Together with Rachael Rose

Post-traumatic growth after birth trauma and the Australian Birth Study

Rachael Rose + Alysha Fameli Season 1 Episode 4

In this conversation with Alysha Fameli we hear how Alysha transformed what was a really difficult initiation into motherhood, into a beacon of light for others. We hear about how Alysha's passion to advocate for other women not experiencing what she did has led her, to dedicate years of her life to studying birth trauma.

You’ll hear us discuss:

  • Alysha's first pregnancy and birth within the hospital system
  • How being told to ignore her body wisdom when in transition impacted Alysha
  • The impact of disrespectful treatment on her birth and mother/baby bonding
  • How birth trauma influenced Alysha's postpartum period
  • Using science and research as a way to plan her second birth
  • The difference in receiving continuity of care in her second pregnancy
  • Getting involved in birth advocacy in her final trimester with her second baby
  • Alysha's second birth being an unplanned homebirth 
  • The Australian Birth Study and why Alysha is dedicated to this research 

MEET ALYSHA FAMELI

Alysha is a mother, psychologist and PhD researcher at the University of Sydney. Alysha’s two very different birth experiences led her into a new passion, academic research, where she hopes to translate science into practice for new mothers.

"“I remember asking a midwife, if it was okay to pick my son up, and she looked at me like I was crazy. Then I remember trying to learn how to breastfeed and it was really painful. We found out later, he had a lip tie and a tongue tie and I was told, no, it's fine. It's supposed to hurt - while they grabbed my breasts. It was a surreal experience, like it wasn't happening."

Connect with Alysha via Instagram @australianbirthstudy
Website: http://australianbirthstudy.com/

Connect with Rachael Rose

Instagram: @the_rachael_rose
Website www.rachaelrose.com.au

"I am deeply moved and touched by every story that I hear. I feel really honoured to hear these harrowing experiences of women's births and I feel an enormous amount of pressure in a research space To carve out reverence for these stories. It's really hard because academia is a patriarchal system, and I'm trying to come at this from a feminist perspective and carve out space  for reverence."

Full Transcript attached
Music by Edwina Masson 'The Feminine Spitfire'

Alysha's experience of Post-Traumatic Growth after Birth Trauma and her research with the Australian Birth Study.

Rachael Rose: Today I speak with Alysha, a mother, psychologist and PhD researcher at the University of Sydney. Alysha's two very different birth experiences led her into a new passion, academic research where she hopes to translate science into practice for new mothers. This was a really powerful conversation and I resonated so much with what Alysha shared around birth trauma and post traumatic growth.

But I will give a word of warning to any pregnant women that this might be something you wanna skip over and come back to at a later date. I'm really aware of the vulnerability and sensitivities of pregnant women and how open you are to other people's stories. And Alysha does detail some of her traumatic experiences within the hospital [00:02:00] system.

She also talks about how this impacted her and her early mothering experience. And I think this conversation will benefit those who have experienced birth trauma because you're going to hear her words and you are not gonna feel alone. And you're also going to hear how Alysha has taken what was. A challenging start to motherhood and is now using that experience to fuel the fire for change.

She is. Leading a project called the Australian Birth Study. , she's recruiting participants who have experienced birth trauma and she's gonna make an impact with this work. And you'll hear her talk about that. Because she is an incredible researcher. I was corrected after we finished this interview that when I said that 10% of women leave childbirth [00:03:00] with P T S D it's actually more.

Around 4% and it's 10% who may display signs of psychological distress, but not necessarily have post-traumatic stress disorder. So I wanted to clarify that mistake. Apart from that, the conversation really will take you on a journey through Alysha's two births. Her second birth. There's a little bit of a surprise there, so I'll let you hear that.

And then what she hopes and dreams to achieve through her research with Australian birth study. I hope you enjoy the episode. Go gently if it brings up any feelings for you. We are strong and I believe that women can handle these stories and that these stories are really important to be shared.

 Welcome, Alicia to The Together podcast. I'm really excited to have you [00:04:00] on today because I want more stories of post-traumatic growth out there. That's something that I've experienced. It's been my personal journey with my first birth experience, and I know how impactful it can be for other women to hear that there is growth on the other side especially if they're deeply in it at the time.

 I think we should begin really with your first pregnancy, with your first son, and I'd love to hear how you went into that pregnancy. I'd also love to know how old you were and just all the thoughts and feelings around becoming pregnant.

Alysha Fameli: Yes. Thank you for having me, Rachael. I feel really honored and delighted to speak to you today. I went into my first pregnancy very much how I think I spent that first part of my life. Got. Into [00:05:00] things. I was really excited. I love to learn. I went in doing lots of reading. I'm not sure I was reading the right stuff, but I was doing lots of reading.

I felt really nervous about my baby. So I did have that kind of worry. Nothing that impacted my capacity to function or cope. But I did find myself thinking about my baby a lot and monitoring movements and being really focused on whether baby was okay. I. Had some friends around me who were having fertility struggles, and I think that maybe contributed to my hyper focus on baby.

And also I'm a hyper focusy person. I find something that kind of interests me or captures me, and I get really tunnel visioned onto it. And I guess I, I'd really hoped to carve out a different narrative of birth [00:06:00] for maybe just the women who come after me because the stories that I'd heard from the women in my family always painted birth as something to be fearful of that you hand over.

You hand yourself over to doctors and that birth is unpleasant, but then you forget it once it's over. That was the narrative that I had been told. I am really lucky to be born in the age of social media. So that was really a blessing, I think, in lots of ways because I was able to expose myself to different kinds of stories and I was 26, so I was pretty bright-eyed and bushy-tailed and ready to go in and sort it out.

I did hate being pregnant, though. I should preface it. I was excited. I also really hated. Pregnancy. I hated feeling less mobile than usual. I had, I'm hyper mobile, so I had like pelvic dysfunction [00:07:00] stuff and I really hated not being able to just go like I normally would, which in hindsight was maybe that was part of my entrance into mattress sense was learning how to slow down.

And that's something I have since learned, but it was a bit tricky at the time.

Rachael Rose: Yeah, you sound type A and that's pretty good. If you want to have a PhD, you need to have that single focus. So towards the end of your pregnancy, had you done any childbirth education? What was your birth prepping and planning like?

Alysha Fameli: Yeah. So I went in really naive. I did trust health. Professionals and doctors. I'm an allied health professional, I'm a psychologist, so I had a sense of, they, they know what they're doing. They've seen lots of births, they know what's best. I went to the hospital, antenatal classes and I hated them.

I found it to be really against just my social values. [00:08:00] I found that it was like fear monger and a bit scary, and I remember them at one point handing around an epidural needle and making everyone hold it and look at it,

Rachael Rose: Wow.

Alysha Fameli: was really, I just found really strange. And they were talking about how important it was to have an active birth, but really giving no skills, not really teaching us anything about active birth and just making.

Things like pain relief, sound really scary. And I had wanted to go in and have a natural physiological birth. I didn't wanna have interventions, I didn't want to have medication. And I also had a kind of thing that I was holding that if something happened and that needed to happen, I was at peace with that.

So I, I wasn't really rigid in either camp. However, I'd, my preference was very natural birth. So I read Juju Sundance's birth skills book. Which I really loved and I practiced the strategies with my part. I think I [00:09:00] only went to two of the hospital classes cuz I hated it so much. Even the sensory aspect of it.

I was sitting in this horrible room, it was 6:00 PM I was still working at the time. I was hungry. The lights were making my eyes go funny. I remember them showing a video of a woman giving birth and it looked so unnatural. There was like lots of people around her and I just remember, this is really strange, but the camera just zooming in on her butt hole and being just feeling really like why is it zooming in on her butts? Let this woman have a bit of dignity. And I just remember yeah. Being like, this is really awful and I hate it. So yeah, I moved into more the kind of the birth skills path and reading. Reading stuff about active birth, but really naively, I just didn't think I needed more than that. I was like, I will figure it out.

Cuz I, I actually am pretty good at figuring things out. It's a thing I'm really proud of myself for.[00:10:00] And I can I go into things with maybe a weird sense of confidence that I'll at least do it good enough. So I went in going yeah, no I'll be fine.

Rachael Rose: Were you in a continuity of care model or were you just seeing a different midwife at every appointment?

Alysha Fameli: Yeah. So I was in a shared care model with my gp, who I didn't have a lot of Connection with at all. I found my GP to be quite dismissive, so I got diagnosed with an autoimmune disease during my first pregnancy, Hashimoto's underactive thyroid disease. And it just, the response was really dismissive this is something I'm now gonna have my whole life.

And I was like, yeah, no, yeah, you've got this thing. And I really, there was no reverence to how I was being treated. It was all very mechanical and I I was just like, okay, I guess this is what it's like. I really didn't know any better. And then towards the end of my pregnancy, I was in the hospital antenatal clinic for those, [00:11:00] routine checkups where they did start talking about induction really early.

Which was unusual because there was no reason to induce me. And I remember walking away feeling like, why are they trying to get me to have an induction? I'm 39 weeks pregnant. I'm not, there's no reason for that.

Rachael Rose: So how many weeks did you go to.

Alysha Fameli: I think I was 40 plus five with my first, so just over 40 weeks. And they were, from the end of 39 weeks talking about inducing. I was saying, I don't want to do that. I'm, I'd read lots of things about the cascade of intervention. So I did know that induction, if not medically indicated, was not in my best interest.

So I was able to say, I don't wanna do that. I felt very uncertain though. I did feel like, oh, maybe I, oh, maybe I'm supposed to. As well as really. I didn't have a village of women around me, so it was, I didn't really have anyone to say this edgy feeling, like [00:12:00] wanting it to be over that is pretty normal.

And you can write it out. You are capable of writing it out. So yeah, I didn't have that.

Rachael Rose: Yeah, it makes a huge difference. And even just. Other stories of women gestating to 41, 42, 43 weeks. It penetrates your brain and it normalises it. And if you don't have that, it can be really challenging.

Alysha Fameli: Yeah. Yeah. And I was one of the first people out of my friends to have a baby, so I think that was part of it as well. I really hadn't heard many birth stories, and I feel like the ones I'd heard had been bad ones. I feel like I really only heard bad ones.

Rachael Rose: Yeah. And that influences us with fear and doubt and all kinds of things. On the birthday itself how did you find labor?

Alysha Fameli: Yeah, so I woke up at two in the morning and went to go to the bathroom and my waters broke and I was [00:13:00] like, oh, have I weed myself? And then I was like, oh no, that's not we. And so I felt really excited and my husband, who is wonderful, he, I woke him up and whenever he gets woken up, he acts like we're under siege.

So he woke up really wild eyed and started looking for his wallet, weirdly. I was like, it's fine. We don't have to pay for the baby. It's, you get to keep it. And then we rang the hospital and they said to come in and just get checked out. So we went down and they just checked that there was no meconium in the waters and then they sent me home.

And so we went home. We had a really chill morning. I watched about five episodes of Dexter. I had a coffee,

Rachael Rose: Dexter.

Alysha Fameli: ah, it's a bit morbid. That's my light entertainment. And so yeah, in hindsight, probs not the best choice of of what to watch on the day. And then I started having [00:14:00] contractions and I was really excited and they, I was at home so I had a chance for them to slowly ramp up, but it didn't feel too intense.

And then, I did start to feel nervous cuz I didn't know what to expect. And like I said, I didn't have, I didn't have wise older women around me telling me that I was okay. I had my husband who was like losing his wallet and stuff, so he was like, yeah, you are in charge. You tell us when to go. And then the water in my shower, the hot water ran out and I was like, oh, I'd really to be in the hot water.

And my contractions started coming faster. They started to get to between three to five minutes apart, so we decided to go to the hospital. At the time, they didn't have a room for me, so I was hopped in. What I would describe as a storeroom Bath in it. So this is in the old unit of the local hospital that [00:15:00] I used to live at.

I had midwives coming in and out getting towels, and I was in the bath and I was still having a bit of a merry old time. I'm a pretty playful person naturally, and the pain wasn't anything I didn't feel like I could handle, so I was just breathing through them and splashing around. And then they gave me the gas for a little while, which really did nothing for pain relief, but was a bit fun.

And what was weird was no one really told me what it was. So I was just really naive. I had not wanted any pain relief for intervention, but then here I was like really inhaling deeply on the gas and I had no idea what it was. And then things ramped up and I still felt really, I felt really lucid and okay.

I ended up getting moved to a birth suite. I was in the shower, I was on all fours. It was all great. I do remember the point where I was, I now know I was in transition and I said through gritted teeth, this gas is no longer working. My husband had the bottle [00:16:00] replaced like three times. They were like, it's just, yeah, it's, it is working.

It's just not working anymore. And then I said, oh, I feel like I need to push. And they said, no, you don't. And that's really the moment that things went downhill. The moment that I said, I feel like I need to push. And someone said, no, you don't. They wanted to check baby's heartbeat. They couldn't. Get him on the Doppler.

They told me I had no choice but to get on the bed, which I said, I don't wanna do that. I don't wanna be on my back. I don't wanna lay down. I needed to move. I moved my whole labor until that point and I had a, around a 12 hour labor. And then it was just, it's blurry. This is where the kind of trauma happens.

It's where it felt like everything was in my hands to all of a sudden it was very out of my hands. And I think until that point I'd really been left alone cuz they were very busy. So I really, I was, it was just me and my husband, which was really lovely. And then [00:17:00] I was on the bed and I was trying to flip onto all fours.

I was fully dilated. I was ready to push and they flipped me back. They. Held my arms and flipped me back and were putting the CTG monitor on me. And I, that's the moment I felt myself start to dissociate. I was like a caged animal at that point. They had the CTG monitor on me and they were saying that baby's heart rate was dipping.

And then the, an obstetrician came in and was really disrespectful and said, has she had an epidural? She's not pushing properly. And then without consent, I was given an app episiotomy and in the wrong spot. So it resulted in lasting damage. They also hid an artery, and I don't blame the midwife who did that.

She's being directed by the obstetrician who told her to do it. And then when she did it wrong, he chastised her in front of me. [00:18:00] But not only did he chastise her, but they hit an artery. So then blood spurted, it was like nice homage to Dexter, when all of a sudden there was like a slash of blood across this like obstetrician and this midwife and like I think about the reverence of birth and there was no reverence in that moment.

I was on my back. I felt caged. I wasn't being held down, but I might as well have been cuz that's what it felt like after that first hands on me experience.

And then the obstetrician said, I'm gonna give you one more chance to push this baby out, or I'm going to vacuum him out. And I had dissociated and they said, on the next contraction you have to push.

And I said, I've been ignoring the contractions cuz something's wrong. And so then they vacuumed him out and his shoulders got stuck and they called it a shoulder dystocia when actually it was just, I was on my back and I shouldn't have been, I never should have birthed on my back.

And then they did [00:19:00] what they do with shoulder dystocias and Roberts maneuver, flashing lights, people coming in, humidity cribs coming in, like all the people.

And I was just not there. I was not in my body. I remember looking at my husband and. He looked terrified and they got B out. And I just remember feeling really disconnected and looking at my son and not knowing him, not recognizing him, feeling like, is that my baby? Because he had a lot of hair and all the babies in my family had been bald.

So he, it was like really weird for me. And then they just, they took him and I remember saying, is he alive? Is he okay? And no one was really talking and they were screaming at my husband to cut the cord and they'd give him, given him clamps and not scissors. And so he was trying to, and he, they were screaming at him, hurry up.

And then I heard my son cry and I remember feeling relief like, okay, he's alive.[00:20:00] And then it's blurry. And then they were stitching me up and they called it a second degree tear. It was actually a third degree tear. I should have gone to, Theater stitched up, but I wasn't. And I could feel it all.

I remember saying, that really hurts. And the obstetrician said to me, how can you even feel that?

And then I felt myself come back to my body and I remember I've just, I made a joke like, I'm not gonna do that again. I'll like the baby can come out the sunroof next time. Cuz I, I was te really traumatised.

And then the obstetrician was like, no, that's not what you should do. You should have a natural birth. I just remember being like, just cut up. And I remember looking between my legs and seeing this obstetrician and the obstetrician had on am minion's like head covering. And I just remember thinking like, what are you doing?

Like this? I'm so vulnerable. And you have this silly little hat on your head.

[00:21:00] And then, yeah. And that was my entry into motherhood and it was. Really awful. And I remember my, I heard hushed voices of the midwives when my dad and my grandmother came to visit and I heard them say it was really awful.

She had a rough time. And I hadn't, I hadn't really realised it was awful. Like I, I knew and I didn't know. And then everyone was oh. And I know I looked not like myself. I was really, I felt like dead in the eyes, like a shell. And I just felt really hypervigilant. Like I, when the hearing test people came to take my son to get his hearing tested, I remember being like, oh, okay.

And they started to wheel him away. And then I got up and started running down the hallway and was like, actually no. No, you can't just take my baby. This is weird. I'm coming. And they looked at me like I was crazy. And yeah, just then that [00:22:00] awful experience of. People who are tired and underpaid trying to help you learn how to be a mother.

And I remember asking a midwife, it was if it was okay to pick my son up, and she looked at me like I was crazy. And then I remember trying to learn how to breastfeed and it was really painful. We found out later, he had a lip tie and a tongue tie and it was, I was told, no, it's fine. It's supposed to hurt while they grabbed my breasts, like they're grabbing at me.

And it just, yeah, it was just this like really surreal, like it wasn't happening experience. And then when you're a new mom, I think people forget how vulnerable you are. So everyone was coming over and I was trying to breastfeed and I just, I didn't have the skills I have now to carve out time or space for my family.

So I was like letting them come and yeah, it was awful.

Rachael Rose: That's massive [00:23:00] and. It sounds like you were pretty close to giving birth on your floors, and if you had just been left alone.

Alysha Fameli: yes.

Rachael Rose: Yeah. And I've, as a doula and a circle facilitator and I've run circles on birth story processing and it's that when people tell us what is happening with our body, when we clearly are the ones who are embodied, who are experiencing it, it can be such a disconnect. And it is such an injustice and so disrespectful to be told something other than the reality of what is happening.

You clearly were feeling the urge to push and being told that you are not, makes you feel like a child, a naughty child that's done something wrong. Like

Alysha Fameli: And the kicker is that I was [00:24:00] such a good girl like. I'd spent my life just being a good girl and doing what was asked and what I was told to do when I followed the rules. And I took that with me into birth, even though I know that I knew, I know that I knew different. And that was really, I think the most traumatic part of my birth experience was I had the intuition.

My body knew what it was doing, and I was trying to say that, and I felt like it was ripped away from me. So that was my first experience. And what ensued was just. A really hard early postpartum, and I am a psychologist, so I knew that I wasn't doing well and I was trying to tell people. And because I wasn't meeting threshold on the Edinburg postnatal depression scale, I was told no, you're okay.

This is normal. And I was like, it's not normal. Like I, my baby goes to sleep and I can't sleep, and [00:25:00] I am so scared he's just gonna die. And I was like, really terrified and that's not my, it's not my normal way. So it felt really different for me and nobody listened. And it was really, it was gross.

And then I had this beautiful little baby who was just delightful. And he was traumatised too. Like I remember people saying to me from the day he was born, wow, he's so alert. Which now I realise he was like, he was hyper aroused. He was like traumatised

And he found it hard to find sleep and feeding was a struggle and he just wanted to be on me all the time.

And I wanted to give him that because I felt so guilty for his birth. I felt like I had done something wrong. And at the same time I just also wanted to run away. I wanted to [00:26:00] be by myself cuz I was so overwhelmed. And I remember the day it really hit me, he would've been like three weeks old. And I was changing his nappy, and I was very much just going through the motions, like just doing it.

And I looked down at him and I realised I hadn't talked to him. I hadn't told him what I was doing. I hadn't said anything. And he's, he had these big, beautiful eyes and he was looking up at me, just waiting for me to look at him. And I was not, I wasn't talking to him. I wasn't looking at him. I was just, I was looking after him, but I wasn't connecting with him.

And it hit me like a ton of bricks. And from that moment on, I made this real, it was an effort. It wasn't, it didn't come naturally. I made an effort to speak to him and to really gently caress him and touch him and hold him and try and repair the lost bonding that we had. And we did it. And we [00:27:00] have a really beautiful relationship now, and he is the most.

Delicious child. He's really strong-willed, but he gets that from me, so that's okay. And I just, I dread to think what maybe our trajectory would've been like if I didn't know what I know.

Rachael Rose: Yeah, and you know we are mammals and we can see by. Looking at other mammals like chimpanzees and orangutans, if they're separated from their baby at birth, it can have dire consequences in terms of that mother rejecting the baby, the mother falling into depression

And when no different and when there's been a separation at birth it does take repair.

And the hard thing is that it's on the mom to do that repair when she's also in a state of shock and trauma. And I remember with my own daughter, I just didn't put her down for two years. [00:28:00] Like literally I baby war until my back ached and didn't want her out of my sight. And I can see now in hindsight, that was that hypervigilance and that trying to repair from our separation at our birth, whereas with my son, was, it was just a lot easier and I felt a lot more comfortable and he could be in another room and I didn't think he was dead.

There was, yeah, some really interesting stuff happening in my brain as a result of that traumatic experience. And you've just described what I know unfortunately a lot of mothers will have gone through, because we know the statistics, right? It's one in three women experience birth trauma and one in 10 will have P T S D.

And that influences the early stage of mothering in a big way. So for you, where did you feel like your [00:29:00] head came up above water? And what were some of the tools and strategies that you used to. To reconnect with yourself, your body, and I wanna say the word heal, but heal is a bit naf, but yeah, heal the trauma of that experience.

Alysha Fameli: I think. What you've described in that, that first two years, that was my exact experience. I just, I had a baby strapped to me for two years. And my son loved that and became reliant on that. And I think I just, the fog slowly lifted and I don't know that there was an exact time, but I certainly didn't, I didn't deal with the trauma until my next pregnancy.

It wasn't until I fell pregnant again that I realised how traumatised I'd been. In fact, I was sprouting the narrative oh, thank goodness they saved us. Oh, thank goodness I was [00:30:00] saved and I was one of these people that went, When people would talk about the importance of natural physiological birth, I'd be like, yeah, but sometimes you need a medical professional or you could die.

And I kinda, I'm doing a funny voice cuz I feel probably quite ashamed of that response. But I also feel so much compassion for that version of me who was just trying to survive. And that narrative, I think was the narrative I needed to hold in that moment in order to just push through. And I think, relationships between moms and babies are bidirectional.

It's not, we, as moms we don't get full influence. And I was. So delighted by my son. He was so funny and animated and engaged with the world, and he's a natural little scientist. So I just found him so delightful that I think I really immersed myself in seeing the world through his eyes, which [00:31:00] I'm really lucky that is probably a way that I like to be.

I, I work with children, so I really do enjoy children. And it wasn't until my second when I fell pregnant for with my second child, which wasn't planned that I really went, oh my goodness. I have lots of work to do here.

Rachael Rose: So did you seek out therapy? Do therapists get therapy?

Alysha Fameli: Therapist should always get therapy. I am a terrible client. I'm not anymore. But at that time I was a terrible client. I was very resistant. I thought I knew better and I was not in a space where I was good at being vulnerable. So at that time, no, I did not seek therapy. I sought knowledge, which is my avoidant comfort space.

So I did a lot of research about shoulder dystocia. I found that. The conditions under which I was, and I will say forced cuz I, I do feel, I feel like I was forced to birth. The [00:32:00] conditions that I was forced to birth were actually risk factors for shoulder dystocia. And I went to my initial antenatal appointments and I was trying to advocate for continuity of care.

And I was denied that because I have Hashimotos, which was very unusual because my Hashimotos is extremely well managed. I don't have any symptoms because it's managed with medication. And I went through every possible continuity of care model I could find until I found one that fit and I interviewed.

I interviewed, I really did interview two private midwives because I really wanted to have a person with me in the birth space that I felt I could trust, who trusted birth and who trusted me because I knew that I needed to learn to trust myself. And I found a beautiful private midwife who has the exact opposite energy to me.

[00:33:00] She was very steady and very calm and very measured, and I am chaotic, and she was not. And I told her my birth story, and I think she knew that what I needed was science. So she gave me a bunch of papers to read and basically told me that there was no evidence to suggest I couldn't birth on my own without any intervention. I still plan to give birth in the hospital because I was scared. I was really scared. So I was gonna bring my midwife in with me and I really wanted to have some control of my birth space. So I was trying to advocate for myself with the hospital, and I had asked to take in a birth pool. And then I did a thing, which [00:34:00] I don't know how wise this was, but I decided to be a bit of a martyr and advocate for other women to have control in the birth space.

And I got involved with a local birth advocacy group who took my story to the media and there was an article published about the. Not having the right to access water during birth at our local hospital. And I was 39 weeks

Rachael Rose: Oh, okay.

Alysha Fameli: and I did a really dumb thing and I read the comments on that article, which were so awful. They were people saying that I was entitled and righteous and what do I want a blow up flamingo? And I

Rachael Rose: Ah, suck it up, sweetheart,

Alysha Fameli: yes. Yeah, there was so much. Suck it up. We've all given birth there. Oh, there was like women in third world [00:35:00] country comments.

It was really awful. And I acknowledge that I am so privileged. I'm a white middle class woman. I would never say that I have not been blessed with privilege. And also I wanted to have the right to have some control in my birth space.

And the hospital finally got back to me after putting me off for months and said that it was an insurance issue because there would be no one to empty the pool, to which I said, I've got people to do that.

And that was not okay. But the real kicker was that a midwife from that hospital commented on the article and said, I've read this woman's notes. I know that there's other issues at play here and there's reasons why she can't labor in the water. And I'd already come up against hospital executives and, just this awful social media stuff.

And I just was like, I can't go there. [00:36:00] I can't, they're gonna treat me really badly and I'm gonna end up worse than I started. And so on the day that I went into labor, I had still told everyone the plan was to go to hospital, but I'd done all this research about home birth and I really, truly, I wasn't like I'm going to have a home birth, but I had done research about the risks cuz that's what my scared brain does.

And on the day I just looked at my husband while I was in the throws of contractions and said, I'm not leaving, I'm giving birth here. And he just had to be okay with it. And he was, cuz he, he knew that it was my thing to decide and my space to hold. And my midwife was wonderful. And she was appropriately risk aversive, but she was not scared.

And then I had this beautiful birth in my lounge room, in a birth pool on all fours. And I pulled my baby out of the water [00:37:00] and. I held him and heard him cry, and it was pure magic.

Rachael Rose: Yeah. Was your other son there

Alysha Fameli: No, I wouldn't handle the sensory overload of having my two and a half year old then I needed to just not have him there. And I wouldn't, I don't think I would change that. For me, I totally understand family-centered birth, and I think it's really beautiful for people who want that. But I am a very, I'm a really stoic person.

I'm like, you know how mammals. Dogs and cats go onto houses and give birth in the dark. That's me. Like even having anyone there I think was too much. I think I could easily just give birth on my own. But the people who were there, which was my husband and my midwife, they were so reverent and they just left me alone.

 My husband was just topping up the hot water and my midwife just sat on my couch eating toast. And it was like [00:38:00] just, it was magic. And I had no doubt that I was gonna do it, and I was gonna be fine. And it was really wonderful. And afterwards I had this huge rush of elation and love and joy and delight, which I'd never gotten the first time.

And I was over the moon and I felt so protective of what had just happened that because I didn't wanna deal with. My fearful family, I really didn't tell many people that I'd had a home birth. And I held it as this little secret.

Rachael Rose: I love that. And it's yours to hold. You don't need to tell anyone if it's not appropriate. And I also wanna say like a family-centered birth is great and I wouldn't have my toddler at my birth if I was to give birth Again. Like it's really dependent on the child and where they are in the family and [00:39:00] all of that kind of stuff with influences our decisions there. So what was the difference in your second postpartum?

Alysha Fameli: It was so different and it's I don't wanna act like I was so magic. It was still really hard. I had had a two and a half year old and a brand new baby and it was really, it was still hard. I was sleep deprived and I was breastfeeding again, and I really didn't have much of a break from breastfeeding.

I breastfed all the way up until I was pregnant with my second son. I breastfed my first son, so I was like, oh, I'm doing this again. And it was all the same things that were hard and yet somehow I was so much more myself. I felt connected to myself. I felt connected to my two kids.

I felt like I could see clearly and think clearly. And I wasn't scared. I wasn't scared that my. Younger son was going to [00:40:00] die. And I had that same thing where I could put him down and know that he would be all right. And I still did all the baby wearing stuff cuz I just found that worked for us.

It was easy, but it didn't feel like I had no choice because of fear. I felt like I was, it was a choice I was making. I think that's the big thing. I felt like I was making choices and I had, beautiful postpartum care from my midwife who came and visited me for six weeks. So I felt for the first time, like I had a village and I really think it's the first time I felt like someone trusted me as a mother.

Oh. That, I think that's the first time I've ever said that, that makes me cry. But she just had this like innate like, yeah, of course. And I would say something and she'd be like, yeah, of course. Let's check that or let's look into that and. She was so wonderful and I think that's just maybe who she is as a person.

And she was really like, she would've [00:41:00] fought for me tooth and nail if I had gone into the hospital. And I was glad I didn't put her in that position cuz I didn't realise the position I was also putting her in at the time.

Rachael Rose: Yeah, because she wouldn't have had admitting rights, so she wouldn't have able been able to do midwifery care per se. She would've been an advocate slash doula in the

space. Yeah. 

Alysha Fameli: So I was getting her in a tricky spot too, which I didn't know. I was naive.

Rachael Rose: I'm wondering, did the midwife who commented publicly have any disciplinary action taken against her, because that is so not okay.

Alysha Fameli: I didn't take it any further. I saw it, I screenshotted it, I, my heart broke and then I just moved away because I just. I'd already given so much energy to this terribly broken system where there was no respect for women and I didn't wanna give it any more energy. And I also think that when you're in a broken system, [00:42:00] it can break you.

So in some ways, I have some compassion for people in the system who might be perpetuating it. I think that they've had their spirits broken, so

I wasn't in the business of trying to make someone else's life hard.

Rachael Rose: Yeah. And look I personally never did a formal complaints process. I didn't have the energy for it, and I turned my kind of activism towards speaking publicly about the issues, becoming a doula, supporting other women, and hearing their stories and. You are doing that now in a different capacity through research.

So can you tell me about the Australian birth study?

Alysha Fameli: Yes. So I, I started doing my research. I, oh, my youngest son was one, so I had, that's crazy to say. A four year old and a one year old. He's nearly four now. So I started off when he was very [00:43:00] little, so maybe a month old, and I started. I volunteered for a birth advocacy group in my area. And I was going into the hospital and I was trying to advocate for women and I just, there was so many roadblocks and so much like weird victim blaming.

And it was so sad cuz I was hearing women say this to me. These traumatised women, they're not really traumatised by birth. They probably already have P T S D and they're just getting confused. So is this like awful narrative? And I felt so angry and so furious about how birth trauma was being treated.

And there was also, I think, fear. From other women to talk about birth trauma, cuz I think there's this worry that you're gonna make other women scared. So I think it was like this weird issue and it was really hard to get the traction I was hoping to get. And so I realised that the thing that [00:44:00] empowers me is knowledge.

And I have always loved research and I've always really loved researchers who take what is hard to understand and pate and they make it so that everybody can understand it. And so I wanted to do a PhD about birth trauma that. Could get the information back to women and no matter who they were or their place in the world, or whatever, they could understand the outcomes of my research and use some of that information to benefit them.

So the Australian birth study is the overarching name for my PhD. There are a couple of smaller projects within it. I essentially wanted to make sure that childbirth, P T S D is recognised as a legitimate experience that some women may have and that. It reaches the [00:45:00] people who need to hear about it, that, that healthcare providers actually understand it.

And so one of my studies was looking at a standardised measure of childbirth, P T S D and validating it for an Australian population, which I finished that study. I had 705 wonderful women participate in that study. The measure is sound, it can be used, it's self-report, so it's women's experiences. And it allows us more scope than just the standard Edinburgh postnatal depression scale.

So it allows women to be captured and understood as having experienced their birth is traumatic. And then the study I'm doing now is about understanding how traumatic childbirth experiences impact the unfolding mother infant relationship. I am conducting clinical interviews with women about post-traumatic stress symptoms related to their birth, and I am also observing them interacting with their [00:46:00] baby.

And I'm, it's a bit nerdy, but I'm coding those for a thing called Synchrony, which Synchrony is wonderful because I feel like it's where art and science, the art and science of being a human actually intersect. It's a beautiful concept and it's essentially that when we are in relationships with people, so babies or toddlers or partners or friends in interactions, there is a thing called Synchrony that we can observe and it is more than just our behaviours, even though that is what I'm looking at and I'm coding the behaviours.

Synchrony has also been linked to biobehavioral processes. So like when you are really in sync with your baby, your EEG waves sync up and , there's a mirroring, it's like a dance. It's really beautiful. And my hunch is that when we've experienced traumatic birth, that when we are trying to get in sync and dance with our babies, it is [00:47:00] hard and we're dancing to different soundtracks and we're stepping on each other's toes and it is effortful and that when we have not experienced traumatic birth, that we may experience less of that.

Rachael Rose: Oh, that's so fascinating. How long is this going to take you?

Alysha Fameli: Good question. So I started off in, it was 2020. And I am still going. I did drop back to part-time because I never wanna miss out on the early years of my boys. So I wanted to make sure that I could still do this and it not consume me, cuz I am prone for tunnel vision. So at the moment I have, I'm aiming for 150 mother baby dias and I have approximately 90 have come through all the way through my study.

So I've still got a little ways to go and then I will have to analyze that data and write up [00:48:00] some meaningful papers. And then also before I actually officially finish my PhD, while I have access to the university, I wanna make sure that I am disseminating that information to the people who need to read it, which is mothers and the participants of my study.

Rachael Rose: How far postpartum are the participants? Does it matter? Can they have birthed in the last five years or is there a sort of age gap bracket?

Alysha Fameli: So because because science likes things to be very standardised and you have to try and control as much of it as you can of the variables that as you can, the babies are between four to six months old. But I do recruit mothers anywhere from birth to six months. And then we just wait until baby's old enough to participate.

And the reason I chose the four to six month Age bracket is that Synchrony is very observable in this age group because babies are really reliant [00:49:00] on their mom for social engagement. They are really cute into it. They are seeking it, but they're also not super mobile. So we are getting a really clear sense of the dance between mums and babies, and we are taking away some of the variables like baby, getting more interested in the bottom of the couch or 

Rachael Rose: Yep. Chewing on the car keys and

all that. 

Alysha Fameli: that's right.

Yeah. So when they get older you have to do like much longer observations to get a true sense. And Synchrony is something that is actually relatively stable. So I'm observing it in this very discreet timeframe where it's really evident, but it is a stable construct if there's no intervention.

Rachael Rose: What's it been like as a researcher who had a lived experience of trauma to then dedicate years of your life to studying trauma?

Alysha Fameli: I think I had dedicated my life to trauma anyway, because I am a psychologist [00:50:00] and I work with children, and I have always worked with trauma. This was a different kind of trauma. I think. I think this is where post-traumatic growth becomes really prevalent in my life. I felt like I'd moved beyond my own experience enough that I am not triggered in an individual sense by the stories that I hear.

But I am deeply moved and deeply touched by every story that I hear. I feel really honored to hear the experiences, these harrowing experiences of women's. Births and I feel an enormous amount of pressure to, in a research space carve out reverence for these stories. And it's really hard because academia is a patriarchal system, and I'm trying to come at this from a feminist perspective and [00:51:00] carve out space.

And so for that reason, sometimes the interviews go for much longer than maybe they should, but it is because I really just want women to be able to have a space where they can tell their story and know that I am holding it. And although the data may not reflect the nuances, what I am hoping is that I can create something in the science world that gains traction and gains attention and makes real change.

I'm hoping that. By observing Synchrony, I can develop interventions for moms who have experienced birth trauma so that they can learn to dance with their babies much earlier in the piece rather than having to suffer and struggle. And so that it's taken seriously in the health community that, births that are seen as relatively straightforward can [00:52:00] cause enormous psychological damage to the women who live through them and to the babies.

I think, I think that's one thing that no one's really looked at properly is how this impacts the babies.

Rachael Rose: Yeah. And I imagine for your participants, it gives them something to anchor towards as well. It's something that they feel that they can do to make change in a small but very meaningful way as well. And I love that you say that you spend more time with them because, We don't actually want to repeat what is happening to women within the maternity system, which is where they have five minutes with a midwife and they don't have their stories held.

So if you can even do that in a research capacity, I imagine that sometimes they're telling their stories for the first time and you get to be the one privilege to hear that.

Alysha Fameli: Yes, and I just do it. I just make sure that. I carve out the time I allow,[00:53:00] I probably could have had more participants at this stage, but I never overbook myself. And if I'm at a point, sometimes I'll start to hear a story and I know that there is so much that woman is holding, but I also know that it's like school pickup soon.

So I will say, I so desperately wanna hear this and I don't wanna rush you. Would we be able to reschedule this part to tomorrow so that I can make sure that I can give you the time that your story deserves? And I found that women are so wonderfully flexible and willing to shift and change and also I, of course, am because I know what it's like to have a baby.

And so there's lots of rescheduling on both ends at times. But I just feel like even if that is part of the impact, if women. Who participate in my research have felt like I've really held their stories. And I do, I hold them with reverence in my heart. And I've cried, which is probably not in the protocol, [00:54:00] but 

Rachael Rose: the protocol like,

Alysha Fameli: I wrote the protocol,

Rachael Rose: but that's the thing, like in, that is what is lacking in patriarchal systems. It's that emotion. And we saw Jacinda a Hern in her departing speech. Talk about the fact that she was a crying prime minister. Thank you that you were a crying prime minister. May we have more feeling in things that matter.

For me, if I sat across someone and I told my deep dark story of birth trauma and I. I could feel that they were not moved at all. I would feel like I was talking to a robot and it would be more harmful than it would be helpful. So to know that, I had goosebumps when I was listening to your story.

I was deeply feeling your experience as well and we need that. So fuck the protocol.

Alysha Fameli: Yes. And that has been my, I've always been [00:55:00] just, so funny because I spent my life being a good girl, and yet I can just recall so many times in my life where I've been a total system disruptor from a little girl, like really pushing up against things. I've always pushed up against things that don't feel right.

And I've found academia to be one of the things I feel myself pushing up against. And I'm really lucky I, in finding, so usually you don't do a PhD the way I've done it usually you're you're part of a uni or a research assistant, someone says there's this project coming up and then you get given a project and you get to of course develop it and put your ideas into it, but it starts off a seed somewhere else.

I didn't do that. I contacted a bunch of researchers and was like, I wanna do a PhD. Here's what I want it to be about. And we really hoped to have. A team of women and I just couldn't find a female academic who was interested in my research. [00:56:00] And so I ended up with my current supervisor, professor David hoes at University of Sydney.

And he is been really wonderful in so many ways. And I think even that's been healing where I'm like pushing up against these patriarchal systems and he, will tell me about how the process goes. And also he holds space and reverence for the fact that sometimes I don't give a fuck about, I'm not allowed to say that.

Rachael Rose: You're allowed to say that.

Alysha Fameli: See, it's still the good girl. Listen to that. I am allowed to say that. But yeah, so I've been really blessed in that sense where I've had this supervisor who is oh, okay, yeah.

Rachael Rose: Alysha's at it again.

Alysha Fameli: Yeah,

Rachael Rose: Yeah.

Alysha Fameli: and I think, I think he must, there must be something about that he sees value in and he's within an institution. But yeah, he lets me push boundaries and I think understands that I will [00:57:00] never compromise my values for anything.

Rachael Rose: Oh, you sound like an amazing researcher. So how can women get involved if they want to be part of your study?

Alysha Fameli: So I have a website the Australian birth study.com and they can contact me through there. It has information about the current study that's running. It's got information about the paper that I published recently. If anyone's interested in the paper, they can request that from me cuz I know it's not accessible to everyone if you're not part of a university, a lot of academic research is just hard to get your hands on.

I'm happy to send that to anyone that would like to read it. And yeah, you can email me.

Rachael Rose: Awesome. Thank you Alysha. Thank you for sharing your story today. And yeah it's been a privilege to hear it and to hear how you've transformed what was an awful experience and a really difficult initiation into motherhood, into [00:58:00] a beacon of light for others. And I just love to hear stories like this.

Alysha Fameli: Thank you so much for having me.