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Postnatal Wellbeing

What is Birth Trauma ?

Taken from Birth Trauma Association

 https://www.birthtraumaassociation.org.uk/for-parents/what-is-birth-trauma 

Birth trauma is a shorthand phrase for post-traumatic stress disorder (PTSD) after childbirth. We also use it for women who have some symptoms of PTSD, but not enough for a full diagnosis ( sub threshold trauma).

 

What makes birth traumatic is the fear that you or your baby are going to die. We very often see birth trauma in women who have lost a lot of blood, for example, or who had to have an emergency caesarean because their baby’s heart rate suddenly dipped.

Symptoms of birth trauma (postnatal PTSD)

 
There are four main symptoms:
  • Re-experiencing the traumatic event through flashbacks, nightmares or intrusive memories. These make you feel distressed and panicky.

  • Avoiding anything that reminds you of the trauma. This can mean refusing to walk past the hospital where you gave birth, or avoiding meeting other women with new babies.

  • Feeling hyper-vigilant: this means that you are constantly alert, irritable and jumpy. You worry that something terrible is going to happen to your baby.

  • Feeling low and unhappy. You may feel guilty and blame yourself for your traumatic birth. You may have difficulty remembering parts of your birth experience.

Not everyone who has had a traumatic experience suffers from PTSD, but many do. It’s a completely normal response, and not a sign of weakness. It’s also involuntary: brain scans show a difference between the brains of people with PTSD and those without. PTSD is not something that can be cured by “pulling yourself together” or “focusing on the positive,” despite what other people may tell you.

 

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What is Perinatal Mental Health 
 

Perinatal mental health refers to your mental health during pregnancy and the postnatal years after, sometimes many years after. This could also include emotional difficulties you encountered before pregnancy such as infertility diagnosis or fertility treatment or perhaps sadly, pregnancy loss. You may have struggled with anxiety and low mood before you decided to become pregnant. Perhaps you had an event that had a big impact on your emotional wellbeing. Sometimes these past events can feel difficult to manage and filter when you become pregnant and so start to make you feel upset again. 

 

You could be experiencing a wide range of feelings some of which might only have a limiting  effect on your life, or some which could be making your day-to-day functioning really challenging. Recognising these feelings can be difficult when you’re not feeling your best or when the expectations are that you feel should be really, really happy.  It could mean therefore, that asking for support from health professionals such as midwives or GPs is hard. If you’re experiencing intrusive and frightening thoughts for example, you should not delay asking for that important support.

 

Your mental wellbeing during this perinatal time is so important. If you do experience problems related to thoughts, feelings or behaviour, it’s imperative that you have trustworthy professionals to hand who are trained to support you through this tricky period. I am a skilful and experienced therapist and will help you overcome those difficulties.

Who gets birth trauma?

Some women experience events during childbirth (as well as in pregnancy or immediately after birth) that would traumatise any normal person.

For other women, it is not always the sensational or dramatic events that trigger childbirth trauma but other factors such as loss of control, loss of dignity, the attitudes of the people around them, feelings of not being heard or the absence of informed consent.

There is still a lot of research to be done, but some of the factors that make birth trauma more likely are:
  • Lengthy labour or short and very painful labour

  • Induction

  • Poor pain relief

  • Feelings of loss of control

  • High levels of medical intervention

  • Forceps births

  • Emergency caesarean section

  • Impersonal treatment or problems with staff attitudes

  • Not being listened to

  • Lack of information or explanation

  • Lack of privacy and dignity

  • Fear for baby's safety

  • Stillbirth

  • Birth of a baby with a disability resulting from a traumatic birth

  • Baby’s stay in the special care baby unit or neonatal intensive care unit

  • Poor postnatal care

  • Previous trauma (for example, in childhood, with a previous birth or domestic violence)

Finally, people who witness their partner’s traumatic childbirth experience may also feel traumatised as a result.

So how do we treat this trauma? 

Fortunately, human givens practitioners are taught a simple and effective way to deal with all these

 

circumstances. If a traumatic memory is causing panic attacks, phobias or symptoms post-traumatic stress, they can

 

use a powerful, painless visualisation procedure, known as The Rewind Technique, to take the emotion out of the

 

memory and enable the memory of the event to be stored away as history, instead of as one that continues to

 

intrude on the present. The memory remains, and always will remain, but no longer one that is emotionally arousing.

 

This technique has beed approved of but the Royal College of Midwives and has been shown to  be very quick and

 

effective in dealing with trauma. This method can work swiftly and reliably even in the most extreme of cases.

 

Follow this link to find out more about The Rewind Technique:

https://www.hgi.org.uk/useful-information/treatment-dealing-ptsd-trauma-phobias/rewind-technique

Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. Perinatal OCD is when you experience OCD during pregnancy or in the first year after giving birth.

OCD has two main parts: obsessions and compulsions.

  • Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind. They can make you feel very anxious, although some people describe it as 'mental discomfort' rather than anxiety.

  • Compulsions are repetitive activities that you do to reduce the distress and anxiety caused by obsessions. It could be something like repeatedly checking that you locked a door or repeating a specific phrase in your head. Repeating compulsions is often very time-consuming, and the relief they give doesn't usually last very long.

It's normal to worry about your child's wellbeing and want to protect your baby while you are pregnant and after giving birth. But if you start to experience obsessive and compulsive symptoms that affect your daily life and wellbeing, you may be experiencing perinatal OCD.

The obsessions and compulsions you may experience are likely to relate to feelings about being a parent . 

 

Common obsessions: 

  • intrusive thoughts about hurting your baby, during or after pregnancy

  • disturbing thoughts of sexually abusing your child

  • fear of being responsible for giving a child a serious disease

  • fear of making the wrong decision – for example, about vaccinations or medical treatment.

These thoughts can be very upsetting and frightening. It's important to remember that they are not your fault. Having an intrusive thought doesn't mean that you want to act on it, or that you will act on it.

 

Common compulsions:

  • excessive washing of clothes, toys or bottles

  • avoiding changing soiled nappies because you're worried about accidentally touching your baby inappropriately

  • keeping your baby away from other people in case they hurt them or contaminate them

  • constant checking on the baby – for example, waking them up when they're asleep to check on them

  • repeatedly asking people around you for reassurance that your baby hasn't been hurt or abused

  • going over what happened each day to reassure yourself that you haven't harmed your baby.

It can be very hard to open up and talk to someone about your obsessions or compulsions. But there are treatments and support options which may help.

 

Within a setting of our therapeutic relationship you will begin to feel you can trust again and not feel afraid of being judged.  We can work through these thoughts and fears together. By understanding that the obsessive compulsive thoughts are a way of you managing the anxiety you are feeling, we can start to help you feel more in control and not controlled by your thoughts. 

 

Do you seem to blame others and vent your anger at them. Or do you just feel numb and detached from what happened and that the only way to process it is to keep yourself busy and distracted. All very understandable responses. I completely understand this. 

 

This is such an evocative and sensitive area of the care that I offer.  An unbearable, unthinkable place of sadness coated in inextricable pain and sadness of loss can be too much for us to bear or endure.  Maybe you feel angry, full of self- loathing, or do you feel you need to blame others and vent your anger at them. Or do you just feel numb and detached from what happened and that the only way to process it is to keep yourself busy and distracted. All very understandable responses. I completely understand this. 

Source: 

https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/perinatal-ocd/

Postnatal Depression 

The 'baby blues' is a brief period of low mood, feeling emotional and tearful around 3 to 10 days after you give birth. You are likely to be coping with lots of new demands and getting little sleep, so it is natural to feel emotional and overwhelmed. This feeling usually lasts for a few days and is generally quite manageable. 

Postnatal depression is a much deeper and longer-term depression. It is very different from Postnatal PTSD  but sometimes gets confused. PND usually develops within six weeks of giving birth and it can be gradual or sudden. It can range from being mild to very severe and it can last for quite a while if you do not get support. 

If you have perinatal depression, you might feel:

  • down, upset or tearful

  • restless, agitated or irritable

  • guilty, worthless and down on yourself

  • empty and numb

  • isolated and unable to relate to other people

  • finding no pleasure in life or things you usually enjoy

  • a sense of unreality

  • no self-confidence or self-esteem

  • hopeless and despairing

  • hostile or indifferent to your partner

  • hostile or indifferent to your baby

  • suicidal feelings

As an HG Therapist I can explore how you are feeling and make sure that what you are experiencing is low mood and not a response to trauma. We can set about finding out which of you emotional needs are not getting met well and we can begin to find ways of breaking the cycle of depression that you find yourself in. We will also work on self care and sleep – really important for making sure you are well as well. We will work together to help you find ways to feel more positive.

​Lots of people are aware that you can become depressed after having a baby. But many people also experience anxiety during pregnancy and after giving birth. In fact, it is common to experience depression and anxiety together. Anxiety can be physically and mentally debilitating, very tiring and very consuming. Here are some things you may feel.

The common effects of postnatal anxiety on your body include:

  • a churning feeling in your stomach

  • feeling light-headed or dizzy

  • pins and needles

  • feeling restless or unable to sit still

  • headaches, backache or other aches and pains

  • faster breathing

  • a fast, thumping or irregular heartbeat

  • sweating or hot flushes

  • finding it hard to sleep, even when you have the opportunity 

  • grinding your teeth, especially at night

  • nausea (feeling sick)

  • needing the toilet more or less often

  • changes in your sex drive

  • having panic attacks.

The common effects of perinatal anxiety on your mind include:

  • feeling tense, nervous or unable to relax

  • having a sense of dread, or fearing the worst

  • feeling like the world is speeding up or slowing down

  • feeling like other people can see you're anxious and are looking at you

  • feeling like you can't stop worrying, or that bad things will happen if you stop worrying

  • worrying about anxiety itself, for example worrying about when panic attacks might happen

  • wanting lots of reassurance from other people or worrying that people are angry or upset with you

  • worrying that you're losing touch with reality

  • worrying a lot about things that might happen in the future

  • rumination – thinking a lot about bad experiences, or thinking over a situation again and again

  • depersonalisation – feeling disconnected from your mind or body, or like you're watching someone else 

  • derealisation – feeling disconnected from the world around you, or like the world isn't real 

Using HG tools I can help you to deescalate these anxious feelings and sensations and teach you ways to manage the anxiety.  You will begin to understand the anxiety isn’t you but something you are experiencing and we can find ways for you to see that you are not anxiety. You can be anxious and recognise this but not be of it. 

Client comments are shared with permission

                                                                                                             

Further reading: 

Adams, Shona, and Steven Allan. “Human Givens Rewind Trauma Treatment: Description and Conceptualisation.” Mental health review journal 24.2 (2019): 98–111. Web.

Slater, P.M. “Post-Traumatic Stress Disorder Managed Successfully with Hypnosis and the Rewind Technique: Two Cases in Obstetric Patients.” International journal of obstetric anesthesia 24.3 (2015): 272–275. Web.

Gray, Richard M, and Richard F Liotta. “PTSD: Extinction, Reconsolidation, and the Visual-Kinesthetic Dissociation Protocol.” Traumatology (Tallahassee, Fla.)18.2 (2012): 3–16. Web.

Postnatal Depression

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