In the UK, around 30,000 women a year suffer post-traumatic stress after giving birth – but there is help at hand
After a 70-hour labour, with multiple medical complications, my son was born via emergency caesarean. Afterwards, I struggled with flashbacks, intense anxiety, guilt, and anger because it seemed like nobody understood how I felt at the time.
I now know that post-traumatic stress disorder (PTSD) after giving birth affects around 30,000 women every year in the UK – and that this figure likely excludes many more who struggle in silence.
I was fortunate to access birth trauma therapy on the NHS, via my local perinatal mental health team. Although it was daunting at first, therapy has helped me cope with the symptoms of PTSD. I rarely have intrusive flashbacks, and I can now talk about my experience without feeling like I’m back in the hospital ward, going through it all again.
Different therapists have their own approaches to counselling – and often, this depends on the needs of the client. But, here’s what you might expect if you decide to explore birth trauma therapy.
Building trust
Before I began talking about my birth experience, my therapist took time to get to know me. She encouraged me to talk about my job, life, and background, so she could understand my needs, and build a trusting relationship. There was no pressure to immediately start talking about my traumatic experience – she recognised that getting to that would take time.
“When working with someone who has experienced birth trauma, I would start by building trust between myself and the client,” says psychotherapist Laura Wood. “It is important that the client feels safe, knows they will not be judged, and that they have confidence in the therapist’s skills. The client can choose when they start to talk about their birth or pregnancy, and they can talk at the speed that they’re comfortable with.”
While therapists have different approaches, trust is recognised as crucial to all therapies. Numerous studies over the years have suggested that being in a safe and secure environment, with plenty of validation and support, can help promote trauma recovery, including 2022 research in Psychiatric Quarterly.
Going over your experience
Processing trauma is difficult, but necessary. In my weekly sessions, my therapist encouraged me to talk about my birth experience in as much detail as I could manage. We worked through the events slowly and methodically, talking about what happened and how I felt at the time. The more I talked about it, the less intense the emotions felt.
“The client will go over their traumatic experience of birth, sometimes repeatedly and from different angles,” Laura explains. “Common emotions that come up are helplessness, anger, frustration, and disappointment.
While a client is telling a story of something traumatic, it’s important to pause and allow them to focus on what happens in their body when they remember the traumatic event. The emotions that were too painful to be experienced in that traumatic moment may come up to the surface at this point.”
It was difficult, but acknowledging these emotions helped to lessen their hold on me. After each session, my therapist made sure to ‘ground’ me, so I wasn’t left feeling too raw. She did this by asking me to name five things I could see, four things I could touch, three things I could hear, two things I could smell, and one I could taste.
This exercise brought me back to my immediate surroundings, as talking about a traumatic experience can make you feel like you’re reliving it. It also helps to calm your fight-or-flight response which is often activated when talking about trauma.
The value in validation
Another important aspect of birth trauma therapy is feeling validated. When I was in labour, I felt like my pain was being dismissed by the doctors and midwives. Specifically, I remember being told that “everyone asks for a C-section” after requesting one – and feeling angry when I later needed an emergency caesarean.
My therapist encouraged me to open up about my feelings of anger. She also helped me acknowledge that I hadn’t done anything wrong. “It is important that the therapist validates the trauma that the client has experienced,” says Laura. “Validation requires therapists to understand the complex social and political reasons why birth trauma occurs, so the client is seen and understood in context.”
For example, PTSD can occur as a result of unexpected medical interventions, birth injuries, and pain, as well as systemic problems like an understaffed or underfunded maternity ward.
Looking after yourself during therapy
My birth PTSD therapy journey came to an end after six months of therapy sessions. I was happier, the flashbacks were less common, and I felt like I could live my life normally again. When my therapist asked if I could go back to the hospital without feeling distressed, I truthfully said yes.
While therapy was life-changing, it was very difficult. I often dreaded the sessions and, afterwards, I felt emotionally drained. As you heal from trauma, it’s essential to look after yourself. Give yourself time after each session to switch off, instead of going straight back to work or to your baby. Be kind to yourself, and do things that you enjoy. And, importantly, talk to loved ones about how you’re feeling – don’t keep all those difficult emotions to yourself.
If you’re struggling with postnatal PTSD, talk to your doctor or health visitor. You can also self-refer for talking therapy on the NHS, although it may not be specifically tailored to birth trauma. You can also find private therapists via the Birth Trauma Association.
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