Monday, May 16, 2011

When birth is trauma

I came across this article written by Elizabeth Ford published in Midwife Thinking Blog
"For most women, birth is not the blissful event of three easy pushes and welcoming their precious baby into the world. Even for those women who have a short straightforward vaginal birth, it can be a tough slog and a real test of the depth of their resources. However, for some women, birth is much more than that. It is a physical and psychological trauma. The aftermath of a traumatic birth can affect a woman for months or years and impact on her bond with her baby, her relationship with her partner, her decision to have another baby and even her willingness to engage with future health care.

Birth as a trauma
Childbirth is a common event in society so is viewed by most people as “normal”.  It may therefore be difficult to understand how it can be traumatic for some women. However, case studies and other research make it clear that women can suffer extreme distress as a consequence of their experiences during childbirth. A small proportion of pregnancies and births involve events that most people would agree are potentially traumatic, such as stillbirth, severe complications, or undergoing invasive medical interventions without effective pain relief.  Other women may have a seemingly normal birth but feel traumatized by aspects such as loss of control, loss of dignity, or the dismissive, hostile or negative attitudes of people around them.
Post-Traumatic Stress Disorder
Recently it has become recognised that women who experienced a traumatic birth can develop post-traumatic stress disorder (PTSD). Some women experience childbirth as threatening and frightening and go on to develop PTSD symptoms.
The American Psychiatric Association defines the symptoms of PTSD as (1):
  1. Persistently reexperiencing the event, by flashbacks, nightmares, intrusive thoughts, and intense distress at reminders of the event.
  2. Persistent avoidance of reminders of the event, and emotional numbing and estrangement from others
  3. Persistent symptoms of increased arousal. This means difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance or an exaggerated startle response
For a diagnosis, patients must report experiencing all three types of symptoms for longer than one month. Many women (around 30%) experience these symptoms in the days or weeks following birth, and this is a normal way of coming to terms with a stressful or overwhelming event. It is only when symptoms do not get better that PTSD is diagnosed (in 1 to 5% of women). "

You can read the rest of the article on Midwife Thinking Blog

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