Postpartum University® Podcast

EP 139 The Impact of Birth Trauma on Postpartum Recovery with Carla Sargent

November 21, 2023 Maranda Bower, Postpartum Nutrition Specialist
EP 139 The Impact of Birth Trauma on Postpartum Recovery with Carla Sargent
Postpartum University® Podcast
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Postpartum University® Podcast
EP 139 The Impact of Birth Trauma on Postpartum Recovery with Carla Sargent
Nov 21, 2023
Maranda Bower, Postpartum Nutrition Specialist

When 1 in 3 women in the U.S. are experiencing birth trauma, I knew we had to have this important conversation with Carla Sargent.

 Carla Sargent is a home-birthing mother of three, an ex-midwife, an educator, an author, a podcast host, and the founder of her birth trauma support and education business, Healing Birth.

Through her holistic and unique Healing Birth work, Carla has helped hundreds of families find healing after a traumatic birth and prepare for a positive and empowering next birth.

She has also worked with a vast array of birth keepers, helping them to understand the causes and impacts of birth trauma, including its prevention and how to support the healing process.

In this episode, we are sharing:

  • Why we're else seeing a significant rise in birth trauma and what Carla believes to be the root cause.
  • How birth trauma differs from a challenging experience and how hormones play a role.
  • Why birth trauma matters and is relevant to postpartum healing.
  • The processing steps Carla walks her clients through and how moms can get started healing.

This is an episode you'll want to hear, especially as a new mom or someone who supports them! 

Feeling inspired and ready to learn more about how you can actively revolutionize postpartum care?

Show Notes Transcript Chapter Markers

When 1 in 3 women in the U.S. are experiencing birth trauma, I knew we had to have this important conversation with Carla Sargent.

 Carla Sargent is a home-birthing mother of three, an ex-midwife, an educator, an author, a podcast host, and the founder of her birth trauma support and education business, Healing Birth.

Through her holistic and unique Healing Birth work, Carla has helped hundreds of families find healing after a traumatic birth and prepare for a positive and empowering next birth.

She has also worked with a vast array of birth keepers, helping them to understand the causes and impacts of birth trauma, including its prevention and how to support the healing process.

In this episode, we are sharing:

  • Why we're else seeing a significant rise in birth trauma and what Carla believes to be the root cause.
  • How birth trauma differs from a challenging experience and how hormones play a role.
  • Why birth trauma matters and is relevant to postpartum healing.
  • The processing steps Carla walks her clients through and how moms can get started healing.

This is an episode you'll want to hear, especially as a new mom or someone who supports them! 

Feeling inspired and ready to learn more about how you can actively revolutionize postpartum care?

Read the transcript of this episode:

Depression, anxiety, and autoimmune symptoms after birth is not how it's supposed to be. There is a much better way, and I'm here to show you how to do just that. Hey, my friend, I'm Maranda Bower, a mother to four kids and a biology student turned scientist obsessed with changing the world through postpartum care. Join us as we talk to mothers and the providers who serve them and getting evidence-based information that actually supports the mind, body, and soul in the years after birth.

Hey, everyone, welcome to the Postpartum University podcast Maranda Bower here and I have an incredibly special guest here. Her name is Carla Sargent. She is a home-birthing mama of three, an ex-midwife, an educator, an author, a podcast host, and the founder of her birth trauma support and education business, which is Healing Birth.

Through her holistic and her unique healing birth work, Carla has really helped hundreds of families to find their healing after having a traumatic birth and really prepare for a positive and empowering next birth. She's worked with a really vast array of birthkeepers and providers and moms and helping them to really understand the causes and impacts of birth trauma, including prevention, how to support the healing process and so much more. That is really why she is here today with us on this podcast so that we can have this incredibly important conversation. Karla welcome.

Carla: 1:40

Thanks for having me here, Miranda. I'm really looking forward to this conversation.

Maranda: 1:44

Tell us how you got started in this work. You've got a lot going on. Home-birthing mama. You're an ex-midwife, an educator. There sounds like there's so much to be said here.

Carla: 1:58

Yeah, and I am in a bit of a unique role, I guess, doing birth trauma support work. I don't have a counseling background or a psych background. I've come to this place very organically really.

Yes, I do have a background in midwifery. That sort of fell to the wayside when I was a solo mum with my little girl, who's now 23. So it's been a long time since I've practiced midwifery. But about 10 years ago my sister was working with new mums with these support groups, weekly meetings for the first year of the baby's life, and she was relaying countless stories of traumatic birth to me that she was hearing in these meetings and she was like Carla, I don't know what to say to these mums. I don't know where to send them for further support, like help.

And you know what, even with my background in midwifery, I knew so little about birth trauma and about the support services that were available. I mean, it's not something we learn about in midwife school. And so, yeah, I was like, look, if any of your mums want to come and share their birth story with me, I'm happy to listen. I don't know if I'll have much to offer in terms of advice, but, yeah, happy to listen and actually, if you're them to come and share their stories with me, and that was really, you know, a really powerful starting point for them to begin to feel seen and heard around their traumatic births.

Most of the time when people who have experienced a traumatic birth try to share their story with somebody, they are met with messaging like you know, at least you've got a healthy baby. Just focus on the positives. It could have been so much worse.

This messaging sort of sends the idea that we ought to be grateful and suppress our own, you know, experiences of like fear and grief and anger and disappointment. You know, and I tell people all the time, we can experience those things simultaneously.

Yes, of course, we're grateful for our beautiful, healthy baby, but we also can simultaneously feel, you know, disempowered, fearful, upset, angry, etc about the way our babies were brought into the world.

They are not mutually exclusive things.

So, anyway, yeah, I was able to hold this space for people to share their story with me and I was like, wow, this is making a really big impact and you know like this is simple stuff.

Maranda: 4:55

Why isn't there more of this available?

Carla: 4:56

And I really wanted to understand more about, yeah, the support services around, and there was so little information available, and so I was like, well, I'm just going to conduct my own survey, I'm going to do my own research, and so I created an online anonymous survey that delved into questions.

Questions for Processing Your Traumatic Birth Experience

What was the cause of your traumatic birth? What were the consequences? What sort of support services did you access? What was helpful? What wasn't? What would you have liked available?

It was asking a lot of respondents in terms of the emotional investment, I guess to relay their stories to me, and so I didn't expect to get many responses.

I got 319 impassioned replies to that survey, and that just spoke volumes in and of itself. You know, women want to be heard, they want their story to be heard, and they were dissatisfied with the support services and what I was hearing that they needed. I felt I was equipped with what was needed to be able to offer that service.

So, back in 2015, I started up my birth trauma support business at Healing Birth it was actually called Voice of Appearance back then, but rebranded a few years ago and have offered one to one healing services to hundreds of families and have worked with perinatal care providers to help them to better understand birth trauma and, more recently, have started working in training others for the last two and a half or three years, training others in the art of holistic birth trauma support work. So there are more people out there who have the same understandings as I do around how we can provide healing for people out there who have experienced traumatic birth.

Maranda: 7:15

This is incredible and you know, birth trauma is such a common thing and it's frightening really. I know that in the US alone and I don't know where it is where you are currently but one in three people describe their birth as a traumatic experience. I really want to maybe know a little bit more, especially because you have this background and you've done all of this research.

What have you come to understand as being the root cause of so much of this birth trauma that so many women are experiencing?

Carla: 7:58

I'm here in New Zealand, Maranda, and we do have a maternity system that has such amazing potential. Women are able to choose who their care provider is, and around 90% choose a midwife as their we call them lead maternity care are here, they had that same midwife or group of midwives follow them through all of their pregnancy care, their birth care, their postnatal care.

So we do have a continuity of care model and people can choose where they give birth so home birth, birth centre birth, hospital birth, and so we do really have a lot of choices here that are unavailable in other parts of the world, and yet we, too, have a really high rate of birth trauma.

So there's something else at play apart from, you know, lack of choice around who you have providing your care and where you choose to give birth, and it's really a multifaceted thing, right?

It's pretty hard to nail down in one word or whatever what the root cause of traumatic birth is, but what I've come to understand over the years of doing this work is that we could probably summarise the root cause using the word disempowerment.

Contributing Factors for a Disempowering or Traumatic Birth Experience

So, yeah, what causes that disempowerment? There are multiple things. One of them is the conditioning we grow up with.

You know what we come to believe about birth and about our capacity to give birth as we grow up. In our current culture, which you know like, birth is really sold to us as a medical event, as being dangerous, as being something that, in order to have a safe outcome, requires to be taken place in the hospital and to have, you know, medical experts kind of overseeing that.

So this conditioning doesn't set us up too well to have a lot of faith in our ability to birth our babies, when you know, actually we're mammals.

We are women, we are beautifully designed to give birth and it's the fear that we bring into the birth space that comes from multiple angles that often gets in the way of physiology being able to do its thing, get those good hormones flowing, and get our babies born.

What other conditioning contributes to that sort of feeling of disempowerment? We are taught to tune out to our body wisdom from a young age.

So, you know, we get a headache and we're told to take a painkiller rather than then explore what's the messaging, our body is trying to give us here.


Why have we got a headache, is it that we need to rest? Is it that we need more water?

That's just one example of countless examples of ways that we are taught to ignore or tune out to our body's wisdom.

Our bodies are clever, they are wise and they know we know how to heal ourselves so much of the time.
And the same is true for birth.

So that messaging doesn't help. The message not to trust our intuition, that that's a bit of woo-woo nonsense. That we really need to put our faith in the authority figures in our lives, that the doctors, the midwives, the priests, the teachers, the parents, they know better than we do what's best for us and our bodies.

We are taught to give our power away from a young age, and this is so evident in the birth space, where we have been taught to be compliant, to not question authority, to not trust ourselves. And, yeah, in birth we really really need that innate trust.

We need to understand our physiology, we need to know how to support our physiology and we need to take responsibility for our birth experiences, but we're taught that if we're a responsible mum, we're going to do what the doctors say. We're going to follow that medical route of birth.

Birth has become incredibly overmedicalised, like in the US and New Zealand, we had rising rates of birth interventions. Things like caesarean or cips and volunteers deliveries, inductions of labour, epidural pain relief these are going up and up and up and they are done in the name of safety, so women are led to believe that these things need to happen in order to keep their births, their babies, safe.

The truth of the matter is and you know, in working with people on a day-to-day basis, hearing their stories of traumatic birth is that the very interventions that are done in the name of safety are so often the thing that is causing the birth to become traumatic.

Maranda: 13:48

Right, so true.

Carla: 13:51

Yeah, so women are led to believe. You know you need your labour induced because you are quote, unquote, overdue right and like your body isn't going to go into labour when it's ready to.

Maranda: 14:04

You know it's kind of crazy.

Carla: 14:06

So yeah, you need to have an induction because you're overdue, or because you are too old, like once with that one, or because your baby's too big or your baby's too small, I don't know. There's countless reasons that women are led to.

Maranda: 14:21

There's always some reason right.

Carla: 14:23

There's always something yeah and I think that's what we've dealt with as women, for our whole lives.

Maranda: 14:29

Our body is not good enough, you're not good enough. Yeah, we have that repeated over and over and over again. And pregnancy and birth and postpartum yeah absolutely Absolutely so.

Carla: 14:43

I don't know what the numbers are in the states, but in New Zealand about a third of women are having their labors started with a medical induction and I hear the stories of you know that cascade of intervention that ensues as a result of that.

So women leave the birth space with this belief that it was just as well, I was in the hospital. It was just as well. Those medical experts were there to save my baby from my faulty body. That's the message people are left with.

They take the baby home.

They think it was their fault.

They think the body let them down.

They think that they weren't enough. They went strong enough, they couldn't cope with the pain, so they needed that epidural.

And that epidural meant that their labors slowed down and then they had to have some pitocin, then the baby got distressed and then they needed a caesarean.

It was my fault because I wasn't strong enough, and needed that epidural if I need.

A medically induced labor is just so different from the experience we have when we have a physiological birth.

When we have an undisturbed birth, we, as we are equipped with all of the things that we need.

When we are supported to trust that physiology, we don't need pain relief because when our oxytocin is flowing in our brains, which is, though it's chemically the same as that Pitocin or New Zealand we call it centosin in, that's given intravenously, although it's chemically the same structure and, yes, it causes the uterus to contract and forces the cervix open, gets the baby born, it can't cross the blood-brain barrier and influence the brain the way that our endogenously produced oxytocin does.

That looks like helping us to fall in love with our babies, to bond with our babies.

That looks like supporting the breastfeeding journey, helping us to produce the hormones that support milk production.

That looks like stimulating the release of endorphins, which are our natural painkillers, naturally produced opiates that help us to transcend the pain of labor.

That looks like helping us to stay calm and in that Parasympathetic nervous system sort of part of our brain, where we kind of go into Labor land, go into the birth zone, and we have this beautiful, potent access to our instinctive behaviors that support us to feel really safe and to help progress our labor.

So somebody who is in the zone is going to be upright and rocking and swaying and seeking out a dark, quiet space, away from prying eyes, you know, away from strangers and scary noises and those sorts of things.

She might be vocalizing and, yeah, all these things help to open her body, they help to get that, you know, the good hormones flowing and they help to get a baby born, and really a really safe and rewarding way, and they help set her up to meet her baby full of belief in her capabilities as a mother, which is so important because, yeah, the real hard bit starts when we try and navigate new parenthood and it's exhausting and it's like, Well, you know, babies don't come with a manual, so these, so much to navigate, and those early days and weeks.

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Okay, I think it's, it's gonna be a little of both a little, a little of me right like I think birth is inherently a challenging experience.

I think it's designed to be that way and I and I'll go into that in a little bit because I think this is an important understanding to have.

There is a lot of suppression of people's experience of birth as being traumatic because they, because of that messaging that says be grateful, it could have been worse and yeah, like it could have been, it could have been worse, you know, and yes, there are always people who had it worse off or better off than you.

But those comparisons are never, ever helpful. If you are left with feelings of unshakable grief or anxiety or depression or hypervigilance, just constantly worrying that the worst-case scenario is gonna happen with your baby, any of these things indicate that you have unresolved, unhealed trauma related to your birth and you deserve that healing.

It doesn't matter if your birth looked like, you know, a really straightforward, one-hour birth that took place at home, because you know well it'll just happen so quickly and easily. Like that could be, and often is, a really traumatic experience for people.

We can't say what a traumatic birth looks like only the birthing person can say, yeah, that felt traumatic or actually there, that was difficult.

But you know I'm not left with any sense of disempowerment, any sense of ongoing grief around my experience. So, coming back to what I said earlier, I have this belief, this kind of theory that birth is inherently a really physically, spiritually, emotionally, psychologically challenging experience for most of us, because that enables us to come out the other side of that massive challenge, using all those internal resources that I was describing earlier.

I'm out the other side of that, going like fuck, yeah, like look at what I just did, look at what I'm capable of when I trust my instincts, when I listen to my intuition, look at what my body does without the need for any outside interference, like I am made for this mothering thing, yeah, and as well as that kind of that sense of like empowerment and belief in ourselves that comes through an undisturbed birth experience like that.

Maranda: 23:13

That's so beautiful and powerful.

Carla: 23:16

Yeah, we are also primed with this incredible flood of oxytocin at the time that our baby is born. That, like I said earlier, helps us to fall very in love with our babies very quickly and that's nature's design to ensure that we will want to protect our newborn from harm.

So that is what we need in order to begin that postpartum, that really difficult postpartum journey.

I mean for most of us, Maranda, you know, in this, in our Western culture, we have such terrible support around that really really difficult journey.

Even when birth has gone really well, it's usually pretty challenging because of that lack of support. We don't have our village around us.

We don't have somebody coming in and cooking us nutritious meals and massaging us and keeping us warm and just helping to keep that oxytocin flowing and allowing our bodies to rest and heal and recover and for us to, you know, establish that breastfeeding relationship with our baby and develop that bond and learn their cues and those sorts of things, even when we have a really positive birth experience.

So imagine how difficult that postpartum journey is for somebody who has the exact kind of opposite experience to what I just described. They come out the other side of birth going I failed, I can't trust my body, I can't trust my instincts, I can't trust my intuition. I need the experts to tell me how to parent my baby. I don't feel a bond with my baby. Like what sort of a mother am I? I failed at birth and now I failed to bond with my baby and, oh lo and behold, breastfeeding doesn't happen because of all the stress and the lack of helpful oxytocin and all those things.

Maranda: 25:24

So, oh gosh, I failed at that as well. At the top of the nervous system, that's changed significantly. Just because you've had a baby and you're here to keep this child alive, Make the biological shifts and changes that are taking place and you are in this completely different place of trauma which sets off your nervous system to operate at a whole different level. It's just a huge cluster that is setting you up for failure.

Carla: 25:53

Absolutely, and you know what most new moms do in the wake of a traumatic birth, and this is a survival technique. This is the nervous system, focusing on what's needed for survival.  They suppress and they encourage to suppress their experience, their need for processing and healing from their trauma, because you know, like, how can you do it all?

That's just you don't have the capacity to be up to a crying baby all night and to, yeah, to heal from that surgical birth or to learn to like navigate motherhood.

Maranda: 26:41

Yeah, how do you heal from a traumatic birth, while you're taking care of a newborn and trying to heal the physical wounds of your body?

Exactly, it feels impossible. So the only logical thing is to suppress that which has such significant consequences for us and our long-term health.

We know that our bodies store trauma within the cellular structures, absolutely, and we know that a female body in particular stores a lot of trauma in our pelvic region. So there's so much that we could even go in in the conversations of that. But I'm curious about your perspective.

You are in this trauma, this birth trauma support role. How do you help people find healing after a traumatic birth?

Carla: 27:32

Yeah, yeah, so like the one-on-one work that I do with people, it's over the years it's kind of developed and shaped itself and sort of shifted as I've learned more about people's needs and what works best and actually it might sound really full-on and intense and indeed it is.

But a session with a client that I call an unraveling your trauma session typically lasts around three hours. So we do this via Zoom or in person if they happen to live nearby. But I work with people all over the world, so Zoom is awesome like that and they share their story and sometimes that takes 20 minutes and sometimes that takes two hours.

And this is a really, really important piece for them to have an opportunity to express their experience, their feelings, where I can hold that space and let them feel validated and whatever their experience was, and let it be a shame-free space to say. And when my baby was first put on my chest, I felt nothing. I felt like it wasn't my baby, I just wanted them to take it away and the grief and guilt and shame that they hold onto around that sort of experience and story that they have like I wasn't enough, I'm a failure.

So sharing their story and having it reflected back from me that you have no wonder you feel like that and this is a really common and normal response to a traumatic abuse like you just described to me, and that in itself is huge. For a lot of people that's a really important first step on their healing journey.

But in the next three hours after they've shared their story, I then use my really in-depth understanding of birthing physiology and understanding of the birthing system and the power dynamics at play within that system. My understanding of the various interventions and how they impact physiology and how they impact, for instance, the ability to bond with our newborns, that sort of thing.

My understanding of the trauma brain and when somebody is saying during their story, I wasn't something enough or I should have stood up for myself more, why should have said no, why should have asked more questions.

And I explained to them how, when we are in a trauma state, the fight or flight has shifted into freeze because we can't fight and we can't flee.

Then the neocortex, the thinking rational part of our brain, that part that's responsible for language, it's shut down. We're in survival mode and so we don't actually have access to the ability to say, to speak, to say, stop to ask more questions, you know like, yeah, so these sorts of I use these understandings to help and, and my understanding of the conditioning that I talked about earlier, to help them understand why their birth went down the path that it did, why they have been left feeling the ways they do, about their capabilities as a person, as a mother, as a human.

Perhaps you know their traumatic birth has impacted their relationship with their partner. That's really common. So helping them to understand that dynamic and their bond with their baby.

And then I offer a bunch of tools, so like tools for kind of ongoing processing and healing after our call ends, and I send them a follow up email that has covers all of the tools that I've suggested, the instructions around those, the any links to articles or podcast episodes or or other professionals who might be helpful for them to further their healing journey.

And so, yeah, that's that's an unraveling your trauma session. And the other thing, the other big aspect of my one to one work is working with people who are pregnant again after a traumatic first birth and we, yeah, after we've done an unraveling your trauma session, we let a book, a planning for a healing birth and positive postpartum sort of session and so so, yeah, like unpacking the trauma, helping them to gain a new perspective on why their birth went blank and having them to understand physiology and that sort of thing, and then looking forward to a next birth. How can they set themselves up for that, for a different experience next time?

Maranda: 32:46

Yeah, that's amazing that you really do all of this and you also teach this to others, and that's actually how I found you is through some students who were in the postpartum at university membership and who've gone through our certification program and who are absolutely in love with the work that you're doing as well.

Where can people find you to connect in to you and all of this incredible work that you're doing?

Carla: 33:16

Likewise, I love the work that you are doing with people, helping them to understand.

You know, people who work with new mothers need to have a really good understanding of what is required to nurture that postpartum experience in a culture that, like we talked about earlier, is severely lacking in a lot of regards around postpartum support.

Yeah, like I love it when anybody who works with new mothers or pregnant women or birthing people you know anybody who works in that sphere I think it's just so important for them to have a real understanding of what is causing birth trauma, what you know, so how we can mitigate it and then how to support somebody in the wake of a traumatic birth.

That's especially true for people who are working with postpartum mamas, right? So I love that people who have trained with you are also coming and training with me as well.

People can find me on Instagram healingbirth, facebook healingbirthwithcarla you can, yeah, my website, and under the training tab, it has all the information.

I do have a free it's called understanding birth trauma basics course that I offer. That's about six hours of recorded content with a beautiful printable workbook and, yeah, and that's a really good starting point for having some base understandings of these things, but also getting a bit of a feel for me and how I work, and whether you might want to go on and become a certified healing based practitioner, which is the training that you're talking about there.

Maranda: 35:06

Yeah, I love it. I love it. I feel like we could have this conversation for so long.

There's so many different avenues that we could go into and I'm just so appreciative of your time and your attention to this. Thank you from the bottom of my heart of all the things that you are doing here and for showing up today to share it with everyone about this incredible conversation. I just truly appreciate you, thank you.

Carla: 35:32

Well, thank you, Maranda, and yeah, likewise for the work that you were doing.

Thank you, I am so grateful you turned into the postpartum university podcast. We've hoped you enjoyed this episode enough to leave us a quick review and, more importantly, I hope more than ever that you take what you've learned here, applied it to your own life and consider joining us in a postpartum university membership. It's a private space where mothers and providers learn the real truth and the real tools needed to heal in the years postpartum. You can learn more at That's the letter We'll see you next week.

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