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I have been offered a birth debrief – what does this mean?

Helen Stanley, midwife, explains the process and how to get the best out of communication after traumatic birth, known as a birth or postnatal debrief, birth reflection or birth afterthoughts.

Posted on 13 June 2024

For parents, events around a baby’s birth may have been confusing, unexpected, or unplanned. It may have been different to the plans made during pregnancy. There may have been a need for a medical intervention or even a sudden medical emergency. Such events are often difficult to understand without information to “fill the gaps”.  

Debriefing provides an opportunity to have questions answered. To understand the medical assessments and decision-making process by the professionals caring for you during your labour and birth. Even though it should have been explained at the time, and consent gained, it is often difficult to take it all in. Even if it is explained again immediately following the birth, this can be too soon for the family to process, so there is no time limit for debriefing and women can contact the hospital when they feel ready. 
Hospital Trusts now provide training to midwives in perinatal mental health and birth debriefing. All women should be given the chance to discuss a difficult birth with a midwife who has been trained in debriefing.  
Some women meet criteria set by the NHS and are automatically offered a debrief. For example if, you have suffered a stillbirth or neonatal death, your baby has suffered a birth injury such as HIE (lack of oxygen that causes damage to cells within the brain), you have had an injury for example a third- or fourth-degree perineal tear, an obstetric emergency happened during delivery for example a shoulder dystocia, or post-partum haemorrhage.   
Anyone can request a meeting to discuss their birth. Midwives are aware that a mother may feel their birth was traumatic without an emergency event and their experiences are just as valid. Sometimes women have questions some years after the birth for various reasons.  A common one is finding out that a perineal tear is causing them long term problems but did not receive a diagnosis for some time. Having the chance to review the birth again with a midwife can help answer questions as to what may have gone wrong.  
How do I prepare? 
Often, the debrief takes place in hospital around eight weeks or more following the birth. For some this can be triggering, and home visits should be offered if this is the case.   
It is normal and understandable for you to feel upset or angry and even cry at the appointment, and you will be supported by the midwife. Try not to attend alone if possible. Write down any questions you may have before you attend and take notes at the meeting.   
Remember a debrief is for you and should be run at your pace. If you need to stop the meeting this is fine and if you need more time, a new appointment can be made.  All debriefing appointments should be followed up with a letter outlining everything that was discussed.  
Why should I go? 
Birth trauma and post-traumatic stress disorder (PTSD) is on the rise. The all-party parliamentary group on birth trauma – listen to mums: ending the postcode lottery on perinatal care (2024), was told that as many as one in three women find some aspects of birth traumatic. Birth trauma affects 30,000 women in the UK every year and 53% of women who recognised a difficult birth, felt less likely to have another child. Perinatal mental health and psychological safety should be a priority in maternity care. Having the opportunity to discuss what happened with a trained person may assist you on your recovery, help you understand what happened and inform you on how this may affect a future pregnancy.   
Helen Stanley has worked as midwife in the NHS for 25 years and leads our medical negligence triage team. She is dedicated to supporting women who have experienced a birth that did not go to plan, empowering birthing people to get the answers they need.  
For more help and support contact: clinnegnce@leighday.co.uk 
Helen Stanley will be giving a post-natal debrief talk at the Everywoman Festival in Cardiff on 15  June. Come and see us! 

Helen Stanley (1)
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Helen Stanley

Qualified midwife Helen leads our new client enquiry team handling calls and enquiries from across the UK

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