Maternal mental health Funding

• Around 1 in 5 women experience mental health problems during or after pregnancy and suicide remains the leading cause of direct maternal death in the first postnatal year. It is therefore critical that those with the most severe and complex illnesses can access specialist care close to home.
• In the last decade, the overall provision and quality of specialist perinatal mental health services have improved but progress across the UK has been uneven. 
• According to Maternal Mental Health Alliance (MMHA) research, this is largely due to workforce planning and shortage issues, made worse by insecure or late allocation of funds.
• At a time when demands on mental health services are so high, it is vital that commitment to maternal mental health remains, and the improvements in care, which we now know can be made, must be sustained.

The MMHA’s latest report on specialist perinatal mental health (PMH) community services in the UK highlights the significant progress made in all four nations since 2013. However, access to life-saving mental healthcare for pregnant and new parents remains uneven, with many regions still lacking the necessary resources. Mental health-related deaths during pregnancy or up to six weeks after birth are increasing, emphasising the urgency of addressing this issue.

As a charity which supports everyone affected by Post Traumatic Stress Disorder, we know how vital is it to support maternal mental health, as approximately 9% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.

What is Post Natal PTSD?

Post-natal PTSD is a type of Post Traumatic Stress Disorder (PTSD) that can occur after childbirth. It is estimated that approximately 9% of people who have given birth experience Post-natal PTSD. The condition is often caused by a traumatic childbirth experience, which can include complications during delivery, a difficult labour, emergency C-sections, or a traumatic birth environment, but it’s vital to understand that Post-natal PTSD isn’t necessarily always caused by sensational or dramatic events during childbirth or pregnancy.  There can be a complicated mix of objective (e.g., the type of delivery) and subjective (e.g. feelings of loss of control) factors which can cause Post-natal PTSD 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
• You experienced poor postnatal care
• The birth had to be induced

Why is it important to recognise Post Natal PTSD and what should I look out for?

The impact of Post-natal PTSD can be significant. People with Post-natal PTSD may find it difficult to bond with their baby or may feel guilty about their inability to enjoy their new-born. The condition can also have an impact on relationships with partners and family members, and may lead to social isolation.

If left untreated, Post-natal PTSD can have long-term effects on mental health, however, the perceptions of childbirth and experiences can vary wildly and so people with Post-natal PTSD frequently find themselves very isolated and detached from other parents who may find it hard to understand how much a bad birth or pregnancy can affect them, so they don’t reach out for help.

Post-natal PTSD can make sufferers feel lonely and depressed as they often feel they are somehow ‘weaker’ than others because they are unable to forget their birth experience, despite being told by others to ‘put it behind them’ or just ‘be grateful you’ve got a healthy baby’. This may also result in intense feelings of guilt.

Symptoms of Post-natal PTSD can vary from person to person, but common symptoms include:

• intrusive thoughts or memories
• nightmares or flashbacks which revisit images of labour and birth
• avoidance of triggers that remind them of the trauma
• hypervigilance (feeling on alert all the time)
• anxiety and depression
• fear of and avoidance giving birth in the future
• difficulty in feeding
• lack of interest in, and avoidance of, sex and shunning physical contact
• difficulty with bonding with your baby, and guilt as a result
• avoidance of medical treatments like smear tests
• Some people may also experience physical symptoms such as headaches, chest pain, or difficulty breathing.

Is Post-natal PTSD the same as Post-natal depression?

It is important to note that Post-natal PTSD is not the same as Post-natal Depression, although they can have some similar symptoms, and the two conditions can coexist. Post-natal Depression is a type of depression that can occur after childbirth and is characterised by feelings of sadness, hopelessness, and fatigue. Due to the similarity in symptoms, and current lack of awareness of PTSD and C-PTSD, many people are often misdiagnosed with Post-natal Depression (or only diagnosed with one condition, when they actually have both). Research shows that up to 25% of people who have Post-natal PTSD could remain undetected because they are also experiencing Post-natal Depression, so the PTSD goes undiagnosed.

What do I do if I think I, or my partner may have Post-natal PTSD?

Acknowledging that you may have Post-natal PTSD can be hard, and the changes in your mental health may have felt so gradual you might have not noticed the issues. You may feel that your symptoms are simply due to adapting to a new life as a parent, or from lack of sleep perhaps.

If you feel that you may be experiencing symptoms of Post-natal PTSD, speak to your midwife, GP or health visitor about how you’re feeling. It is important to know that it is possible for Post-natal PTSD to be successfully treated, even years after the birth occurred, which means it is never too late to seek help.

For some people, the first step may be ‘watchful waiting’, then exploring therapeutic options such as individual or group therapy. NICE guidance (updated in 2018) recommends trauma-focused psychological treatments such as EMDR, and trauma-focused cognitive behavioural therapy (CBT). You may also want to explore holistic non-pharmacological therapies, or talk to your doctor about treatment with appropriate prescription drugs. 

Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD.

You can find out more about the causes, symptoms and treatments of Post Traumatic Stress Disorder on the PTSD UK website, along with information about PTSD in birthing partners, and PTSD as a result of pregnancy loss (including miscarriage, ectopic pregnancy, stillbirth, SIDS, terminating a pregnancy for medical reasons (TFMR) and new-born deaths).