Postnatal depression and perinatal mental health

Explains postnatal depression and other perinatal mental health issues, including possible causes, sources of treatment and support, and advice for friends and family.

What is PTSD and birth trauma?

You may develop post-traumatic stress disorder (PTSD) if you experience:

  • a difficult labour with a long and painful delivery
  • an unplanned caesarean section
  • emergency treatment
  • other shocking, unexpected and traumatic experiences during birth

This is also called birth trauma. The impact of these experiences is often underestimated, as people may feel that the baby is adequate compensation for the trauma and that, as a new mother, you will soon forget it in the joy of motherhood.

However, a traumatic childbirth and developing PTSD can impair your relationship with both your baby and your partner. You may feel acute disappointment that childbirth was not the experience you were hoping for, and feel angry with the medical staff if you felt that the delivery wasn’t handled well. If you develop PTSD, you're likely to also experience flashbacks or unwanted memories of the traumatic birth.

This might mean you feel anxious about having another baby.

This page covers:

"I had a traumatic birth. I was so petrified that my son would die that in my head it was easier not to love him just in case."

What are the common signs and symptoms?

Re-living aspects of the trauma

  • vivid flashbacks (feeling that the trauma is happening all over again)
  • intrusive thoughts and images
  • nightmares
  • intense distress at real or symbolic reminders of the trauma
  • physical sensations such as pain, sweating, nausea or trembling

Alertness or feeling on edge

  • panicking when reminded of the trauma
  • being easily upset or angry
  • extreme alertness
  • disturbed sleep or a lack of sleep
  • irritability and aggressive behaviour
  • lack of concentration
  • being easily startled
  • self-destructive behaviour or recklessness

Avoiding feelings or memories

  • keeping busy
  • avoiding situations that remind you of the trauma
  • repressing memories (being unable to remember aspects of the event)
  • feeling detached, cut off and emotionally numb
  • being unable to express affection
  • using alcohol or drugs to avoid memories

What are the treatments?

The treatments for PTSD are primarily talking treatments:

  • Trauma-focused cognitive behavioural therapy (CBT) which is specifically designed to treat PTSD. See our pages on CBT for more information.
  • Eye movement desensitisation and reprocessing (EMDR). In this treatment you are guided by a therapist to make rhythmic eye movements while recalling the traumatic event. The eye movements are designed to stimulate the information-processing system in the brain. The aim of the treatment is to help you process the traumatic events, and speed up re-adjustment and recovery.

Medication is not normally offered to treat PTSD but, as it is common to also experience anxiety and depression alongside PTSD, your doctor might offer you medication to treat this. Your doctor might also offer you medication to support you to feel more stable and able to care for your baby, or if there's a long wait for talking treatments in your area.

See our page on treatments for PTSD for more information.

How can I help myself cope?

Coping with the after effects of a traumatic birth can feel very challenging, but there are some things you can do to help yourself cope:

  • Learn to manage difficult emotions. If you find yourself struggling with strong feelings of anger or anxiety, it can be helpful to think about ways to manage these emotions. See our pages on coping with anger and anxiety, and our page on managing difficult emotions, for ideas.
  • Learn some relaxation techniques. You might want to try meditation, breathing exercises or mindfulness to stay calm and manage your triggers.
  • Give yourself time. It can feel frustrating to be struggling with PTSD symptoms, and it's easy to get angry with yourself for not 'getting over' it. But recovering from a trauma takes time, and it's important to allow yourself space to do so. Putting pressure on yourself to get better can end up making you feel worse. Make a note reminding yourself to take time to recover, or ask loved ones to remind you whenever you're struggling that recovery takes time.
  • Contact specialist organisations. The Birth Trauma Association has more information about birth trauma and PTSD, including support for fathers and partners.

For more general ideas see our page on looking after your mental health as a new parent.

This information was published in July 2016. We will revise it in 2019.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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