Anyone who is a part of a birth oriented support group is likely familiar with the heading: TRIGGER WARNING. But what is a trigger warning? What is a trigger? And why is it important to know these things?
What is a trigger?
Iím talking about triggers in the context of PTSD, specifically, birth related PTSD. A trigger is a sensory experience that brings on PTSD symptoms. A common trigger for women who have suffered birth trauma is watching birth scenes on television. Another might be a smell from the birthing room, for example I used a particular massage oil during my first labour and when I recently smelled it in the shop again I felt physically ill. Triggers can be really obvious or quite subtle.
Not the kind of trigger we are discussing. Image courtesy of Wikimedia Commons.
Why itís important to know about triggers:
Itís important that everyone knows about triggers. Both their own and things which could trigger others. The birth groups that I run have a hugely diverse membership. Women who have had just about every possible type of birth experience and life experience are members of these groups. This means that there will be a massive range of topics that are potential triggers. However, some things are quite common as triggers. And when you consider that 1 in 3 women will experience birth trauma, birth trauma related PTSD is on the rise, 1 in 3 women are victims of sexual assault and stillbirth and miscarriage are very common what these potential triggers are becomes rather obvious.
Common trigger topics include discussion of: Birth trauma, obstetric violence, caesarean surgery, induction, sexual violence and stillbirth or loss. These are some topics which very commonly trigger a physical response in others. Especially pregnant women!
Triggers can leave the woman with a full on physical response. Image courtesy of Wikimedia Commons.
Trigger vs Offensive:
Is it okay to still discuss trigger topics? Of course! Itís really important to note that just because a topic is a potential trigger does not mean it is offensive. If you are asked to put a trigger warning at the beginning of a question or comment it is not because the topic is offensive - if a group moderator finds a post or comment to contain offensive material you wonít be asked to put a trigger warning, you will be asked to delete the post and apologise or will be removed from the group. A trigger warning is a common courtesy to others who may wish to avoid a particular topic. Women in late pregnancy may not wish to read a story of stillbirth, women planning a vbac may find discussion of uterine rupture very distressing, women who are recovering from a traumatic caesarean may find photos of a caesarean prompts flashbacks of their experience. Depending on the specific type of group you are in the common trigger topics will vary. It pays to use common sense and be aware of whoís in the group and what things are likely to be common triggers.
Looking after yourself:
Some women are completely knocked for six when they discover they are triggered by a topic. It can come as a complete surprise. They donít realise they are triggered by a topic until they find that they have posted a very rambling, disjointed, panicked or snarky response to a question - sincere apologies to everyone who has been and will be on the receiving end of these from me. Or they donít know that a topic or situation is a trigger for them until they are having a panic attack in a hospital car park. Or they burst into tears and start to shake while watching a birth scene on a TV show. Or a woman might feel that she has moved on and healed from her trauma only to find herself triggered by something when she least expects it.
Some women find themselves suddenly triggered by the sight of a doctor in scrubs. Image courtesy of Wikimedia Commons.
Once you discover a topic that triggers you itís important to develop strategies for self-care. You may wish to avoid the topic completely. Donít read about it, donít comment on it and donít enter into discussions about it. But that can be very hard to do and still go about normal life. Some women are able to seek help for the underlying trauma that is reignited by the triggers. Finding a therapy and therapist that specialises in birth trauma related PTSD can be very useful and help women to move through the healing journey. Although many women find that seeking institutionalised medical help is very difficult and potentially triggering in itself if they have suffered from trauma caused by institutionalised medical care. The midwife who saw me for my booking in appointment during my second pregnancy offered me a referral to a hospital psychologist, but given that my previous trauma was caused by hospital staff and situations I felt that this would cause more anxiety than it would help. Some women find a meditation or self-hypnosis style strategy that works for them. I found that some of the breathing and visualisation techniques that I learned through the Hypnobirthing Australia course I did during my second pregnancy have been really useful in assisting me when triggered. Distraction can also be a useful technique Ė if you find yourself triggered go and make a coffee, read a book, do some housework or head into the garden.
Itís okay to say ďIím triggered by thatĒ. Being triggered by something doesnít make you a bad person. If you feel that a comment or question is a trigger for you but you still want to respond just post a little comment at the start acknowledging that you are triggered. Just because you are triggered doesnít mean that you have nothing to add to the conversation. Your experience could provide inspiration or learning to another. Acknowledging that you are triggered simply allows others to read your information with that in mind. Context can be the difference between someone understanding your opinion and experience or not.
Even a simple blood pressure test can trigger PTSD symptoms. Image courtesy of Wikimedia Commons.
So when you are posting or commenting in groups just take a second to think: What is the purpose of the group Iím in? Who is in this group? What are some likely common triggers? And how will I feel if someone is triggered by my post? And if you notice a topic that triggers you, feel free to acknowledge your feelings. If you have concerns that the topic may be triggering for other women (some triggers are VERY individual) a polite comment saying so may alert the poster and the admin team. Itís important to acknowledge triggers and thereby bring birth related PTSD and the women who suffer from it out of the shadows. Letís break the silence.
If you or someone you know suffers from birth related PTSD please contact:
Thank you for this post it is so difficult sometimes. Like you, I apologise for the rambling, disjointed and apparently snarky comments I have made and am likely to make in the future. You are so right too that sometimes it just comes out of left field and its out before you can shove it back in its box and slam the lid down. I have many triggers and some just depend on the day and how much sleep I have had and how many triggers I have encountered in the one day. It can be the simplest and silliest of phrases. So on any one day it can just be a straw.