Maternal PTSD is affecting 28,000 women a year
A study by City, University of London has found that approximately 3.3% of women in pregnancy have posttraumatic stress disorder (PTSD) and 4% of women suffer from postpartum PTSD. As part of Mumsnet's campaign for better postnatal care, we want to raise awareness of the profound impact that birth trauma can have, in the hopes that more women will seek the treatment they need.
A study by City, University London has revealed that up to 28,000 women per year could be suffering from maternal PTSD. The study's authors are calling for greater awareness of birth trauma and PTSD in new mothers, and say that there is a need for healthcare professionals to receive better training in order to identify women at risk.
The study says: “Findings suggest that perinatal PTSD is linked with some negative child outcomes. Early screening for PTSD during the perinatal period may be advisable and onward referral for effective treatment, if appropriate. Future research using larger sample sizes, validated and reliable clinical interviews to assess PTSD, and validated measures to assess a range of child outcomes, is needed.”
NHS England told the BBC today that it was “improving mental health support for new mums”. However more high-quality studies of postnatal PTSD are needed in order to identify it as early as possible. The lack of awareness among clinical professionals has been cited by Mumsnetters as an issue while they have struggled to get the right, or any, treatment.
One user's doctor seemed to have no idea of the impact a traumatic birth can have: “GPs need to be more aware of this, too, as mine didn't seem to think that I had PTSD and just wanted to stick me on antidepressants. He didn't think birth could be traumatic.”
Traumatic experiences on the postnatal ward can have shattering effects on women and their families. A shocking 19% of women who had a hospital stay say it affected their mental health for the worse; 5% say they developed postnatal depression and that the environment in the hospital after birth was a contributing factor. 20% were frightened for their own or their baby's wellbeing; 15% did not always feel safe during their stay on the ward. 45% were sometimes unable or not able at all to access pain relief when they needed it.
After a traumatic birth, during which a midwife performed an unauthorised episiotomy, one user described her struggle to get a diagnosis for the way she was feeling, which seems to be all too common when it comes to postnatal trauma and PTSD.
“For months, I have been having flashbacks and nightmares of my experience, and I've missed out on so much of my baby's development. My doctor thought nothing was wrong, but eventually recommended a therapist who has diagnosed me with PTSD and postnatal depression.”
Another Mumsnet user who found diagnosis and treatment hard to come by tried various avenues before finally being treated almost 10 years after a traumatic birth: “I had a terrible time. My baby was very ill and no one helped me, I didn't get any help or support from my GP, health visitor – no one. Looking back, I think I had severe PND and PTSD. I had visions of hurting my baby and I wanted to die. Yet I slipped through the cracks in the care system.”
Maternal PTSD symptoms
These signs, according to the Birth Trauma Association, could be an indication of PTSD – if you find you recognise any of them, please do talk to your GP or health visitor:
- Flashbacks, nightmares, persistent distressing images or thoughts (re-experiencing)
- Feeling numb, emotionally, or being unwilling to think or talk about the traumatic experience
- Hypervigilance – feeling constantly on edge and worried that something might happen to your or your baby
- Feeling generally low and upset
- Irritability and sudden anger
- Difficulties sleeping and concentrating
Where to find help
The Birth Trauma Association is a charity helping women who suffer from maternal PTSD. As well as offering a wealth of information about birth trauma and PTSD, they can also put you in touch with counsellors and run a Facebook support group.
Mental health charity Mind has lots of useful information on PTSD and birth trauma, and runs a hotline for anyone who feels they need urgent help.
Make Birth Better campaigns for changes to maternal and postnatal care and is coordinating women's efforts to raise awareness among health professionals and clinicians.
Dr Patrick O’Brien, Consultant Obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG) said:
“For the majority of women, childbirth is a safe and positive experience. However, for some women, it can be a distressing process, particularly for those who have a long and painful labour, develop complications, require an emergency caesarean or assisted vaginal birth, or experience heavy bleeding after birth. Some women may go on to develop postnatal post-traumatic stress disorder (PTSD).
“Women with trauma may feel fear, helplessness or horror about their experience; suffer recurrent, overwhelming memories, flashbacks, thoughts and nightmares about the birth; feel distressed, anxious or panicky when exposed to things which remind them of the event; and avoid anything that reminds them of the trauma – this can include talking about it.
“Women who develop postnatal post-traumatic stress disorder may have a range of symptoms which can significantly affect their quality of life and prevent them from planning to have more children. Symptoms can develop immediately post-birth or not until months afterwards.
“PTSD is not the same as postnatal depression but they can occur at the same time. It is extremely important that timely and specialised support is provided to women. A doctor may prescribe medications and/or recommend counselling or cognitive behavioural therapy. These can help to address fears and provide an opportunity for women to talk through their concerns to help them come to terms with their traumatic experience. Support can be provided by a range of healthcare professionals including midwives, obstetricians, and occasionally perinatal mental health specialists so that the most appropriate choice of care can be delivered.
“Women are encouraged to speak to their partner, friends, family, doctor, midwife or other healthcare professional about their feelings. Talking with someone who was there at the birth about what happened, what they remember and how they felt can really help women to understand what occurred. Speaking with other mums who have had similar experiences can also be beneficial.”
I had EMDR [Eye Movement Desensitization and Reprocessing] for trauma after childbirth. Only diagnosed three years on.
Please ask your GP for help. Ask someone to be your advocate if it is too stressful.
I thought I was being oversensitive about all this at first, but I'm extremely disappointed to hear how frequently it happens. It should be mentioned in antenatal care so women can spot PTSD and seek help sooner.
I had a traumatic birth experience where I ended up having an emergency c-section. At the time I couldn't face speaking about it as I was having horrible flashbacks every time I closed my eyes. Now that I want a debrief, they've never got back to me. I've been referred for counselling but have been told I will only get five sessions.
My psychiatrist essentially told me that, as I was 'articulate, rational and middle class', I'd get over it all by myself and thus don't need any help from the NHS.