Can having a baby give you Post Traumatic Stress Disorder
Yes, say these mothers who have suffered from flashbacks, nightmares and crippling depression…
23:07 GMT, 22 August 2012
Depression: Kelly Barrett has struggled to overcome the traumatic labour she had with son Harry
Sixteen months have passed since Kelly Barrett gave birth to her second son, Harry. Yet still she struggles to discuss his entry into the world. As she recalls the terrifying story of his birth, tears spring to her eyes.
‘I don’t think I’ll ever be able to forget it,’ says Kelly, 28. ‘I wish I could wipe my memory clean, but I can’t.’
Her first son Daniel, now three, was born after a smooth nine-hour labour with no pain relief, so Kelly, from Ashford, Kent, had been looking forward to the birth of her second child in May last year.
But once his head had been delivered, Harry — who weighed 10lb 15oz — became stuck, causing his heart rate to drop.
‘The labour was really fast and intense,’ says Kelly, a full-time mum. ‘Twenty minutes after I arrived at hospital, the room was full of people shouting and machines buzzing. A midwife even started hitting my stomach to dislodge the baby. I’d had no pain relief and was screaming in agony.
‘Somehow I pushed Harry out — he was limp and blue after the cord became wrapped around his neck. The last thing I saw was a midwife cradling my baby, racing from the room with a grim expression on her face. The room went deathly quiet as the door slammed behind her.’
Kelly shouted for her husband Dave, 30, a secondary school teacher, to go with their son, then collapsed on to the bed shaking.
She was haemorrhaging from the tearing she’d suffered. As doctors battled to stop the bleeding, she became convinced Harry was dead.
‘It was just five minutes before Dave returned to say Harry was fine, but they were the longest of my life,’ she says.
While most new mothers quickly shut out any negative memories of childbirth as they bond with their baby, Kelly has struggled to move on from that traumatic day.
She’s suffered from debilitating flashbacks, nightmares and depression, and been diagnosed with post-traumatic stress disorder (PTSD), a condition more commonly associated with survivors of wars, terrorist attacks and major disasters. And while Kelly’s case might sound extreme, it’s far from unique.
A study carried out at Tel Aviv University revealed this month that one in three women who have given birth experience symptoms of PTSD, from heart palpitations and insomnia to a phobia of giving birth again.
Maureen Treadwell, co-founder of the Birth Trauma Association, is in no doubt that these figures are reflected in the UK. ‘We use the term “birth trauma”, which includes women who may not meet the strict clinical criteria for PTSD, but who have some symptoms of the disorder,’ she says.
‘And we estimate that 30 per cent of mothers are affected, with around 10,000 per year developing full-blown PTSD and a further 200,000 suffering some of the symptoms. The repercussions can be devastating.’
So can childbirth really leave mental scars like those of people who have lived through wars
Kelly certainly thinks so. Within a week of giving birth, she suffered flashbacks.
‘The images were so vivid and could hit me at any moment. It was almost impossible to hold it together,’ she says. ‘At night I dreamed Harry had died, which was horrendous, making me dread going to sleep.
‘I didn’t tell anyone how I was feeling because I thought I should be able to just move on, but I couldn’t stop replaying the birth in my mind. I didn’t want anyone to think I couldn’t cope as a mum.’
Susanne with Luka, left, and Claire with Owen: Both new mothers had bad experiences of childbirth which they struggled to forget
However, four months later, Kelly broke down during a routine check-up and was diagnosed with PTSD and post-natal depression. She was sent to trauma counselling.
‘I felt a huge sense of relief that I’d been taken seriously, and that I wasn’t just a bad mum,’ she says.
‘I was put on antidepressants for a couple of months. I talked through the birth, the fears and anxiety, which was painful but really helped. Now the flashbacks have stopped, but I still have the occasional nightmare.’
Simon Mehigan, consultant midwife at Liverpool Women’s Hospital, has dealt with many women who have suffered birth trauma.
A midwife for 16 years, he says that of the 500 women he has counselled in the past three years, 80 per cent have gone on to recover and have further natural births.
‘They are usually referred to me during a second pregnancy when they’ve asked for a Caesarean because they’re too scared of giving birth again,’ he says.
'I would wake up sweating and frightened. It got to the point where I was too scared to go to sleep'
‘Some have had a panic attack just from coming back into a hospital environment to see me. But with the right support, birth trauma can be overcome.’
Simon believes a number of factors are contributing to the increase in women suffering PTSD symptoms.
‘The profile of women giving birth has changed dramatically in the past 20 years,’ he explains. ‘Mothers are older, they have health conditions which, in the past, would have precluded them from having children. Babies today are also bigger. These are all factors which can result in complicated, traumatic labours.
‘Also, the birth rate is rising but the number of midwives falling, so women aren’t getting the one-to-one care they once expected.’
Maureen Treadwell adds that women are not being prepared for the realities of childbirth during their ante-natal care.
‘There’s a culture among healthcare professionals of shielding people from the reality of labour because they don’t want to frighten women. But that just leaves them unprepared and vulnerable to subsequent trauma. Honesty is crucial.’
So have modern mothers — with their expectations of candlelit birthing pools — lost touch with the visceral reality of bringing new life into the world
Susanne Remic, a 34-year-old primary school teacher from Bolton, says trauma should never be underestimated.
While she has never been formally diagnosed with PTSD, she was plagued with flashbacks after her son, Luka, was born by emergency Caesarean in 2009.
Ordeal: One in three women who have given birth experience symptoms of PTSD, from heart palpitations and insomnia to a phobia of giving birth again (posed by model)
‘The birth of my first child, Eva, now seven, ended in an emergency C-section, as she became distressed during the labour, so I requested an elective section with Luka,’ says Susanne, who’s married to Peter, a 34-year-old civil servant.
‘But the hospital postponed it by four days and I went into labour before I could have it. When I arrived at hospital, at 3.30am, I was told I wasn’t in labour but they would admit me because I was a “high-risk” patient. Peter was sent home so I was left alone, in pain, with only two paracetamol. A midwife and a doctor examined me and reiterated that I wasn’t in labour. So why was I in so much pain
‘The next day, I was found to be 7cm dilated and rushed to a delivery suite. Luka’s heart rate began to drop, then stopped completely.
‘It was absolutely terrifying. I remember the eerie silence when the beeps from the monitor suddenly stopped. Then all hell broke loose.
‘Woozy from the gas and air, all I can remember is being rushed down a corridor, crying because I thought my baby was dying inside me.
‘Eyes stared at me from behind surgical masks, just before I was put under a general anaesthetic. It was like a bad dream.’
When Susanne came round, her son had been born by C-section and was being held by Peter.
‘I felt very confused and detached because here was this baby, and I remembered nothing of him coming into the world,’ she says.
In the months that followed, Susanne relived her experience on a daily basis.
‘I would wake up sweating and frightened. It got to the point where I was too scared to go to sleep. I couldn’t enjoy being a mum to Luka, because I was still dealing with the trauma of his birth. I’ll never forgive myself for that.’
When Luka was eight months old, Susanne was diagnosed with post-natal depression by her GP — wrongly, she believes.
‘I’d explained about how I couldn’t move on from the birth, but felt what I was saying was just dismissed,’ she says. ‘I knew I wasn’t depressed and refused antidepressants.’
Instead, Susanne sought support from the Birth Trauma Association, and began to write a blog called Ghostwriter Mummy.
‘I found writing about my experience therapeutic. Being contacted by lots of other mothers helped me feel less isolated.’
Maureen Treadwell agrees that, historically, women with trauma have been misdiagnosed with depression.
She adds: ‘Also, many women have suffered in silence because it was taboo to complain about giving birth. To do so was akin to not loving your child.’
Forty per cent of mothers now ask for a Caesarean with their second child due to a traumatic labour
In Susanne’s case, she soldiered on and when she became pregnant, unplanned, with her daughter Isobel, now aged six months, she hoped her birth trauma was behind her.
‘I was focused on having a good birth,’ she says. ‘I had an elective C-section and it was all very calm and relaxed.
‘But as I held her, I cried not just tears of happiness but of guilt that Luka had come into the world in such an awful way. I knew then I needed some professional help to stop it haunting me.’
As a result, Susanne is about to undergo cognitive behavioural therapy on the NHS, to help her deal with Luka’s birth once and for all.
For some women, even counselling cannot change their minds about giving birth again.
‘When I see pregnant women, I’m relieved I’ve made my decision and I’ll never be in that position again,’ says Claire Wadey, 25, a teacher from West Sussex.
Claire had hoped for a natural water birth, but because her son Owen, now ten months old, was in a ‘back-to-back’ position — the back of his head facing her spine — labour was very painful. ‘I arrived at hospital after labouring for four hours, and was 5cm dilated. I was able to get in the pool for a little while, but the pain was unbearable and I had to get out to have diamorphine.
‘It made me very disorientated, but I remember clearly the fear that something terrible was going to happen.
‘Owen was becoming distressed and had to have blood taken from the top of his head while he was still inside me,’ says Claire, who is married to Grant, a 31-year-old electrician.
‘Nothing could have prepared me for when the obstetrician tried to move part of my cervix. I screamed in agony and begged the doctor to stop, which is when I was taken to theatre.
‘I had to have an episiotomy, a cut that allows the vagina to extend more fully, and Owen was delivered by forceps with his cord around his neck, before I was stitched, which was agonising.
‘Thankfully Owen was fine, but I felt shocked at how brutal his birth had been. For the first week I was just relieved he was OK, but then I had a massive panic attack. I couldn’t understand what was happening to me.’
Claire began suffering from anxiety and had flashbacks to the labour.
‘I couldn’t relax, constantly thinking about the birth, and I told Grant I didn’t want to have another child. I’d been worried about telling him, but he agreed that I shouldn’t take the risk of another traumatic birth.
‘My GP diagnosed me with symptoms of PTSD and post-natal depression. I was prescribed antidepressants and referred for counselling. Talking about the birth helped me deal with it. But it hasn’t changed my mind about having another baby.
‘People say it wouldn’t be the same, and there are times when I do feel guilty Owen will be an only child, but I’m just not prepared to take that risk again.’