Post Natal Post Natal Post Post

Traumatic Traumatic Stress Stress

DisorderDisorder

What is it??What is it??• A type of anxiety disorder which results

from a traumatic event that involves the threat of injury or death.

• PTSD can be a consequence of a traumatic birth experience

• Approximately 1-2% of women suffer from this disorder

• Causes vary• PNPTSD is often misdiagnosed with Post-

Natal Depression• Treatments are still being researched due

to the fact that it is often mistaken for PND.

CausesCauses

• Mode of Delivery Mode of Delivery

• Fear for child’s life and Fear for child’s life and mother’s own lifemother’s own life

• Lack of ControlLack of Control

• Previous traumatic eventPrevious traumatic event

““The midwife was listening for my baby's heartbeat and asking The midwife was listening for my baby's heartbeat and asking me what was me what was

wrong then she panicked. ‘The heartbeats too low we have to wrong then she panicked. ‘The heartbeats too low we have to get this baby out get this baby out

now, your blood pressure is too high, we need to get a drip into now, your blood pressure is too high, we need to get a drip into you……you are you……you are

going to bleed too much.’ She was so unprofessional I going to bleed too much.’ She was so unprofessional I completely freaked out completely freaked out

and was screaming out for help. My mum and husband were and was screaming out for help. My mum and husband were panicking too panicking too

although they were telling me that everything was okay and although they were telling me that everything was okay and that it’d be alright but that it’d be alright but

I could tell that something was wrong. …..At the same time I I could tell that something was wrong. …..At the same time I had a doctor trying had a doctor trying

to get a drip in my hand and the doctor and midwife arguing to get a drip in my hand and the doctor and midwife arguing that they needed that they needed

more help and the midwife saying that all the other midwives more help and the midwife saying that all the other midwives were busy. That’swere busy. That’s

when they pressed the alarm and suddenly there were loads of when they pressed the alarm and suddenly there were loads of people in the people in the

room. I really thought at this point that my baby was dead, in room. I really thought at this point that my baby was dead, in fact I was telling fact I was telling

myself you have 2 beautiful children already you are so lucky. It myself you have 2 beautiful children already you are so lucky. It was the most was the most

awful feeling in the world and one I wouldn’t wish on my worst awful feeling in the world and one I wouldn’t wish on my worst enemy.”(Lucy)enemy.”(Lucy)

SymptomsSymptoms•   Flashbacks of Flashbacks of

the event, vivid the event, vivid & sudden & sudden memories memories

• Post-natal Post-natal isolationisolation

• Fear of sex and Fear of sex and childbirthchildbirth

• Mother-baby Mother-baby bonding bonding problemsproblems

““I feel utterly robbed. Cheated. You I feel utterly robbed. Cheated. You can’t turn the clock back now so I have can’t turn the clock back now so I have to live with this feeling every day but it to live with this feeling every day but it hurts me to my core. I look at pregnant hurts me to my core. I look at pregnant

women and other mothers and I feel women and other mothers and I feel resentment and anger at their resentment and anger at their

happiness. It’s almost like my baby happiness. It’s almost like my baby died. She didn’t, she’s here, but I am died. She didn’t, she’s here, but I am

grieving. People don’t understand grieving. People don’t understand that, but to me it’s easy. My that, but to me it’s easy. My

daughter’s birth should have been a daughter’s birth should have been a joyous occasion, but I feel only intense joyous occasion, but I feel only intense

pain at its memory. It was the worst pain at its memory. It was the worst day of my life. This was my start to day of my life. This was my start to

motherhood and I’m expected just to motherhood and I’m expected just to get on with it” (Melissa)get on with it” (Melissa)

POST NATAL POST TRAUMATIC POST NATAL POST TRAUMATIC STRESS DISORDER STRESS DISORDER VSVS POST POST

NATAL DEPRESSIONNATAL DEPRESSION

PN PSTDPN PSTD BOTHBOTH PNDPND

FLASHBACKSFLASHBACKSLoss of interest in Loss of interest in previously enjoyed previously enjoyed activities (sex)activities (sex)

Sad moodsSad moods

DISTRUST OF DISTRUST OF AUTHORITY AUTHORITY FIGURESFIGURES

Sleep disturbanceSleep disturbance Thoughts of Thoughts of harming babyharming baby

AVOIDANCE OF ALL AVOIDANCE OF ALL REMINDERSREMINDERS Memory LossMemory Loss Negative/obsessive Negative/obsessive

thoughtsthoughts

INTENSE INTENSE PSYCHIOLOGICAL PSYCHIOLOGICAL STRESS FROM ANY STRESS FROM ANY REMINDERS OF REMINDERS OF EVENTEVENT

Excessive feelings Excessive feelings of guilt and of guilt and inadequacy inadequacy

Body aches, pains, Body aches, pains, headachesheadaches

TREATMENTTREATMENTBecause the symptoms of the two disorders overlap, Because the symptoms of the two disorders overlap,

individuals often become misdiagnosed. They are individuals often become misdiagnosed. They are not dealth with distinctively and idividually as they not dealth with distinctively and idividually as they

should. 25% of women with PNPTSD are not should. 25% of women with PNPTSD are not suffering with PND and thus remain undetected. suffering with PND and thus remain undetected.

Misdiagnosing this disorder for PND often results in Misdiagnosing this disorder for PND often results in the treatments for antidepressants which often do the treatments for antidepressants which often do

very little to help with the situation.very little to help with the situation.

When properly diagnosed, the one treatment proven to When properly diagnosed, the one treatment proven to effectively succeed in treating and individual is effectively succeed in treating and individual is

PsychotherapyPsychotherapy. It will help to develop strategies for . It will help to develop strategies for coping, to reduce and manage anxiety, build a coping, to reduce and manage anxiety, build a

woman's self confidence and self-esteem, identify woman's self confidence and self-esteem, identify negative thoughts and address relationship issues.negative thoughts and address relationship issues.

In addition, support groups, individual counseling, In addition, support groups, individual counseling, Cognitive Behavioural Therapy groups, and Cognitive Behavioural Therapy groups, and

medication are also treatments used.medication are also treatments used.

What Can be Done?What Can be Done?Antenatal EducationAntenatal Education1.1. Managing expectationsManaging expectations

2.2. Empower the woman to choose her own birth Empower the woman to choose her own birth choiceschoices

3.3. Hospital educationHospital education

Improvement of Hospital CareImprovement of Hospital Care1.1. Fully trained maternity staffFully trained maternity staff

2.2. Decent, supportive, and sensitive post natal care Decent, supportive, and sensitive post natal care for all womenfor all women

Post Natal SupportPost Natal Support1.1. Local support networks to help those who feel Local support networks to help those who feel

isolated.isolated.

2.2. Psychotherapy to validate and tackle these issues.Psychotherapy to validate and tackle these issues.

3.3. Recognize difference between PTSD and PND to Recognize difference between PTSD and PND to avoid misdiagnosing and mistreating an individual.avoid misdiagnosing and mistreating an individual.