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Post Traumatic Stress Disorder

Caring for Mothers Suffering from Postnatal Post Traumatic Stress Disorder (PTSD)

By Martha Jesty

Director of the organisation ‘Help Women and Children’, Martha Jesty suggests ways in which local churches can become better equipped to help women suffering from PTSD resulting from childbirth and other associated stressful situations.

Mary (not her real name) is one of dozens of Christian women who approach us for professional counselling, by telephone, e-mail or face to face. We provide this service for women suffering from postnatal illnesses.

“I had an abortion two years ago with the consent of my husband, he is also a Christian. He seems fine but I was never fine. I had nightmares, flashbacks from the horror of what I did, and the worst of all is the guilt, the guilt that is so heavy that I can’t share it with anybody in the church for fear of judgment… And that is why I am here because I know you are not affiliated with any church and you are a Christian.”

I started the organisation ‘Help Women and Children’ four years ago as a result of my two-year healing process during which my husband spent hours listening to my troubled mind. I was in fact suffering from Post Traumatic Stress Disorder (PTSD) that had surfaced several years earlier. The church had not been involved in my healing process.

It is surprising that symptoms of PTSD may occur in up to 30% of women following childbirth. This means that 200,000 women in the United Kingdom are affected each year. In around 2% of women, these symptoms are sufficiently severe to meet full DSM-IV criteria for PTSD (Ayers and Pickering, 2001; Loveland Cook, 2004). This amounts to around 10,000 women developing PTSD in this country. If PTSD is untreated it becomes chronic and has a huge impact on women and their children.

Despite setting up the non-profit making organisation ‘Help Women and Children’, I have found it extremely difficult to work with churches and their pastors and vicars, both male and female. I believe that this is due to their lack of understanding of women's situations where they have been traumatised by childbirth, rape, abortion and conditions such as fear of childbirth and sexual dysfunctions.

Women are invariably offered prayer but what they really need is a series of non-judgmental counselling sessions where they are listened to and can be helped to overcome the trauma they have suffered so that their lives are improved.

The women that come to us have nowhere to go. GPs prescribe antidepressants that help to some degree, but most women are misdiagnosed with postnatal depression. Often their marriages are collapsing and most of them think that they are experiencing madness. Some of them hate their children; some are even suicidal yet they can’t contemplate the idea of sharing their experiences with Christian leaders. What is the function of a local church if it is not to change lives and positively impact on the core of our society - the family? What can church leaders and church communities learn from organisations that are positively impacting on the lives of vulnerable women? My advice is as follows:-

• Have a professional qualified counsellor on your pastoral team to work with women and their families.
• Train members of your church community in professional counselling.
• Organise a healing clinic where people from the community at large can receive free professional counselling and spiritual replenishment. The use of different counselling approaches such as Cognitive Behavioural Therapy and Person Centred Counselling, in conjunction with the gifts of the Holy Spirit, will be of significant value to women and their families who are in crisis.
• Work together with organisations such as ‘Help Women and Children’ that are set up to help families.

If church leaders feel able to implement some, if not all, of these ideas, I believe that this will bring about changes in our society particularly where women and families are concerned. Isn’t that what Jesus did?

Martha Jesty is Director of Help Women and Children based in Surbiton, Surrey where she runs workshops for Christian leaders and health professionals. She is also the author of ‘Real Healing after Caesarean’, a book written to raise money for this organisation. You can order a copy through www.realhealing.co.uk 

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The term Post Traumatic StressDisorder (PTSD) is a relatively new one, but the condition has been around and written about for hundreds of years. Variously called ‘railway spine’ or ‘shell shock’, it was the experience of Vietnam veterans, which led to the clinical classification of PTSD in 1980. At that point it was considered that to get PTSD, a person had to go through an event out of the normal range of human experience so it was originally taken to apply only to events (or ‘stressors’) like disasters or wars. Eventually, understanding of the concept was broadened; enabling road traffic accidents and the like to be considered as traumatic events but it was the re-definition of the diagnostic criteria in 1994 that allowed a wider range of experiences to be considered as traumatic stressors.

The re-defined criteria focus the definition of trauma on the subjective perception of the individual so that now, any traumatic event, which precipitates acute feelings of fear, helplessness and horror, can be included. An examination of the role of health related events (cancer treatment, obstetric and gynaecological care) and trauma followed. Although studies had indicated, for many years, that women could be suffering PTSD type symptoms after birth, it has only recently become generally accepted that a birth experience can provoke a traumatic stress response and that women can go on to develop PTSD as a result. Childbirth is now accepted to be both a possible primary trigger to PTSD and an experience, which can re-traumatise those who have suffered previous trauma. PTSD following childbirth is known as Post Natal PTSD.

However, we must not limit consideration of the traumatic event to the birth itself as it has been shown that events during pregnancy, birth and post natal issues can give rise also contribute. It is also important to remember that PN PTSD is the term applied to normal reactions to a traumatic experience during pregnancy, labour and the post natal period, so it is important not to label women as mentally disordered.

Understanding the subjective nature of trauma is the key to understanding PN PTSD. In all situations of trauma, it is the person’s perception of the event, which causes PTSD and not someone else’s perception of whether the event should be traumatising. However, the obstetric setting may be unusual because often the caregiver’s perception of what can be traumatising can differ widely from the mother’s and this can cause very real problems in the post natal setting.

Clearly, it is not always the sensational or dramatic events that trigger childbirth trauma. Equally, it is important to note that not everyone exposed to a traumatic birth experience will go on to develop PTSD. Dr Susan Ayers distinguishes between those who appraise birth as traumatic, those who develop a traumatic stress response and those who develop PTSD and says we must be careful not to pathologise women’s experiences.
Extracted from Real Healing
After Caesarean by Martha Jesty. Visit www.realhealing.co.uk