The birth of a child is a major event, both physically and emotionally.  For many, although a challenging experience, it is also a welcome one.  Feeling physically and emotionally prepared for the birth, having a birthing plan and feeling that medical staff are supportive and able, all contribute to childbirth being a positive experience.

For a significant percentage of women, however, childbirth can be experienced as a traumatic event. This is more likely to happen when women feel out of control during labour, when they do not feel heard or supported by medical staff, or when they have poor pain management or obstetric complications, such as instrumental delivery or emergency Caesarean section.  Even when the birth has gone relatively smoothly, parents may feel emotionally disturbed and traumatised by the experience.

Repeating the story of a baby's birth, often many times over, is a natural way in which women help themselves to emotionally process and come to terms with a very powerful and often disturbing experience.  Sometimes, if the birth felt emotionally overwhelming, it can be helpful to seek professional help. This may just involve one session, or might require more extensive help.

Feeling traumatised by a birth can sometimes lead to mental health problems. In the immediate aftermath of a traumatic birth, up to 60% of women may experience some symptoms of post-traumatic stress disorder.  This falls to about 4% still experiencing significant problems a year later.  About 15% of women experience postnatal anxiety; 10-15% may experience postnatal depression.

Sadly, about 15% of all pregnancies result in loss, either early in pregnancy (miscarriage) or later on (stillbirth).  Such loss, that is often sudden, may be accompanied by deep feelings of grief, anxiety and depression and may affect the relationship between the couple.  About 25% of women experience chronic post-traumatic stress disorder after a pregnancy loss.
Post Natal Post-traumatic Stress Disorder (PTSD)
How do I know if I'm suffering from post natal post-traumatic stress disorder?

Trauma is generally understood to mean that a person feels themselves or an other (your baby, or from the father's perspective, both his partner and their baby), to be threatened by serious danger, damage, injury or death.  At such times, we are liable to feel overwhelmed and helpless.

PTSD is an anxiety disorder characterised by intrusive thoughts that relive the event: memories, flashbacks, nightmares.  Increased irritability, sleep problems, feeling on edge; or feelings of numbness and estrangement from others and the world, are all common symptoms.

Whilst many women experience some or even all of these symptoms in the immediate aftermath of a traumatic birth, fortunately, for most people, they tend to fade away within the first few weeks. For some, the symptoms and the distress associated with them, lasts for longer and may be associated with postnatal depression or difficulties in bonding with the baby.  The couple may struggle with their relationship, sexually and emotionally.

Although it is the woman who has the baby, being an observer to a birth can also stir up disturbing and overwhelming feelings in fathers.  Both fathers and mothers can experience postnatal post-traumatic stress.  Sometimes anxieties settle down, but re-emerge strongly when a couple may want to consider having another baby.  This can lead to feeling extremely apprehensive about another pregnancy or birth , avoiding another pregnancy, or to pre-natal PTSD.

How can we help?

There is evidence that emotional preparation for childbirth – talking about hopes, fears, plans, how to cope if things don't go to plan and working together as a couple, all help women and men deal with the powerful experience of childbirth.  Facing Parenthood therapists offer help with preparing for birth:

Preparing for Parenthood Groups: for Couples, Pregnant Women and Fathers-to-be

Preparing for Parenthood Weekend Workshops: for Couples and for Pregnant Women

Individual and Couple Counselling and Therapy may be indicated if you feel anxious about a birth; when thinking about another baby after a traumatic birth; or if as a couple, you are experiencing stress in your relationship around the birth plan.

At Facing Parenthood we have a number of therapists with particular experience of helping people with PTSD associated with childbirth.  NICE Guidelines on Antenatal and Postnatal Mental Health, recommend the early diagnosis and psychological treatment of mental health problems associated with pregnancy, birth and the first year after birth, (known as the perinatal period).

For some people, the opportunity to work through feelings of distress associated with a birth in brief or longer-term counselling or psychotherapy is helpful.    

For others, specific treatment like Cognitive Behavioural Therapy  (CBT) has been shown to be helpful.

If the problems have become located mainly in the relationship between the couple, going together for counselling or therapy might be most helpful.
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