Birth Trauma and Post Natal PTSD


It has long been recognised that following a difficult childbirth some women may go on to develop psychological problems. However, it is only relatively recently that it has become accepted that women can develop Post Traumatic Stress Disorder (PTSD) as a result.

Unfortunately, the perceptions of childbirth and genuine experiences can vary wildly and so Post Natal PTSD sufferers frequently find themselves very isolated and detached from other mothers who may find it hard to understand how much a bad birth can affect you.  The Birth Trauma Association acknowledges that ‘this can make sufferers lonely and depressed as they often feel they are somehow ‘weaker’ than other women because they are unable to forget their birth experience, despite being told by others to ‘put it behind them’. They may feel incredibly guilty as a result.’

Birth trauma or Post Natal PTSD isn’t necessarily caused by sensational or dramatic events during childbirth but there a complicated mix of objective (e.g. the type of delivery) and subjective (e.g. feelings of loss of control) factors such as:

  • You had a very lengthy labour
  • You had a very painful labour
  • You had an assisted birth with ventouse or forceps
  • You had an emergency caesarean section
  • Your baby was born with a disability
  • Your baby spent time in special care
  • You feared for your, or your baby’s life or health, during or after the birth
  • You felt powerless during the birth.
  • Your medical carers were unsupportive or unsympathetic.
  • You’ve had a traumatic event in your past
  • You felt you were not in control
  • There were high levels of medical intervention
  • You felt you were not being listened to
  • You felt a lack of information or explanation
  • You felt a lack of privacy and dignity
  • Your baby was stillborn
  • You experienced poor postnatal care

In these scenarios, people who witness their partner’s traumatic childbirth experience may also feel traumatised as a result.


What is different about Post Natal PTSD and PTSD?

There are many symptoms of PTSD, but it’s thought that Post Natal PTSD has some specific symptoms too

  • revisiting images of labour and birth
  • fear of and avoidance giving birth in the future
  • poor self-image and feeling inadequate
  • relationship difficulties
  • difficulty in breastfeeding
  • lack of interest in, and avoidance of, sex and shunning physical contact
  • difficulty with bonding with your baby, and guilt as a result
  • isolation and loneliness
  • postnatal depression (PND)
  • avoidance of medical treatments like smear tests

While some of these symptoms are very normal following a birth, if they continue for months after the birth, you should consult your GP or midwife.

As one of the characteristics of PTSD is persistent re-experiencing of a trauma, for some Post Natal PTSD sufferers, the new baby could be a reminder of the traumatic birth and trigger flashbacks.  A mother may seek to avoid their baby because of his or her association with the traumatic birth.

It’s acknowledged that there is some symptom overlap between Post Natal Depression and Post Natal PTSD but the two conditions are different, and therefore need to be treated separately.

Due to the similarity in symptoms, and current lack of awareness of PTSD, many women are often misdiagnosed with Post Natal Depression, and therefore treatments are unsuccessful, but it’s key to note that it is not uncommon for women with PTSD to also have postnatal depression too – but the presence of one does not always imply the presence of the other.

One study by Czarnocka and Slade (2000) suggested that it is possible that 25% of women who have PTSD could remain undetected because they are not also experiencing postnatal depression, so the PTSD goes undiagnosed.


What can I do now?

Read and discuss your labour notes

If you have Post Natal PTSD, it would be understandable to have ‘blanked out’ the traumatic aspects of the birth, but going through your labour notes with your midwife can help you understand things better, and give you a fuller picture of what happened.
You should be able to request a copy of your notes from the hospital where you gave birth (likely from the patient services manager or medical records officer).

Use a ‘birth reflecting’ service

Many hospitals offer a ‘birth debriefing’ service about six weeks after the birth. It’s important not to worry if you don’t feel ready to talk over your experience for months, or even years – so it at a time that’s right for you.

Speak to your midwife, GP or health visitor

Use the home visits from your community or health visitor to ask any questions you may have about how you’re feeling.

Consider making an appointment with your GP who may refer you to a counsellor so you can talk things through with a professional.

If you are having another baby, make sure you get the care that you need

Make sure you speak to with your midwife about what happened before, and how it made you feel.

It may be difficult, but try to make a birth plan and get to know the midwives who will be caring for you – having someone you trust at your next birth is likely to be very important to making it a better experience.


SOURCES: Birth Trauma Association, Post-traumatic stress following childbirth: a review of the emerging literature and directions for research and practice, PSYCHOLOGY, HEALTH & MEDICINE, VOL. 8, NO. 2, 2003D. Bailham & S. Joseph, Baby Centre,

IMAGE: Baby by Tatiana Vdb

 

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