Are you aware of Post Partum PTSD?
My name is Christy and I blog on Welsh Mum of One (www.welshmum.co.uk). I have a 6 month son and I write about pregnancy, newborns, infants, health and mental health, as well as travel and local attractions. You can keep in touch with me on Twitter (www.twitter.com/welshmumofone) or Instagram (www.instagram.com/welshmum).
I'd like to take the time to talk about post-partum post traumatic distress disorder - or PPPTSD, now that's a bit of a mouthful! Many women suffer a traumatic experience either before, during or after birth. It doesn't matter whether it was a 2 hour labour or a 50 hour one, whether it involved a natural birth or a C-section - this illness is caused by any sort of trauma that occurred during delivery or during the recovery period. Trauma is different for everyone, and every birth experience is valid (http://www.welshmum.co.uk/birth-experience-is-valid/).
Some of the more common physical things that women can find traumatic are
· Unplanned C-section
· Use of vacuum or forceps during delivery
· NICU stay or emergency treatment being needed for baby
· Induction procedures
· Short (precipitous labour) or extended labour times
· Unexpected medical treatment being needed for mum
· Perineal trauma (tearing)
But that's not all. Even a birth plan that goes relatively well by medical standards can result in trauma if the woman feels
· Powerless during delivery
· Uncertain of what was happening during or after birth
When I was going to my midwife weekly towards the end of pregnancy, we did discuss of course birthing techniques and briefly touched on the possibility of needing a C-section, but very little of the practicality of it was discussed. Anything I knew, I knew from reading previous birth experiences - something not every woman does. On top of that, post-partum depression (PPD) was discussed quite a bit, but the fact that women get PTSD from the birth experience was an unknown concept to me, so I didn't know what to look out for. Ultimately the more knowledge we are armed with, the more we can dispel the feelings birth gives of anxiety, powerlessness, uncertainty and fear.
My personal traumatic experience stemmed from an induction due to pre-ecylampsyia, a failed epidural so limited pain management and then an emergency C-section followed by an extended (10 day) hospital stay due to serious infection in both myself and my son. I also suffered from anxiety beforehand, which put me at a higher risk. We came through it and I'm glad to say we have both recovered physically, but mentally 6 months post-partum I am still in the infancy of my mental recovery, which is something I never expected.
After the birth I experienced - and still experience - severe flash backs, nightmares, anxiety and panic attacks on a near daily basis. It took me several months to admit that I was struggling, and I finally did this to the health visitor - who I had been avoiding opening up to as I had some quite bad associations with medical professionals. She was very approachable but I still struggled to put into words what I was feeling and I was quite frankly, terrified. What really pushed me into talking to her was that my mother ended up in hospital with gallstones. It wasn't life threatening, but she had an infection and was in hospital for a week. I was suffering panic attacks when going to the hospital and eventually my husband wheeled her outside so I could visit. The negative associations with the hospital were just too strong and I knew that wasn't normal. I worried about what might happen if I had to go into hospital, my husband or my son and I knew I had to get on top of this. Even the little I did convey worried her and she really pushed me into making an appointment with the GP.
Some of the symptoms to look out for are
· Intrusive thoughts
· Re-experiencing the traumatic event
· Flashbacks or nightmares
· Avoiding things that you associate with the event
· Difficulty sleeping
· Irritability, difficulty sleeping, easily started, exaggerated nervous responses
· Heightened anxiety
· Panic attacks
· A feeling that things aren't real or detachment from things
If you experience any of these post birth, you need to talk to a medical professional. This can be a midwife if you are still under midwife care, your health visitor, or your GP.
At that first appointment we talked about medication options and therapeutic options. We both agreed that we would try without medication first, but my GP made it very clear that she understood how I was feeling and that she treated other mums who felt the same way, who had been helped return to normal both with and without medication. I was referred to my local mental health team and an assessment was made over a 1 hour phone conversation that involved lots of tears! I would need one on one therapy sessions and group support as well. At every step of the way everyone was incredibly understanding.
In the end I do need additional help from medication and if you'd told me that a year ago, I'd have felt ashamed. I don't feel any shame in it though, because I've been supported every step of the way and helped not to feel guilt or stigma. It remains very hard to talk about, but I do think that it needs to be discussed so women can recognize the symptoms and get help as early as possible. I delayed and suffered unnecessarily because I was afraid to acknowledge it, so if anyone out there is in the same situation, please believe me when I say that you do not need to be afraid to talk to your medical team about this and it does get better!
I feel positive about my future now, even though I’m still undergoing treatment. Writing this with my 6 month old son napping beside me, one thing I know for sure is this has all been worth it, no matter how hard the journey has been.