Life & Work

Coping with stress disorder after childbirth

baby

A mother and child. PHOTO | FILE

When most of us hear the term ‘PTSD’ or ‘Post-Traumatic Stress Disorder, we think of soldiers who are struggling with dealing with their war experiences after returning to civilian life.

In fact, PTSD was first identified in soldiers during World War I – back then it was referred to as ‘Shell Shock’.

Over the past few decades, mental health practitioners have come to understand that it also happens in victims of violent crimes, rape, road accident or shipwreck victims, fire casualties and people who have survived bombings, building collapses and natural disasters like landslides, earthquakes, tornadoes and tsunamis.

If you hear someone say ‘‘I survived a bus accident and now I’m traumatised,’’ you will likely sympathise with them and try and offer support and understanding. However, if you hear a woman say ‘‘Giving birth to my child has left me traumatised,’’ you are less likely to be supportive — especially if she has a happy healthy baby.

PTSD related to childbirth is frequently overlooked by doctors and midwives. In fact, it has only recently been acknowledged by medical personnel.

A large number of medics (and society in general) still think women who exhibit PTSD after childbirth just need to ‘deal with it and stop whining! —after all, childbirth is a natural process which many women for countless generations have gone through without much ado’.

However, approximately 10 per cent of women experience post-traumatic stress disorder (PTSD) following childbirth.

Most often, this illness is caused by a real or perceived trauma during delivery or immediately after. It is more common in first time mums.

What childbirth event could lead to PTSD?

Giving birth to a stillborn (dead baby).

Prolonged unsuccessful labour with delivery eventually being done via emergency cesaerean section.

Hospital staff issues: Verbal and physical abuse, impersonal treatment, judgemental attitude of the staff.

Staff who do not believe or listen to anything the mother in labour says. Medics who lack of attention to dignity (for example, not covering her or closing the curtain during examination, performing invasive procedures without explanations or consent).

Women who have experienced a severe physical complication or injury related to pregnancy or childbirth, such as large tears in her genital area or who experience a large amount of bleeding resulting in unexpected hysterectomy (removal of her womb), life-threatening high blood pressure, fits, or heart disease etc.

Extreme pain: Although labour is painful, women who have to have induction (medication is given either to make them go into labour or hasten the progress of their labour) often report extreme pain. Women who get vaginal tears repaired without adequate local anaesthesia can also be left traumatised.

Baby going to new born intensive-care unit because they are either premature or have begun their lives in critical condition (either due to birth complications or congenital defects).

Women who have experienced rape or sexual abuse are at a higher risk for experiencing post-delivery PTSD.

Labour is a particularly vulnerable time for a woman. It is often accompanied by feelings of loss of control and powerlessness.

Any feelings of lack of support either by spouse or hospital staff or conflicting advice given to her about how to manage herself can lead to future distress.

Some women have even commented that ‘though I was surrounded by people, I felt all alone’. Women in labour need good communication, support and reassurance during the delivery

Symptoms of post-delivery PTSD include:

Repeatedly experiencing the distressing events around the birth through flashbacks or nightmares.

Attempts to avoid places and people who remind her of the birth experience such as hospitals and it’s staff members (some women even miss doctor’s appointments and post-delivery clinic visits).

Some women project their feelings on to the baby and may avoid handling him/her or may be unable to breastfeed.

Difficulty sleeping/insomnia.

Heightened anxiety sometimes accompanied by panic.

Irritability and concentration problems.

PTSD may also be accompanied by depression and anger.

Some women also report feeling a sense of unreality, detachment, numbness and isolation

Consequences of traumatic birth experiences

Some women decide never to have a baby again.

Some avoid vaginal deliveries in the future and opt to have scheduled/elective C-section.

Some avoid hospital births and opt to give home under the care of a local midwife or traditional birth attendant (this is very common in rural areas in Kenya).

Ways in which a husband/partner can help

Be calm and supportive —even though you don’t quite understand what she is going through.

Take time to just listen to her — even though she may sound repetitive. Realise you may not be able to ‘fix her problem’ but listening to her express her feelings is often therapeutic

Offer to go with her to the doctor or clinic.

Try to do helpful things without being asked— assist around the home.

Play an active role in caring for the baby – even if you have a nanny. That bonding process between the three of you (mother, father and baby) is crucial.

She is likely to be surrounded by people who don’t understand what she is going through or people who even belittle her and call her ‘weak’ because she has PTSD. Shield her from these people and their unwanted opinions – they do not help with the healing process. In fact, they will often set her back.

Understand that sex drive and desire is usually not high at this time and do not take her disinterest as rejection of you as a man.

Realise that on some days she may not be her usual rational self and emotions will occasionally run high. On such occasions, take some time away from the situation and deal with it once things have settled down.

Take care of yourself. Do not use work, alcohol, another partner, gambling or partying as something to help you deal with her unusual behaviour. The consequences are often dire

PTSD puts great strain on a relationship and do not be afraid to seek marital counselling to help you cope.