Postnatal depression and perinatal mental health

Explains postnatal depression and other perinatal mental health problems, including possible causes, treatments and support options. Also has information for friends and family, including support and advice for partners.

This page is also available in Welsh (Cymraeg).

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Postnatal PTSD and birth trauma

Postnatal post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It is also known as birth trauma.

You may develop postnatal PTSD if you experience traumatic events during labour or childbirth.

This page covers:

Causes of postnatal PTSD

Examples of traumatic events that may cause postnatal PTSD include:

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

Some people feel that having a new baby makes up for any traumatic experiences. Or they may think that enjoying being a new parent means they will soon forget about trauma.

But these traumatic experiences can have a negative effect on your relationship with your baby and the people around you.

You may feel disappointed that childbirth was not the experience you were hoping for. Or you might feel angry with the medical staff if you felt that the delivery wasn't handled well.

Your experiences may also make you feel anxious about having another baby in future, in case you have to go through a similar experience during birth.

"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."

Signs and symptoms of postnatal PTSD

Some of the common signs and symptoms of postnatal PTSD include:

Re-living aspects of the trauma

This may include:

vivid flashbacks (feeling that the trauma is happening right now)
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

This may include:

panicking when reminded of the trauma
being easily upset or angry
extreme alertness, sometimes known as 'hypervigilance'
finding it hard to sleep, even when you have the chance
irritability or aggressive behaviour
finding it hard to concentrate, including on simple or everyday tasks
being jumpy or easily startled
self-destructive or reckless behaviour
other symptoms of anxiety.

Avoiding feelings or memories

This may include:

feeling like you have to keep busy
avoiding situations that remind you of the trauma
being unable to remember details of what happened
feeling emotionally numb or cut off from your feelings
feeling physically numb or detached from your body
being unable to express affection
using alcohol or recreational drugs to avoid memories.

Difficult beliefs and feelings

This may include:

feeling like you can't trust anyone
feeling like nowhere is safe
feeling like nobody understands
blaming yourself for what happened
overwhelming feelings of anger, sadness, guilt or shame.

Treatments for postnatal PTSD

There are various treatments that you may be offered for postnatal PTSD. Your doctor should discuss these options with you, so you can make a decision together about the best treatment for you:

Talking therapy

The main treatments for PTSD are specific types of talking therapy:

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 a therapist guides you 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

Medication is not normally offered to treat PTSD itself. But there are a few related reasons why your doctor may offer you medication:

It is common to also experience anxiety and depression alongside PTSD. Your doctor might offer you medication to treat those symptoms.
Your doctor might offer you medication to help you feel more stable and able to care for your baby.
Sometimes there are long waiting lists for talking therapies in your area. Your doctor may offer you medication to help you while you wait for therapy.

See our page on treatments for PTSD for more information.

Self-care for postnatal PTSD

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

Get to know your triggers

You might find that certain experiences, situations or people seem to trigger flashbacks or other symptoms. These might include specific reminders of past trauma, such as smells, sounds, words, places, or particular types of book or film.

Some people find things especially difficult on significant dates. For example, this could be the anniversary of a traumatic experience, such as a child's birthday.

Confide in someone

If you experience postnatal PTSD, you may find it hard to open up to others. This may be because you feel unable to talk about what has happened to you. But you don't need to be able to describe the trauma to tell someone how you are currently feeling.

It could help to talk to a friend or family member. Or you might want to speak to a professional such as a GP or a trained listener at a helpline. See our page on helplines and listening services for more information.

Give yourself time

Everyone has their own response to trauma and it's important to take things at your own pace. For example, it may not be helpful to talk about your experiences before you feel ready.

Try to be patient with yourself. Don't judge yourself for needing time and support to recover from postnatal PTSD.

Try peer support

Peer support brings together people who have similar experiences, to share and listen to each other's experiences. This includes meeting in person at a local peer support group, or joining an online community like Mind's Elefriends.

See our pages on peer support to find out more.

Find specialist support

There are organisations that specialise in advice and support for postnatal PTSD, for example the Birth Trauma Association.

See our useful contacts page for details of more organisations who could help.

Look after your physical health

Coping with postnatal PTSD can be exhausting. You might feel like you can't find the energy to take care of yourself. But where possible, looking after your physical health can make a difference to how you feel emotionally. For example, it can help to spend time outside, look after your diet, and try to do some physical activity.

For more ideas, see our page on ways to look after your mental health when becoming a parent.