Postnatal PTSD often misdiagnosed, warns expert

Media caption‘I went from a screaming room of people to deadly silence’

Hundreds of mothers suffering from postnatal post-traumatic stress disorder are undiagnosed in Wales every year, according to experts.

Women who have had a traumatic birth are vulnerable to the condition.

The Birth Trauma Association estimates 1,000 women every year in Wales will develop PTSD after birth.

But just 22 cases were recorded in two health boards last year, while others did not provide figures to a Freedom of Information request by BBC Wales Live.

Experts believe this is the “tip of the iceberg” and it often is unrecognised and misdiagnosed by midwives, GPs and health visitors.

The condition leads to flashbacks and anxiety.

The figures do not include fathers who also suffer from PTSD after witnessing a traumatic birth.

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Mark Williams said people did not realise the toll trauma can have on both parents

Mark Williams, from Bridgend, said he was still suffering symptoms of PTSD 13 years after the birth of his son Ethan by emergency caesarean.

He said: “I was totally unprepared for the birth. I knew my wife was in pain just looking at her. I just wanted the baby out – I was getting more and more anxious.

“It wasn’t until many years later that I realised, the nightmares I was getting afterwards and vivid dreams – waking up thinking has my wife died? Has the baby died? They were telling me then years later that it would’ve been PTSD.

“Even when I think about it now I get anxious. The smell of a labour ward can trigger off a flashback and that anxiety.”

Although the condition is commonly associated with soldiers returning from war, PTSD can be suffered by anyone who has a real fear of loss of life of a loved one or themselves.

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Mark Williams

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Mark Williams said he was now looking to get treated for PTSD – 13 years after his son was born

Prof Jonathan Bisson, who heads up the traumatic stress service centre in Cardiff, said: “Some extreme childbirths are up there in some of the most traumatic experiences and most acute cases of PTSD I have seen.

“Primary health services are geared up for postnatal blues and depression so they don’t ask questions around the birth and that means it can be mislabelled as postnatal depression, when PTSD is the actual cause. This means it is a lottery as to whether you will get diagnosed or not.

“I have also seen a lot of fathers who have suffered from PTSD after a traumatic birth. They talk to me about how helpless they felt at the time. Often they were there with their partner, seeing them give birth, knowing things weren’t quite right and feeling helpless to know what to do.

“But the number of individuals we see referred to and coming through the traumatic stress service is likely to be a tip of the iceberg in terms of the true amount of people suffering.”

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Mr Williams said he and his wife did not have any more children due to anxiety over their son’s birth

Since 2015 the Welsh Government has invested £1.5m a year in community perinatal mental health teams across Wales to help mothers before and after childbirth.

But Sara Moseley, director of Mind Cymru said: “The level of training in GPs and midwives is really patchy in terms of awareness about perinatal mental health.

“Whether you are diagnosed or not depends on two things – whether you come into contact with a health professional who understands mental health problems and at what level of severity it is at. It depends if you are in crisis, or living with something.”

A Welsh Government spokesman said: “Traumatic childbirth or admission to neonatal care is a recognised trigger factor for PTSD in parents. We would expect services to actively manage PTSD using the evidence-based NICE guidelines.”

  • Wales Live is on BBC One Wales on Wednesday 6 December at 22:30 GMT or on iPlayer shortly after broadcast

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