We may live in an age of increased awareness around mental health, but some conditions remain shrouded in mystery and carry greater stigma than others. Post-traumatic stress disorder (PTSD) is common, affecting nearly a third of people who have a traumatic experience, but it's still often only considered in the context of military combat or terrorist attacks.
However, many women become crippled by the anxiety disorder following one of the most universal female experiences of all: childbirth. Birth trauma can be triggered by unexpected and traumatic experiences during labour, including an arduous, long and painful delivery, an unplanned Caesarean section, or emergency treatment.
Following a traumatic birth, according to Mind, a woman may relive the experience through vivid flashbacks; experience intrusive thoughts and images, and nightmares; feel particularly alert or on edge and panicky, with trouble concentrating and difficulty sleeping; engage in avoidance strategies such as repressing memories, alcohol or drug abuse, and experience feelings of detachment from her new baby and partner.
Dr Sarah Carter is a peer support group leader for PANDAS UK, a national charity offering support with pre- and postnatal mental illnesses. "In my experience, the most common reasons women develop PTSD after childbirth are that they feel traumatised by the physical experience of birth, by the way they were cared for during birth, or a combination of both. A traumatic birth can be incredibly frightening and can leave new mothers feeling afraid, numb and helpless, especially if they experience this without the support of the people around them during labour and birth."
Twenty-six-year-old Maria Turner (not her real name) experienced PTSD symptoms after the births of her two children, aged three and one. She lays part of the blame for her diagnosis on the insufficient care she received after the traumatic birth of her second child, as well as the physical trauma she endured. Here, she shares her story with Refinery29 UK.
I had a traumatic experience giving birth for the first time. Thirty-six weeks into my pregnancy I got pre-eclampsia. I've got a family history of that and stillbirths, so that set off alarm bells straightaway. They tried to induce me but it failed and then I was given a Caesarean section and received a spinal which didn't work, so I felt the pain of the C-section while it was happening. They asked me whether I wanted to be put under a general anaesthetic but I said no because I didn't feel well informed enough to make that decision. My daughter became stuck and the obstetrician was on the table on top of me, pulling her out. Then they had to make an extra incision, so I've got a t-shaped scar inside me. My baby came out very small but she was fine and, while the experience was traumatic and I didn’t get much help on the ward afterwards, I was generally okay. But then I got pregnant just seven months later and my second birth was much worse.
Thirty-nine weeks into my second pregnancy, I had a uterine rupture at home. My previous C-section scar completely opened itself, so my son was basically in my abdomen and they didn't know this until I was already in surgery and I was put under general anaesthetic, so I wasn't aware of any of it. He wasn't breathing when he was born and because I was under, I didn't know. I didn't meet him for seven hours. An obstetrician told my partner and I that we had a miracle baby who shouldn't have survived and I was lucky not to have died.
The intrusive memories would replay themselves over and over again.
No one properly explained to us what had happened for three days, and this lack of information definitely contributed to the PTSD. No one explained what was happening but they knew what was going on and how rare my experience was. I felt lonely and none of the health professionals seemed to know what a uterine rupture was, so they didn't know what I was talking about. Another factor was that I became severely ill with viral meningitis seven weeks after he was born and had to spend three weeks in hospital separated from him.
I had flashbacks – there was a time when I'd replay his birth in my head every day. I’d be having a bath and wouldn't want to be thinking about it but the intrusive memories would replay themselves over and over again. Another of my symptoms was OCD, which I've always had to an extent. I'd wash my hands excessively and they became very sore because I was trying to be very clean around him. Whenever my partner washed bottles I’d look at them and automatically think they weren’t up to my standard of cleanliness and I'd have to do it all again. This habit was much worse after my second birth because of the PTSD. At other times I became overprotective and wouldn’t be able to share him with anybody. Other times, especially when I came out of hospital when he was about nine weeks old, I felt really inadequate and that I wasn't good enough to be his mum.
The PTSD also affected my relationship with my partner. I was exhausted and at times I was really emotional – I think I felt let down by the whole experience of the healthcare system – so I became angry towards my partner because, emotionally, he deals with things very differently. I would overthink everything, like 'Why did they let me go to 39 weeks pregnant and not do a C-section sooner?' and he would just say, 'Well there’s nothing we could have done,' and be really sensible about it. I was angry with him for not being angry and for not thinking in the same way as me, which I now realise was irrational. We spent a lot of time apart, but he has a lot of patience and waited for me to realise I needed help.
It would take serious consideration for my physical and mental health to get pregnant again.
As well as finding my local PANDAS support group, I paid privately for a type of birth trauma therapy called 'rewind' therapy, a method of treating PTSD that involves reliving the traumatic event. Three sessions of immersing myself in it enabled me to box away the memory. It completely stopped the flashbacks and changed my life. Now, if I want to think about the events, I have to properly think about what happened, rather than it just being in my head all the time, which is incredible.
I'm still coming off my anxiety medication – I have a permanent daily headache and chronic fatigue from the viral meningitis – so we did it slowly to not interfere with any of that. But I'm now in a good place with my mental health and I'm becoming a PANDAS leader. Although once you've been through something like that you're probably never going to lose it completely.
I wouldn't rule out having another child because I'm so young, but I've definitely been scarred and it would take serious consideration for my mental and physical health to get pregnant again. During a debrief at the hospital after my second birth, the doctors told us a third pregnancy would be possible, but it would be seriously scary. It almost would've been easier to deal with if they'd said that, no, medically you can't get pregnant again.