Heartless midwives ‘giving new mothers post traumatic stress’

‘More threatening than caring’

UNCARING or dismissive attitudes from midwives have been blamed for new mothers developing post- traumatic stress disorder.

Even women with medically normal births can get PTSD if they feel midwives do not care, research found.

The anxiety disorder is triggered when stress caused by a traumatic event – such as a near-death experience or witnessing violence – does not subside over time. It can cause panic attacks, flashbacks, nightmares, insomnia and social isolation.

Nearly one in 20 mothers develop full PTSD after childbirth. Many of these cases could be prevented with better communication and support, experts said.

Women with the condition interviewed by researchers said they had felt ‘ abandoned, humiliated, ignored, dismissed or violated’ by midwives, whom they often perceived as ‘hostile’ or ‘incompetent’.

A study by Edinburgh Napier University found women’s perception of their care was a much more significant factor in whether or not they developed PTSD than how physically difficult their labour was.

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 research was based on an analysis of papers from 1980 to 2016, and intensive interviews with mothers and midwives.

Early results from six interviews were presented at the Royal College of Midwives conference in Manchester this week. The authors said many midwives felt they did not have time to talk to or support women as much as they wanted because of pressures put on them by management.

One woman with PTSD described how she was met at hospital by a midwife ‘stood with her arms folded’ who ‘sighed’ at her because she was in a wheelchair. The woman said: ‘I felt like I was a nuisance who had caused a problem.’

Another said her midwife ‘sat in the corner typing’ on a computer while another said her midwife was ‘totally focused on her paperwork and forms’.

One mother said: ‘I felt almost threatened that if I didn’t manage to give birth I was going to have to have a caesarean section … more threatening than helpful or caring.’

A fourth woman 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.’

Jenny Mullan, of Birth Trauma Resolution therapy, told the con- ference: ‘It’s not the most horrific cases that lead to PTSD. Actually the most horrific thing is not being listened to, not being believed, not getting validation and feeling out of control.

‘When we feel like we’re in a traumatic situation and we feel we’re trapped and can’t escape, that often leads to trauma.’ Around 10,000 UK women a year are treated for PTSD after childbirth but Miss Mullan said this could be the ‘tip of the iceberg’ as many cases are not diagnosed.

Nearly half of women find birth traumatic, with 4 per cent developing full PTSD. This rises to one in five for women who experience stillbirth or premature birth. The College’s Mandy Forrester, said there was a shortage of 3,500 midwives and ‘sometimes demand outstrips capacity’, adding: There are a lot of pressures on midwifery services due to staff shortages.’

The RCM is calling for all pregnant women to be given a named midwife as a point of contact before, during and after birth.