1. Post Natal Post Traumatic Stress Disorder

2. What is it?? A type of anxiety disorder which results from a traumatic event that involves the threat of injury or death. PTSD can be a consequence of a traumatic birth experience Approximately 1-2% of women suffer from this disorder Causes vary PNPTSD is often misdiagnosed with Post-Natal Depression Treatments are still being researched due to the fact that it is often mistaken for PND.

3. Causes Mode of Delivery Mode of Delivery Fear for child’s life and mother’s own life Fear for child’s life and mother’s own life Lack of Control Lack of Control Previous traumatic event Previous traumatic event

4. “The midwife was listening for my baby's heartbeat and asking me what was wrong then she panicked. ‘The heartbeats too low we have to get this baby out now, your blood pressure is too high, we need to get a drip into you……you are going to bleed too much.’ She was so unprofessional I completely freaked out and was screaming out for help. My mum and husband were panicking too although they were telling me that everything was okay and that it’d be alright but I could tell that something was wrong. …..At the same time I had a doctor trying to get a drip in my hand and the doctor and midwife arguing that they needed more help and the midwife saying that all the other midwives were busy. That’s when they pressed the alarm and suddenly there were loads of people in the room. I really thought at this point that my baby was dead, in fact I was telling myself you have 2 beautiful children already you are so lucky. It was the most awful feeling in the world and one I wouldn’t wish on my worst enemy.”(Lucy)

5. Symptoms Flashbacks of the event, vivid & sudden memories Flashbacks of the event, vivid & sudden memories Post-natal isolation Post-natal isolation Fear of sex and childbirth Fear of sex and childbirth Mother-baby bonding problems Mother-baby bonding problems

6. “I feel utterly robbed. Cheated. You can’t turn the clock back now so I have to live with this feeling every day but it hurts me to my core. I look at pregnant women and other mothers and I feel resentment and anger at their happiness. It’s almost like my baby died. She didn’t, she’s here, but I am grieving. People don’t understand that, but to me it’s easy. My daughter’s birth should have been a joyous occasion, but I feel only intense pain at its memory. It was the worst day of my life. This was my start to motherhood and I’m expected just to get on with it” (Melissa)

7. POST NATAL POST TRAUMATIC STRESS DISORDER VS POST NATAL DEPRESSION PN PSTD BOTH PND FLASHBACKS Loss of interest in previously enjoyed activities (sex) Sad moods DISTRUST OF AUTHORITY FIGURES Sleep disturbance Thoughts of harming baby AVOIDANCE OF ALL REMINDERS Memory Loss Negative/obsessive thoughts INTENSE PSYCHIOLOGICAL STRESS FROM ANY REMINDERS OF EVENT Excessive feelings of guilt and inadequacy Body aches, pains, headaches

8. TREATMENT Because the symptoms of the two disorders overlap, individuals often become misdiagnosed. They are not dealth with distinctively and idividually as they should. 25% of women with PNPTSD are not suffering with PND and thus remain undetected. Misdiagnosing this disorder for PND often results in the treatments for antidepressants which often do very little to help with the situation. When properly diagnosed, the one treatment proven to effectively succeed in treating and individual is Psychotherapy. It will help to develop strategies for coping, to reduce and manage anxiety, build a woman's self confidence and self-esteem, identify negative thoughts and address relationship issues. In addition, support groups, individual counseling, Cognitive Behavioural Therapy groups, and medication are also treatments used.

9. What Can be Done? Antenatal Education 1. M anaging expectations 2. E mpower the woman to choose her own birth choices 3. H ospital education Improvement of Hospital Care 1. F ully trained maternity staff 2. D ecent, supportive, and sensitive post natal care for all women Post Natal Support 1. L ocal support networks to help those who feel isolated. 2. P sychotherapy to validate and tackle these issues. 3. R ecognize difference between PTSD and PND to avoid misdiagnosing and mistreating an individual.