Post Traumatic Stress - Traumatic childbirth

Traumatic childbirth can lead to PTSD

Recently there have been many publicised incidents of Post Traumatic Stress Disorder associated with labour and childbirth.  This led us to look at the facts. Some of the ladies in question had reported their ‘labours ‘ as exceptionally hard but some were quite normal.  We all know that having a baby hurts but the pain is soon forgotten but for some women it can leave deep psychological scars; that are less related to postnatal depression, but more akin to the anxiety disorder PTSD.

A case study

According to an article in the Guardian  - "Being raped" is how Liz Darke describes giving birth to her daughter. "I had no control," she says, "over what people were doing to my body, despite being fully alert and explaining again and again the kind of treatment that I did and didn't want. I felt I might as well have been a piece of meat."

During the 18 months following her labour, Liz has experienced the following:

  • Periods of feeling completely detached from other people, including her baby,
  • Has suffered flashbacks,
  • Recurrent dreams of the event,
  • Excessive sweating
  • Anxiety

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Prevalence and symptoms

All of Liz’s symptoms above are akin to post traumatic stress disorder (PTSD). According to the same report Liz is not alone; as many as one in 20 mothers suffer PTSD after giving birth.

Other symptoms and difficulties associated with this specific type of PTSD have been said to include:

  • Losing confidence,
  • Self image disturbance
  • Struggling with breastfeeding
  • Parenting problems
  • A feeling of failure and avoidance of sex
  • Flashbacks and nightmares

What is PTSD?

PTSD was first recognised during the Vietnam War having previously been known as Shell Shock in the First World War.  More recently it has been accepted that PTSD can occur after accidents or disasters and we now seem to have evidence that it can and does occur as a result of traumatic childbirth.  Many of those affected have experienced the birthing process as psychological and physical torture, with emergency caesareans and difficult labours being common causes. 

What are the risk factors?

Very few women who give birth at home are recorded as suffering from PTSD whereas those with difficult, induced or caesarean births are more at risk. According to Jean Robinson, honorary research officer at the Association for Improvements in the Maternity Services (Aims) "It is no coincidence that cases of PTSD rose at the same time as the massive increase in induced labours," she argues.

"Nor is it a coincidence that cases have remained common in births when there are other interventions like revving up the uterus with drugs to speed labour up." She suggests that even "normal" births can lead to PTSD, as women are often left feeling helpless at one of the most important events in their lives. One of Joseph's recommendations is that services need reform precisely to address this issue of helplessness.

PTSD and postnatal depression

It would seem that many women who suffer with PTSD after childbirth are wrongly diagnosed with Post Natal Depression, which is quite different.  This leaves the condition untreated or mistreated.  Most new mothers are checked for Post Natal Depression and ideally should be checked for PTSD at the same time.

The condition sometimes does not manifest itself until a year or so after the birth and leaves young mothers bewildered and angry. With the acknowledgement that they are suffering from this condition comes huge relief.  Just the fact that they know what they are suffering from can bring comfort and easing of symptoms.  Sometimes this alone can bring about complete relief from the symptoms.   

Treatment

For severe sufferers, PTSD can require extensive psychotherapy or drug treatment. But for many just a few session of counselling is all that is needed. The simple acknowledgement that these women had a terrible experience, which wasn't their fault, can make a huge difference.

Critics argue that PTSD is ‘a normal reaction to an abnormal situation’ and that childbirth is a totally ‘normal’ situation.  However, the different types of ‘help’ thrust upon a woman during labour can be traumatic and disturbing and sometimes, if only in their perception, very far from ‘normal’.  What most experts seem to agree on is that the sooner people are able to talk about their experiences and start processing them psychologically, the better their chances of early recovery and long-term mental health.

 Don’t ever feel any sense of shame as we all react to different situations in different ways and you can be sure that no two birth experiences will ever be the same.

If you feel that you could be suffering from PTSD after giving birth your first port of call should be your GP or Health Visitor.

Relevant reading

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