What can we do to prevent post-traumatic stress disorder after birth? #pregnancy #birthtrauma

pregnant womanEmma gave birth after a long and exhausting labour. But the worst was yet to come: only part of the placenta was delivered, and Emma became aware of the room filling up with people and the mood changing. Although she was told that all was fine, she knew something was wrong.

A consultant walked in and, without acknowledging Emma, attempted a manual removal of the placenta, which Emma describes as “the most painful thing I’ve experienced to this day. I don’t think I’ll ever get over the shock of it”.

Blood started spurting out and hitting the walls, which Emma’s husband was later to describe as like something from a horror film. The consultant looked at Emma, said, ‘You need to come to theatre now – we need to give you some stitches,” and walked out the room.

Physical recovery from the birth – she suffered a third degree tear – was slow and painful. For several days she lay in bed being pumped with morphine and codeine. But the emotional scars lasted much longer. “It felt like I was reliving it every minute of the day in my head,” she says. Watching or hearing anything relating to birth induced feelings of panic. When I interviewed her for my book on birth trauma, nearly two years after her daughter was born, she still hadn’t fully recovered emotionally.

Emma was suffering from post-traumatic disorder (PTSD), a mental health disorder characterised by vivid flashbacks, hyper-arousal (being extra alert and anxious) and avoidance (staying away from anything that reminds you of the trauma).

PTSD is usually associated with soldiers returning from war, though doctors now recognise that it can be experienced by people who have experienced other kinds of trauma, such as rape or car accidents. People who have witnessed a terrible event (such as a murder) can also suffer from PTSD.

And there has been a gradual increase in awareness that a difficult birth, such as that experienced by Emma, can also lead to PTSD – the Birth Trauma Association estimates that 10,000 women in the UK may suffer from it each year.

Many of those women suffer in silence: as a recent report found mental health problems after childbirth are under-diagnosed and undertreated.

Because so little is still understood about the causes and treatments of PTSD after birth, I’ve created a blog, Birth Traumas, to gather news and information about the condition.

Kim THomasSo what can be done? Women suffering from PTSD can be treated with specialist therapeutic techniques such as trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing therapy (EMDR) – though, sadly, there are often long waiting lists for these treatments on the NHS.

More importantly, there is much that doctors and midwives can do to prevent PTSD. Women who have experienced trauma (such as sexual abuse) in the past should be identified, as they are particularly at risk.

Emma’s story has features familiar to many who suffer from this condition: feelings of powerless; a lack of communication from health professionals about what has gone wrong; and a lack of sensitivity in carrying out medical procedures.

By putting the woman’s needs and feelings first, doctors and midwives can minimise the feelings of panic and fear that so often lead to PTSD after birth.

This is a guest article by Kim Thomas, author of Birth Trauma: A Guide for You, Your Friends and Family to Coping with Post-Traumatic Stress Disorder Following Birth


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