Post Natal PTSD: Sian's Story
It has long been recognised that following a difficult childbirth or pregnancy some people may go on to develop psychological problems. However, it is only relatively recently that it has become accepted that they can develop Post Traumatic Stress Disorder (PTSD) as a result.
Unfortunately, the perceptions of childbirth and pregnancy experiences can vary wildly and so Post Natal PTSD (PTSD as a result of pregnancy and/or childbirth) sufferers frequently find themselves very isolated and detached from other parents who may find it hard to understand how much a ‘bad birth’ or pregnancy experience can affect you.
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 too.
In this blog post, Sian shares her experiences during pregnancy and birth, and how it led to her developing PTSD.
“I will put my hands up and admit that my knowledge of PTSD was very limited prior to my own personal experience. A few months after the birth of my daughter I was diagnosed with Postnatal Depression and my GP recommended I get in touch with my local IAPT service for some therapy. At the end of my initial assessment I was told I was going to be referred for high intensity therapy for post-traumatic stress disorder. WHAT? I remember thinking that the guy was obviously mistaken. I hadn’t been through something huge like a car crash or witnessing a crime so I couldn’t have PTSD! I was so nervous for my first appointment. I was convinced the therapist would laugh or tell me it was a mistake and that I just needed to get on with it. The appointment came and she asked me to explain what had been going on for me. So I told her…
It all started with my pregnancy. At five weeks I had a miscarriage scare. The following week the ‘morning’ sickness began. It wasn’t ‘morning’ sickness for me, it was all day every day from the minute I woke up. I had trips to A&E as I couldn’t keep down water, let alone any food.. I was put on medication to help control it and I was unable to come off of it until I was nearly 30 weeks pregnant. It wasn’t just the physical impact that it had, it was also emotionally draining. Every morning, the second I opened my eyes I would be hit with the pang of nausea. I would know before I had even got out of bed that it wasn’t going to be a good day. This would leave me with a serious lack of motivation to get up and face the day!
I felt guilty that I wasn’t enjoying my pregnancy as much as I should. I felt guilty that it might appear that I wasn’t grateful for being pregnant when there are others who are unable to. I felt guilty that I was letting my baby down as my body wasn’t coping as well as it should. I felt guilty that this was also affecting my Husband and his experience as he worried about me and the baby.
I’d just started my maternity leave when there was a morning that I didn’t feel the baby move. We went to the hospital where I was connected up to a machine. Luckily everything was ok but at the time I was so scared. My due date came and went. I was being monitored as I’d had some symptoms of pre-eclampsia. I was eight days overdue when it was found that our baby was breech. Everything became urgent as I was so overdue, decisions had to made quickly. It was all very overwhelming. We opted to have an ECV first. It’s hard to describe what this actually involved. A Doctor and a Midwife were kneading down into my skin to get to the baby and one would push whilst the other pulled in an attempt to make it turn. It was much more painful than I expected and my husband said it was horrific to watch. After a few minutes of this it was apparent that the baby wasn’t going to budge. My skin was red raw and stinging, it looked as if someone had been doing Chinese burns all over my stomach!! I was booked in for a caesarean two days later.
Once again things didn’t go to plan! That night I woke up at 5:15am having contractions and a few minutes later my waters broke. I had been told that if I went into labour I needed to get to the hospital urgently. The contractions were coming every five minutes. I was panicking the entire journey as it felt like it was all happening so fast. When I arrived at the hospital the Doctors were struggling to work out how far dilated I was due to the position of the baby. They said I may be too far gone to have a caesarean. This made me really anxious as I knew this wasn’t the safest way for my baby to be delivered and it could lead to serious complications. I also started being sick again. Thankfully it was concluded that it was safe to continue with the caesarean. I was in hospital a few days and monitored closely as I had lost 1.5 litres of blood during the surgery. The first day we were at home a midwife came to do some routine checks. It turned out our daughter had lost too much weight and we were quickly readmitted back to hospital. She had dropped from 8lb 6 to 7lb 4 in three days. I was devastated and felt such a failure. I couldn’t believe I had let this happen and was convinced the midwives would think I was a useless mum and she would be taken from me.
Tests were carried out to see if there was a reason for the weight loss. We could tell that something was wrong as the paediatrician was repeatedly listening to her heart. She explained that our daughter had an irregular heartbeat, something that she had not come across before in a baby this young. She also told us that she wasn’t responding as well as she should do, was very lethargic and had a hint of jaundice. The fear and the guilt I felt was overwhelming. More tests were carried out and it was found that she was severely dehydrated. I could not cope with the fact that my body hadn’t provided her with the milk she needed, it was all my fault! The thought of her being that hungry and her needs not being met made me feel like the worst mum in the world.
We had to take her for a couple of heart scans to find out why there was an irregular beat. Seeing my little girl hooked up to a machine with so many wires is one of my main PTSD triggers. Everything seemed to be functioning ok and it was just unexplained.
I tried and failed to breastfeed. After the weight loss I was really struggling to relax about it and I was constantly worrying about whether my body was working, was she getting enough milk, what if she was starving again. I also found it very painful as she struggled to latch on. I know I shouldn’t have, but I worried about what other people would think, they must think I’m a useless Mum if I couldn’t feed my baby properly!
Recovering from a caesarean isn’t easy. It really impacts on how you can care for your baby in the early weeks and my recovery was prolonged as my scar became infected.
At a routine 6 week appointment, the Doctor told me that my daughter was underweight and this needed to be closely monitored. That was my rock bottom. I felt like I was failing once again.
When I had finished telling the therapist all of this, there was silence…she’s trying to find a polite way of telling me to “get over it” I thought. I was wrong. “Wow I just need a minute to take that all in, I can’t believe how much you have been through”, she said. I cried. I was so relieved that what had been happening wasn’t just me ‘making a fuss’ or being weak. Here was someone who didn’t know me and was validating my thoughts and feelings.
She brought up PTSD and asked how I felt about that. I admitted to her that I had found it hard to believe as what I had been through wasn’t ‘major’. She explained that PTSD doesn’t always come from just one trauma. For me, it had been a case of one thing after another and it had got to the point that my brain had shut down and said “enough is enough!”
When you become a parent, your needs are no longer your first priority. Even though things were constantly happening, I had continued to keep going. She said it was as if I had gone for a run, got injured, but then went on to run a marathon with that injury. It’s just something you wouldn’t do to your body. So why do we do it to our mind? Mental health needs to be treated in just the same way as physical health.
She sent me some information on PTSD, there were some particular symptoms that I realised I had been experiencing.
- “It may be like watching a film of what you went through” (flashback)
- Feeling physically and emotionally upset when reminded of the trauma.
- Constantly looking out for danger.
- Problems sleeping.
- Lack of concentration.
- Feeling depressed, anxious or irritable. – Withdrawing from family and friends.
- Feelings of guilt, self-blame, shame or self-criticism.
The metaphor used to explain PTSD was a filing cabinet. Normally the brain ‘files’ memories in the correct drawer. With PTSD, the memory becomes distorted. The brain gets confused with certain facts; where, when, how etc. This then leads to the person experiencing flashbacks and feeling like it is happening then and there, they are re-living it.
Although I was experiencing the ‘movie re-play’ flashbacks which made me feel anxious and upset, I hadn’t yet experience a there and then flashback. My therapist did warn me PTSD symptoms were likely to get worse whilst we worked through these appointments.
After that first appointment it happened. I was watching tv one evening and an advert came on for a children’s charity. The opening line was “there’s nothing worse than witnessing your child ill in hospital”. BOOM. I was back in the hospital room. I was sat on my bed. The paediatrician was lent over my baby girl, she was frowning as she repeatedly moved her stethoscope to my daughter’s heart…” I jumped up from the sofa, this couldn’t be happening, I didn’t know what to do. I went into the kitchen and started sorting the dishwasher, cleaning the sides…anything I could do to stop this flashback from happening. I then told my husband I was tired and was going to bed. I didn’t know how to tell him that what was happening! When I was on my own, the flashbacks kept coming…the paediatrician telling me my little one wasn’t responding as she should, the doctor telling me she was severely dehydrated, being up at 3am desperately trying to get liquids into my baby…I curled up into a ball and sobbed. I was shaking, I felt sick and it felt as if someone was stood on my chest. The next morning I woke up and felt like I had the biggest hang over. It’s incredible how much a flashback can knock you physically as well as mentally!
Having therapy was so helpful to my recovery but it really was emotionally draining. Talking through everything in detail just brought back and heightened all of those feelings. It didn’t help that we had just entered the first national lockdown as this heightened my anxieties
I also started having nightmares. I became anxious about going to bed at night as I couldn’t face the thought of having another dream. Exhaustion would then heighten the anxieties which would lead to panic attacks. It was a vicious cycle. One night a dream was so bad I started having a panic attack whilst still asleep. I woke up to my husband trying to calm me down as I was desperately trying to climb out of bed. I remember the dream was that someone was taking my daughter. Even whilst sleeping, my body had reacted in a panic and I was obviously trying to get to her and save her.
The way my mind looked at the world had altered. It had become used to being alert and looking for danger. There were times it would affect my life greatly as I would avoid going to places or seeing people. When out and about I would find myself looking at the people around me and being on high alert if they got too close. I couldn’t understand why I was reacting to things this way.
My therapist helped me understand that my anxieties around my daughter were a result of having had the constant worry of something going wrong throughout my pregnancy, birth and the re-admission to hospital. I was struggling to accept that my little girl was here, she was safe and well. I was provided with some great techniques to use when these moments happen and they can help to calm my mind and remind it of the reality.
There are two particular techniques that really help me in a moment of panic. The 5,4,3,2,1 senses and the Past and Present technique.
- The 5,4,3,2,1 senses technique really helps to keep your mind in the present. It involves you focusing on 5 things you can see, 4 things you can hear, 3 things you can feel, 2 things you can smell and 1 thing you can taste.
- The Past and Present technique is really useful when experiencing a flashback. It helps your mind to differentiate between reality and past events. It requires you to identify differences between the two moments, for example, “when I had a caesarean I was 30 years old, now I am 32”, “when I was in hospital I was wearing a hospital gown, now I am wearing leggings and a t-shirt”.
It’s been nearly three months since my last flashback but the effects of PTSD are ongoing. A recent miscarriage has triggered off anxieties and disturbed sleep again but I hope with time and by reaching out for additional support, these will ease.
I started a blog called The Maternal Mind (Instagram @the_maternal_mind), it was an outlet for me to write about how I was feeling but I also hoped it might help others who are going through something similar. PTSD can be a very scary and lonely thing to experience and I hope that by sharing my experience of it, it may help to raise some awareness and help others to feel less alone.”
You can find out more about Post Natal PTSD here, and also how birth partners can develop PTSD as a result of a traumatic childbirth here.
NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).
Please remember, the techniques noted in this article aren’t meant to be medical recommendations, but they’re tactics that have worked for others and might work for you, too. Be sure to work with a professional to find the best methods for you.
Image shared with permission from Sian Davies
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It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).
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