The purpose of Unfold Your Wings is to raise awareness of birth trauma and perinatal PTSD, to work to improve the care given to women and their families during birth and after, to campaign for perinatal mental health services, to help train health professionals about the impact of birth trauma and to support families who have been affected.

Every woman has the right during pregnancy, birth and postnatally to be treated with dignity and respect. Also to be shown kindness and compassion, to have their choices supported and be provided with evidence-based information to make informed choices.

The care given should have women and babies at its centre and families should be involved in all decision-making. How a woman gives birth can impact her long-term, everyone who is involved in her care should be aware of her prior history, and personal circumstances and support her in her choice of birth and care.

How can this be achieved?

  • Research to increase understanding of how a birth experience can impact a woman and her partner’s emotional well-being.
  • The acknowledgement that it is not enough to keep a woman physically safe during birth, but that she must be kept emotionally safe too.
  • That women may be more likely to experience trauma, poor outcomes or care due to their race, culture, gender or social and health inequalities. As such we must all work to improve the birth experience for all.
  • That the feelings expressed by women who feel traumatised by their birth experiences should not be dismissed but given validation, regardless of what that experience may look like to others.
  • Antenatal classes should provide evidence-based information to enable families to make informed choices that are right for them and their circumstances. They should help families manage expectations around birth and should help them prepare for when their birth plan may change. Classes should cater for all birth options and should not give the impression that one way of birth is superior to another.
  • Information about emergency procedures, pain relief options and medical interventions should be given to women and their partners, so they can adapt and feel better prepared during birth which may help lessen trauma.
  • Women should be at the centre and be co-designers of antenatal, maternity and postnatal services. with the recognition that the individuality and emotional well-being of women are important.
  • Information about the possibility of feeling traumatised after a birth experience or struggling with feelings after birth should be available antenatal in a factual, non-frightening way.
  • All information should be given in a non-biased way, that is easy to understand, that is evidence-based and clearly states the risks and the benefits. Good quality leaflets, apps and websites can help support this.
  • Women and their partners should be given as much time as needed to talk through any anxieties, decisions and concerns with appropriately qualified staff. Their decisions should be supported and care plans should be individualised, taking into account a woman’s history and circumstances.
  • All healthcare professionals who may be in a position to care for a woman during pregnancy, birth or postnatally should be trained in birth trauma, its impact and the practices that can contribute to or cause traumatic experiences. Including language, communication, poor care and how to respect, choice and dignity.
  • Poor care experiences postnatally can cause or compound birth trauma, it is important that maternity services realise the impact this has and seek ways to improve services that mean all women and their families have access to kind and compassionate care. Also, all staff work together, are fully trained and have in place good governance and structures to support women-centred care that seeks ways to reduce birth trauma. This would include the provision of a specialist perinatal mental health midwife in each unit.
  • All women should have the opportunity to attend and know how to access a ‘debrief’, for them to talk about, and understand their birth experience. This should be done with trained staff, in a safe environment that is compassionate and has a women-centred approach that prevents the re-traumatising of those affected.
  • Postnatally midwives and/or health visitors should screen women for PTSD symptoms and identify those who might need help. This should then be done again at regular intervals.
  • All healthcare professionals especially Health Visitors and GPs should be trained to recognise the difference between PTSD and other perinatal mental health, the consequences of misdiagnosis and what treatments can help those affected. Also what services are available to support families locally?
  • Access to specialist perinatal mental health services should be available to all women and their families affected by birth trauma and perinatal mental health. There should be services that are local enough for a woman to get help and support with minimal disruption to family life. These services should provide treatments such as psychotherapy, counselling, EDMR and peer support. This helps reduce the isolation, guilt and fear associated with birth trauma and perinatal mental health, it validates a woman’s experience and reduces the risk of long-term trauma.
  • Support must be available for women affected by birth trauma for subsequent pregnancies, including secondary ‘tokophobia’ (fear of childbirth). Women also need to be provided with sensitive support and advice about all of their options with regard to another pregnancy and birth.