Birth trauma and Post Traumatic Stress Disorder (PTSD) occurring after childbirth. Whilst PTSD is normally associated with events such as traffic accidents, war-related experiences, and large-scale disasters, people can suffer from PTSD following a traumatic perinatal experience. PTSD is caused by the failure of the brain to process memories in the normal way, so that a trauma and fear that happened in the past still feels real and present. People suffering from birth trauma may constantly be reliving what happened in their mind, may be experiencing flashbacks, nightmares, feel overly emotional or hyper vigilant. These symptoms are the mind's way of trying to make sense of an extremely scary experience. Everyone experiences PTSD differently but almost all describe themselves as lonely, anxious and exhausted. In some cases, due to lack of awareness and education, woman are mistakenly diagnosed as having postnatal depression, whilst birth partners and healthcare professionals are diagnosed as having depression. Whilst these illnesses share some symptoms they are separate and require different treatments. Trauma and PTSD symptoms can be treated quickly, often in one session and do not require medication; trauma or PTSD untreated however can cause depression which may require medication.
Mothers - Around 6% of women are diagnosed with traumatic stress after childbirth. However, it is believed that a further 20 – 25% of women have symptoms that go undiagnosed. This statistic concerns birth trauma and therefore overall perinatal trauma, such as fertility, pregnancy or postnatal trauma is potentially a lot higher. This trauma can not only cause postnatal depression, it can effect bonding with your baby, your relationships with your family members and cause anxiety. In extreme cases it can cause a mother to take her own life. The cause of perinatal trauma is unique to each woman however some may experience trauma from the experience of feeling loss of control, not feeling listened to, fear of their babies safety, induction of labour, premature birth, medical intervention, an unwell baby resulting from birth trauma, baby's stay in SCBU/ NICU, unsatisfactory postnatal care or emergency situations like an emergency caesarian birth or postpartum haemorrhage, breastfeeding problems or repeated sleep deprivation. It is important to mention that an uncomplicated physiological vaginal delivery, may still have felt very traumatic to the mother. Please read the blog we did for the Fathers Network Scotland on Father’s and birth trauma here.
Fathers, birth partners - Fathers and birth partners can experience birth trauma from witnessing a traumatic birth or experience. They may have experienced an intense fears of harm to the mother and newborn or partner pain, feelings of anger and helplessness when they were excluded from decision making or denied the ability to provide support, or fear of high-risk intervention. They may have experienced a traumatic postnatal experience or a previous loss of a baby. They may feel traumatised for the same reasons as mothers.
Healthcare professionals- Including midwives, obstetricians, nurses, theatre staff and clinical support workers, maternity support workers and students. Like fathers and birth partners healthcare professionals can also experience trauma. In fact research shows that at least one in 20 midwives have experienced symptoms of PTSD. This can be from being involved in the care of a traumatic birth, being involved in or feeling responsible for an adverse outcome, the trauma of an investigation, the stress of short staffing and bullying.
For more details on the causes of birth trauma and PTSD please see the Birth Trauma Association website.
Common signs and symptoms of perinatal trauma (MIND.ORG.UK)
Re-living aspects of the trauma
vivid flashbacks (feeling that the trauma is happening all over again)
intrusive thoughts and images
nightmares
intense distress at real or symbolic reminders of the trauma
physical sensations such as pain, sweating, nausea or trembling
Alertness or feeling on edge
panicking when reminded of the trauma
being easily upset or angry
extreme alertness
disturbed sleep or a lack of sleep
irritability and aggressive behaviour
lack of concentration
being easily startled
self-destructive behaviour or recklessness
hyper vigilant (feel jumpy or on their guard all the time)
Avoiding feelings or memories
keeping busy
avoiding situations that remind you of the trauma
repressing memories (being unable to remember aspects of the event)
feeling detached, cut off and emotionally numb
being unable to express affection
using alcohol or drugs to avoid memories
Trauma and grief are intrinsically linked. Whilst trauma is an event, grief can be the response to the trauma. There is no getting away from the fact that grief and loss are traumatic. This 'traumatic grief' sometimes inhibits the neccessary grieving process, or blocks it altogether. The natural healing process of grief is an important one and where needed and wanted there is a lot of wonderful support out there to support you on this journey. In Edinburgh, this includes Lifeline Pregnancy Counselling and The Stillbirth and Neonatal Death Society. If however you feel after some time you can not move on from your loss, or have noticed that you are experiencing some of the signs and symptoms of PTSD mentioned above, then Birth Trauma Resolution may help you let go of the trauma so you can grieve naturally and peacefully. This allows you to hold on to the good memories and let go of the traumatic ones.
Mothers and birth partners may experience traumatic grief from the experience of miscarriage, termination of pregnancy, fertility problems including failed fertility treatments, the experience of having a stillborn baby and the loss of a baby.
Tokophobia, is an extreme fear of childbirth that can be triggered by thinking or even talking about pregnancy. Around 14% of women experience Tokophobia. It can predates a woman’s first pregnancy or it is can be a direct consequence of a previously traumatic delivery.
Feeling a certain level of anxiety about childbirth can be a normal response, and may even be useful in motivating pregnant women to prepare themselves for the birth. However a woman who is tokophobic will have a lot more “severe” thoughts and worries that affect their lives every day. She may experience symptoms of PTSD regardless of whether or not she has ever given birth before.