Shame, loneliness and disappointment: the hidden burden of post-traumatic stress disorder (PTSD) after childbirth
The ‘ideal birth’ and what happens when it goes wrong
A lovely, perhaps natural childbirth, in relaxed and comfortable surroundings, with pain under control and a supportive birth team…. That is what we would all like and what we expect when we are looking forward to the birth of a baby. In many cases that is what happens, and we can hope that as we become more knowledgeable and assertive it becomes the norm.
But for some women the story is very different. I want to tell you about the less rosy side of childbirth based on my experience of helping women who have PTSD following a traumatic birth experience. This goes by a variety of terms, including post partum PTSD, postnatal PTSD or birth trauma PTSD.
But whatever label is put on this complex condition, one thing that many of the clients who come to my hypnotherapy practice share is a sense of shock at their birth experience. They say they had a very positive view of the birth process before they went into labour. In society today we have fewer children, many women do not have children at all, and those who do usually stop at one or two; so it is now quite common for a woman to face childbirth with little support from anyone with direct experience.
Just a few generations ago home births and large families were the norm. From a young age, girls would have had some idea about what the process of birth involved. Mothers, older sisters, cousins and neighbours would have been much more likely to have experienced birth themselves and to be on hand with the folk wisdom and sense of community which provided a network of support and knowledge.
So birth would have appeared less strange, less alien, less outside of the normal run of life.
Medicalisation of childbirth
Today, the common practice is for birth to be treated as a medical specialty, and in some cases as a medical emergency. This is not to say that all medical intervention is bad – it certainly is not. The fall in the rate of infant and maternal mortality is one of the great advances of modern science, and one for which we can be truly grateful.
But perhaps this medicalisation of the process of birth has come at a very high cost for some women. The birth process can be a traumatic and frightening experience. The alien environment of a hospital, the perceived lack of control and hospital staff who the woman may never have met before can all be problematic. For example, dismissive comments (whether real or perceived) from hospital staff, or the wrong thing said at the wrong time can have an adverse long-term effect. Fears for the baby’s safety during a difficult birth, birth of a sick child with time spent in ICU, previous personal experience of trauma and problems such as painful tears and incontinence that hinder post-natal recovery. It is experiences such as these that can lead to long-lasting trauma which can have lifelong consequences for the mother and for her child.
The symptoms of post natal PTSD can include intrusive memories of the traumatic events, avoidance of anything which reminds the woman of the birth, feelings of isolation, guilt and anger and difficulties in bonding with the baby.
Emotion and memories
Research suggests as many as 10,000 women annually are affected by post natal PTSD. So it is a major problem, but at last it is being recognised – and recognised for what it is – a response to trauma.
Every woman will have a unique and distinct story to tell. Women, especially nowadays, are particularly vulnerable to feeling inadequate. They may compare themselves to other mothers and feel their experience is different and somehow wrong, this may translate into a fear that they will fail to be a good mother. They may feel isolated and unsupported and be frightened to ask for help. There is hope for these women as recognition of post natal PTSD increases and there have been massive strides made in understanding and overcoming the effects of trauma in the last few years. I like to think I am part of this change.
Husbands and partners
Before I sign off, I want to apologise for leaving birth partners out of this post. Often, they can also suffer trauma and I will be addressing this over at my own blog very soon.
Fiona Nicolson is an award-winning Cognitive Hypnotherapist with clinics in Henley on Thames and Harley Street, London. She works extensively with women’s health, and uses a range of techniques to help women get their lives back on track after a birth trauma. She has featured on BBC Radio and is co-publisher of The Hypnotherapy Handbook