New research suggests better support is needed to prevent cases of PTSD in new mothers
Preventing Post-Traumatic Stress Disorder after Childbirth: Why Compassionate Care Matters
Author: Guest Writer
By Tracy Sealey
I received a phone call from a client this week, distressed after an appointment with her midwife. She had wanted to discuss giving birth in the hospital’s midwife led unit but had been told that her previous history meant that this was not a possibility and that she would be consultant led. “She didn’t even read my notes properly” she told me. “She kept going on about how busy they were. She made me feel like I was being a nuisance. What can I do?”
Unfortunately, stories like this, and worse, are all too common. I hear them regularly in my line of work as a doula and childbirth educator. The women I speak to often feel as though they are on a conveyor belt, ignored or dismissed by their care providers. At the same time, my midwife friends tell me of their exhaustion and frustration as they struggle to give women the time and support they need against a backdrop of cuts, staff shortages and an ever-increasing workload. Small wonder then that relations in the birth room often become hostile as mistrust grows and communication breaks down.
These communication breakdowns may be at the root of incidences of childbirth related post-traumatic stress disorder (PTSD) according to researchers at Edinburgh Napier University. Preliminary findings from interviews conducted with women who have been diagnosed with the disorder were presented at The Royal College of Midwives conference last week and reported in this article in the Daily Mail. The study has found that women’s perceptions of the care they received during their birth was a much more significant factor in whether or not they developed PTSD than difficulties with the birth itself.
Current statistics suggest that around one in 20 women develop PTSD after childbirth although it seems likely that many cases go undiagnosed.
Lead researcher Jennifer Patterson said “Women talk about feeling unsafe and a lack of trust in their provider of care, a lack of respect and a lack of communication. Improving women’s perceptions of [their interaction with midwives] may reduce the risk of them developing PTSD.”
The interviews revealed that the women felt abandoned, humiliated, ignored, dismissed or violated by midwives. One woman complained that her midwife sat in the corner typing whilst another said her midwife was totally focussed on paperwork and forms. This, in my own experience of attending births, is certainly not unusual.
Someone recently asked me if I wanted to become a midwife myself and I jokingly replied that I couldn’t cope with all the paperwork. But perhaps this is no laughing matter. The word ‘midwife’ originates from the Old English mid, ‘with’ and wif ‘woman’ and thus originally meant with-woman. But how can care professionals truly be ‘with women’ when the burden of paperwork is clearly so onerous?
Another key issue was a lack of autonomy experienced by the women. One interviewee said “I felt all authority was taken away from me. Other people decided what was best for me and my baby and there was very little dialogue.” Again, this is something which very much chimes with my own experience of supporting birthing women. In fact, I am very often hired specifically because women, having lost trust in their care professionals, want an advocate to ensure that their voice is heard in the birth room.
Fundamentally, women need to be respected. They need to be listened to and believed. They need to be given accurate information so that they can make appropriate, informed choices regarding their care. They need to feel like active participants in their birth experience not passive recipients with no control and no support. Women can usually cope with the unexpected twists and turns that childbirth sometimes brings IF they are surrounded by people they believe to be competent professionals, with their best interests at heart, who treat them with kindness, respect and compassion. When this is lacking, women feel trapped in a dangerous situation and this is what leads to trauma.
Whilst it could be said that there is no excuse for a lack of compassionate, respectful care, perhaps it is unrealistic to imagine that the current pressures faced by the midwives will not impact on professional standards. Just last week the Nursing and Midwifery council released a report highlighting a shortage of 3500 midwives. On the same day, the RCM highlighted the need to bridge this gap so that they can provide the continuity of care that women need and midwives would love to provide. Years of pay restraint and significant staffing shortages within midwifery are bound to take their toll. Midwives, like all workers in any caring profession, need support, appropriate working conditions and kindness if they are to be expected to meet the needs of the women in their care.
What is your experience?
Sources and read more:
http://www.dailymail.co.uk/health/article-5041219/Heartless-midwives-giving-new-mothers-PTSD.html
Image credit – http://www.cwcare.net/news/role-midwives
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