In previous posts we have referred to the experience of PTSD following childbirth and we now turn our attention to Postnatal Depression. In the days following the birth of your baby, it is not unusual to experience some degree of mood swings. However, it is the mildness or severity of these which determines what category one falls into. There are three main kinds of mood swings namely ‘The Baby Blues’, Postnatal Depression or Puerperal Psychosis.

In its mildest form, the Baby Blues is unpleasant for new mothers who may have been caught unawares with tearfulness, irritability and feeling vulnerable somewhere between day two and day four following childbirth. It is thought that this is due to the drop in hormone levels at this time and it resolves itself within a few weeks. Puerperal psychosis is a severe form of mental illness, where a woman loses all contact with reality following the birth of her child. This is very rare, affecting 1 in 500 and requires hospital admission and psychiatric treatment. Mothers can make a full recovery with professional help and family support.

About 15% of women in Ireland fall into the category of Postnatal Depression. This can begin as a form of baby blues that doesn’t lift but lingers on and gets worse. It can last for months and even years if undiagnosed. One of the problems with it is that women often don’t know what’s wrong and it can take a family member to notice that there is a problem. Symptoms can include crying, irritability, anxiety (sometimes manifesting as panic attacks), often not knowing exactly why. Loss of interest in yourself, your appearance and your relationships is common. This can manifest in social withdrawal, where you don’t want to see family or friends. You may experience loss of appetite and insomnia, finding it hard to sleep even when your baby is asleep. This results in tiredness and a subsequent inability to deal with the demands of motherhood. This coupled with not really feeling huge love for your baby can leave you feeling pretty awful about yourself. Self Esteem is often low as mothers feel they are not managing as well as others seem to do ( I am reminded at this point of the photo shoots in magazines portraying new mothers (and babies) as perfect, living in a perfect house with a perfect partner). Life isn’t like that but somehow the media’s portrayal of new motherhood sticks and we feel inadequate when we don’t match up to that standard. It is not unusual for some mothers to tip into obsessive behaviour like excessive tidying or some may develop an overwhelming fear (e.g. death).

The good news is that Postnatal Depression is treatable and you will recover. Like any illness, recovery takes time. It is important to concentrate on the practical aspects of daily living, like getting enough rest and eating well. Accepting help from others is a big part of this, reminding yourself that it is temporary. It can be difficult to admit that you need help but your recovery will be quicker if you do. Talking about your feelings to your partner, family, friends, GP or Public Health Nurse will certainly help. Some GPs may offer anti-depressant medication as part of treatment.

It would also be quite common for women experiencing postnatal depression to seek counselling as part of their treatment. Counselling can offer you a safe place to explore your feelings in a non-judgemental way, something that may be difficult to do with people close to you. For some there are other issues from their past complicating or impacting on their mood and recovery. These issues can be conscious or unconscious e.g. If a woman has lost her own mother she may feel this more at this time or if she has had an abusive childhood this may be affecting her at an unconscious level.

Support groups can be very helpful where you can meet with mothers who have had similar experiences to you, facilitated by a trained counsellor. Here at counselling connections we run groups for mothers who are suffering from PTSD and Postnatal depression where women share their experiences with each other. If you are a partner reading this and want to know how to help the first thing to do is get outside help. Remind your partner that this illness will pass and support her in whatever way you can practically and emotionally. This can be a trying time for you too and for your relationship but with the appropriate help, it will resolve.

We tend to think of mothers and babies when we think of birth trauma but what of Fathers? How do Fathers deal with the aftermath of traumatic birth? When birth goes well a Father can feel empowered by the experience, in which he may have been largely involved. This often serves to bring the couple closer together, bonded by this unique experience. However, the opposite can also be true and men can be left feeling isolated and alienated from their partner and baby through the experience of traumatic birth.

For the most part, men are encouraged to be actively involved in their partner’s care, if this is what the couple want. But men may also be asked to take a back seat by hospital personnel if there are complications. This can leave men feeling powerless to protect their partner and baby at a most vulnerable time. They become onlookers in a drama, where a few minutes previously they were active participants. Men can be left feeling they have let their partners down, when choices in labour have been reduced by the nature of the sequence of events. He may feel that as the spokesperson on behalf of his wife/partner, he has been unsuccessful in having her wishes heard and followed through. This feeling of inadequacy can be further complicated where problems with the baby necessitate a visit to the special care baby unit. Men can feel torn between staying with their partner on the delivery suite and going with the baby to ensure all is well, while all the time feeling neither choice is the right one.

Antenatal preparation in the form of parentcraft classes can help shape expectations and can help men to familiarise themselves with what they may encounter on the delivery suite. Men are often witness to instrumental deliveries i.e. by vacuum or forceps, or they may accompany their partners into the theatre for caesarean sections. Seeing a baby born from this angle is very different from the experience the woman has. While in no way minimising the experience of the woman, it is also important to recognise that men may suffer a different kind of trauma in these situations, witness trauma. A man’s role in the birthing process is one of support, comfort and protection. When he has difficulty fulfilling this role through circumstances beyond his control, he can feel frustrated and worthless and frankly ‘less of a man’… This can further lead to low self-esteem and relationship difficulties. It is not uncommon for couples who have experienced a traumatic birth to have sexual problems as a result. While there may be physical and emotional issues on the part of the woman, a man can feel emotionally scarred and reluctant to cause his partner any physical pain or upset.

The dynamic of the couple relationship changes following the birth of the baby. Fathers who have witnessed something traumatic during the birthing process may find that they have difficulty bonding with their baby. The baby can be a reminder of all that went wrong, at what was supposed to be a happy time. He may also be left trying to deal with a traumatised wife, who is struggling herself, while coping with sleepless nights and trying to work. Although society generally views the birth of a baby as a happy time, it can be an extremely stressful and testing time for a couple. There seems to be very little room for couples to say how awful it is for them in these early weeks and months. While women tend to talk about their problems to other women, men are often left with no outlet, fearful of being perceived as weak if they are upset at what the experience of the birth of their child and the impact it has had on them. In the absence of support from family or friends, counselling will offer a safe place to vent these feelings and to learn how to incorporate your experience into your life, allowing you to move on. We at Counselling Connections also run a group for men who have been upset in any way by the pregnancy and birth of their baby. Here, men get to meet with other men who have similar experiences, leaving them feeling less isolated. Knowing there are others who feel the same way as you do and sharing those experiences can be powerful in helping you to deal with this kind of trauma.

The birth of your baby is usually a time of celebration for you and your family. This may ring true for lots of women who have had good experiences of pregnancy and giving birth. But it is not always the case and women and babies can be left traumatised after negative birth experiences. This trauma can affect everyday living, where a mother has huge difficulty getting over her experience. The current medical model of childbirth here in Ireland seems to give out the message that if a mother and baby are healthy, one should be grateful for that. This leaves women feeling unable to speak out negatively about their experiences. However, a traumatic birth experience can affect a mothers relationship with herself, her new baby, her partner, her other children and extended family.

Giving birth is a life event. It is a very vulnerable time for you. If you have had an overwhelming traumatic experience, your body will have gone into shock, both physically and psychologically.   Post Traumatic Stress Disorder or PTSD happens when a person remains stuck in psychological shock. This can happen following traumatic birth.  You may be reliving your traumatic birth through flashbacks and nightmares, leaving you unable to reconnect in your relationships. It can be difficult for you to feel safe again as it may have felt like a life or death experience. This can leave you lacking in confidence with your ability to be a good mother to your baby. Other symptoms can include being irritable, depressed, lacking in concentration or being angry.  It is normal to feel frightened, sad and anxious following such an event. Many mothers describe a feeling of going crazy. For others there is a numbness about the whole event. There can be a deep sense of loss around one’s expectations for giving birth and how it actually turned out.

In our practice here at Counselling Connections, we have met mothers whose experiences may have been recorded medically as “normal” but the woman’s experience felt far from normal. Even a ‘natural’ birth can be experienced as traumatic. Through counselling we can help you work towards feeling safe and in control of your life again. We do this by facilitating you in processing the memories and emotions associated with your experience in a safe, confidential environment. It is only when the experience is felt and understood that it will stop hurting so much.