbirth, they can also occur during pregnancy or postpartum with the same or similar effects.
Personal Experiences of Birth Trauma
The MMHLA spoke with many women, receiving quotes from them about how they felt about their birth trauma. Many women described feeling like they were treated like nothing, coerced or mocked into quick decisions, being belittled or treated like they were incompetent, feeling powerless and having no control over what others did to their bodies, and feeling as if they had been the victim of a violent crime or rape. These feelings may have resulted from physical experiences such as emergency C-sections, experiencing overwhelming pain (possibly with the denial of pain relief), unwanted or unannounced episiotomies, hemorrhaging, preeclampsia (extremely high blood pressure), fetal distress or harm to the baby, or premature birth. In these situations, healthcare providers must act quickly to protect both the mother’s and the baby’s lives and health; unfortunately, many times, they fail to communicate effectively, and this results in trauma to the mother.
Psychological trauma may also occur for other reasons. For example, a woman who experienced sexual trauma earlier in life may relive that experience during childbirth. An incarcerated Black woman who is shackled during childbirth may feel reminded of the violence associated with slavery.
Other Statistics Related to Birth Trauma
When the MMHLA spoke to United States mothers, they found that 20% had experienced some form of mistreatment during pregnancy or delivery care. Additionally, this mistreatment was higher for Black (30%), Hispanic (29%), and multiracial (27%) women. They also found that women of color were three to four times more likely to experience pregnancy and childbirth complications than white women. Specifically, Black women often suffer intergenerational trauma during pregnancy and childbirth, as Black women were frequently used without consent or pain management to experiment and improve obstetric and gynecologic procedures historically. Approximately 4-6% of new mothers will experience PTSD as a result of birth trauma, and an estimated 17% will experience symptoms of post-traumatic stress.
Symptoms and Effects of Maternal Trauma
The symptoms and effects of birth trauma can vary widely among mothers. While there are several common symptoms that individuals, their families, and healthcare providers can look for, it is also essential to recognize that some symptoms or effects may be unique to the individual. If the mother believes she has suffered a birth trauma and that something she is experiencing is directly related to it, she may want to consult with an experienced maternal injury attorney at Erin Marshall Law to learn more about holding a healthcare provider liable.
Physical Symptoms and Effects
Physical symptoms are often the result of physical injuries, though some symptoms (such as chest pain or difficulty breathing) may be physical symptoms of psychological trauma. However, because these symptoms are frequently the result of physical injuries, they may be easier to prove.
Physical symptoms and injuries include:
- Chronic pain related to childbirth
- Pelvic floor tears
- Perineal tears
- Nerve damage
- Fractures
- Episiotomies
- Difficulty controlling the bladder or bowels
- Difficulty engaging in or pain during sex
- Headaches
- Dizziness
- Fatigue
- Hot flashes
- Nausea
- Severe belly pain
- Trouble breathing
- Chest pain
An experienced medical malpractice attorney from Erin Marshall Law may be able to help connect these symptoms to evidence and build a case.
Psychological Symptoms and Effects
Psychological symptoms and effects can result from physical injuries as well as from the mother perceiving the birth as traumatic due to emotional trauma during the birth or trauma that she experienced at some point in the past. When there is no physical injury associated with the psychological symptoms, it can be more challenging to prove that the healthcare provider or institution is liable. However, it is not impossible.
Psychological symptoms and effects include:
- Relationship difficulties
- Trouble bonding with the baby
- Increased risk of preterm birth, low birth weight, and infant mortality (when trauma is experienced during the pregnancy)
- Premature membrane rupture or placental abruption, as indicated by the National Library of Medicine
- Anxiety
- Depression
- PTSD
- Intrusive thoughts and flashbacks
- Hyper-arousal (feeling “on edge” or “jumpy”)
- Negative self-perception
Psychological symptoms can often be just as prevalent and debilitating as physical symptoms, and are worth reporting.
Preventing Maternal Trauma
While some trauma, such as a motor vehicle accident caused by another driver, may be unavoidable, birth trauma is often completely avoidable. There are several things expectant mothers can do to try to minimize the possibility of experiencing birth trauma during pregnancy or childbirth.
Prioritize Clear Communication and Informed Consent
Pregnant patients should prioritize clear communication, particularly if they have past trauma. They should be honest with their healthcare providers about any past trauma that may affect the pregnancy or delivery, and any fears or concerns they have. They may also want to meet with a midwife or therapist to prepare for the birth.
Informed consent requires that healthcare professionals inform the patient of their healthcare options, the advantages and disadvantages of each option, which option the provider recommends, and allow the patient to decide based on that information. While this may not be possible in emergencies, pregnant patients should not simply agree to everything their provider suggests. They should ask questions and ask for more information if they feel the provider has not given them all the information they need. Those who have past trauma should remind providers to ask for informed consent before any procedures, including vaginal exams and episiotomies, and ask them to explain what is happening, even in emergencies.
Develop a Birth Plan
Birth plans, like other plans, may not always be strictly followed depending on what happens. However, having one can give the mother a sense of security, comfort, and control in circumstances that may otherwise feel chaotic and scary. This plan can include details such as pain management, interventions that the mother is comfortable with and ones she would prefer to avoid, and labor positions she would like to use. Not only does this plan inform her healthcare providers about what she would like, but it also helps her to remember what she wants when she is feeling intense pain or other feelings that may cause her to forget. This also allows her to be confident in her decisions if she deviates from her birth plan.
Build a Strong Support System
Whether the expectant mother is single or married, a strong support system can be very valuable in minimizing trauma. Spouses, parents, siblings, friends, or others that the mother feels close to and comfortable with can provide emotional support and speak up on her behalf if the providers are not listening to her.
This support system may also include an individual to whom she has given power of attorney (POA) if she cannot make her own decisions. She may discuss various scenarios that could arise (such as the provider insisting she needs a C-section) and what options she would choose so that the person she appoints as POA is more familiar with what she would want.
Seek Healthcare Providers Who Practice Trauma-Informed Care
Healthcare providers who practice trauma-informed care understand more deeply the need for treating patients with dignity, listening to concerns when they are expressed, and obtaining consent before even the most seemingly minor procedures. This can help patients with past trauma feel more comfortable and reduce the risk of experiencing further trauma during the birth.
Seek Pain Management
While there has been a trend of women wanting to be pain medication-free during their labor and delivery, this may not be the best option for those who have experienced trauma in the past or who have significant fear or worry about pain. Expectant mothers should discuss pain management options with their provider early. They should also be open to how their pain and their plan to manage that pain may evolve during labor so that they can adapt based on their pain level rather than trying to force themselves to deal with unmanaged pain.
Move Around Freely As Long As Possible
For many women, laboring on their backs can cause extreme discomfort, severe pain, and lead to birth trauma. Therefore, to reduce the risk of maternal trauma, it is recommended that women move around as long as possible during their labor. This includes getting up and walking, changing positions (including kneeling and squatting, if comfortable), or even standing up now and then. This can reduce pain, help labor progress, and allow the pregnant patient to feel more in control of the situation.
Push Mindfully During Delivery
Many laboring mothers mistakenly believe that forceful pushing will result in a quicker, possibly less painful birth. However, this forceful pushing can actually result in birth trauma, such as perineal tears. Instead, work with the body’s urges to push and to relax, take short breaths, and use slow vocalizations (such as moaning or growling). These can all allow the body to do what it does naturally during childbirth, potentially making it a less painful and easier process.
Be Your Own Honest Advocate
Perhaps one of the most important things an expectant or new mother can do is be her own, most honest advocate with her healthcare providers. This means being honest about her pain levels, her fears and concerns, her mental health, and anything else regarding her or her baby’s mental or physical health. However, it also means she must firmly and consistently advocate for herself. This means telling her providers if she feels like she has a physical or psychological injury, is dealing with postpartum depression, or other concerns, and continuing to speak up if her providers do not listen or do not take her as seriously as she would like. This may also mean getting a second or third opinion if she is told nothing is wrong, but still feels something is.
Elements of Medical Malpractice That Must Be Proven
To take legal action for maternal trauma, there are specific elements of medical malpractice that must be proven. These include:
- Duty of Care: This means proving there was a doctor-patient relationship during the pregnancy or birth. If the other party is a nurse, pharmacist, hospital, or other provider, the patient must be able to establish their relationship to the pregnancy or birth as well.
- Breach of Duty: This means showing that the provider did not meet the accepted standard of care. This is often a judgment call requiring medical experts to testify that a mistake was made, such as failing to diagnose or misdiagnosing a maternal condition, making surgical errors, failing to properly monitor the mother, or failing to prevent or treat maternal hemorrhaging.
- Causation: This is where the connection between the provider’s breach of the standard of care and the mother’s and/or baby’s injuries is made.
- Damages: This is where quantifiable harm is shown, such as medical expenses, lost wages, or pain and suffering that resulted from the injuries.
An experienced New Mexico maternal injury attorney may be able to assist parents with collecting the evidence or finding the medical experts necessary to prove these elements.
Taking Legal Action
While there is no legal requirement to hire an attorney in New Mexico, one may be able to assist in gathering evidence and handling settlement negotiations. Additionally, if settlement negotiations are unsuccessful and the case proceeds to a lawsuit, it must first be presented to the New Mexico Medical Review Commission, which screens cases to determine whether there is a reasonable basis for the case. Even if they determine there is not, the case can still proceed.
Additionally, it is important to move quickly. NMSA 1976 § 41-5-13 provides medical malpractice victims with three years from the date the malpractice occurred. If the statute of limitations expires, the individual will not be able to bring their case to court or recover compensation. For a parent dealing with trauma, caring for their new baby and any other children they have, and who may not be familiar with all that is required to build a strong lawsuit, it may be easier to allow an attorney to handle matters to ensure that the statute of limitations does not expire before the case is ready to go to court. This also allows the parent to focus on their mental and physical health, which should be a priority whether they decide to proceed with legal action or not.
How a New Mexico Maternal Injury Attorney May Benefit You
The body and mind undergo tremendous stress and monumental changes during pregnancy and childbirth. Sometimes, women experience birth trauma and are not sure if what they experienced is normal or medical malpractice. Whether you know for sure that you experienced maternal trauma or you think you might have and would like to discuss what happened with someone who can help you determine what happened, an experienced New Mexico maternal injury attorney may be able to review your records, and if you have a case, gather additional evidence and engage in negotiations or file a lawsuit on your behalf. Call Erin Marshall Law at (505) 218-9949 to book an appointment.
