The birth of a baby, the most beautiful day of a mother’s life? For some, this moment turns into a nightmare and causes post-traumatic stress disorder which can have lasting repercussions on them and their child.
Since July 1, an early postnatal interview with a doctor or midwife, between the fourth and eighth week following childbirth, has been compulsory for mothers, in order to spot signs of depression very early on.
Alerted by women who break this taboo and by scientific studies, doctors launched a free training course this spring for maternity staff to better take into account the psychological risks of traumatic childbirth.
This post-traumatic stress disorder (PTSD) can be due to a problem that occurred during childbirth (emergency caesarean section, fetal distress, feeling close to death, etc.) or to a bitter experience with medical personnel, even the perception of gynecological violence.
“Childbirth can be a happy event. But a woman who gives birth for the first time has a 20% risk of having a caesarean and a 20% risk of having an instrumented delivery. And 30% of women who have a caesarean do not cause a post-traumatic syndrome”, underlines Dr Amina Yamgnane, gynecologist-obstetrician, who co-directs with Pr Israel Nisand the training “Well-treatment in maternity” for caregivers, offered by the American Hospital of Paris.
Roberta Amprino had a trouble-free pregnancy for her first child. But in the maternity ward, the work is very long. Suddenly, the baby shows signs of suffering and everything accelerates.
“When they put this baby on my stomach, he seemed dead, he was all soft, all green. He had suffered from cerebral anoxia, his brain had not been irrigated,” she says. Doctors do not know if the child will survive, and with what consequences.
The child is fine today, but after-effects, Roberta has kept four years. “I was traumatized, I had anxieties, I saw my childbirth over and over again. If I thought about the present or the future, I was worried about my baby. A harmless little sentence for another parent? I was bursting in tears,” says the 37-year-old marketing executive.
It wasn’t until her second pregnancy that a psychiatrist diagnosed her with post-traumatic stress disorder and she received treatment.
– the breviary of hemorrhage –
As on sexual violence, miscarriages or the experience of gynecological examinations, the #MeToo movement has released the word on this taboo, with blogs like afterbirthtrauma or hashtags like #postpartum.
“The women often told us that they had experienced their childbirth in a traumatic way and that this had burdened or even deteriorated the relationship with their child”, explains Professor Nisand. The first two sessions in the spring were full and the next will take place in October.
“It’s not the same to have a mother who gives you gouzi gouzi in the neck and who sings you lullabies than to have a depressed mother for the first six months of her life”, according to Professor Nisand.
According to a survey by Public Health France published in 2021 and conducted from 2013 to 2015, suicide is, after heart problems, the second cause of maternal mortality: 13% of maternal deaths up to one year after childbirth are caused by suicides, 8% by haemorrhages.
“All the conferences focus on how to treat placenta previa, eclampsia and there people are very competent. The breviary of the haemorrhage of the delivery, the professionals know it by heart. On the other hand, what are the risk factors of stress post-traumatic, what are the consequences? It’s a clean sheet,” said Professor Nisand.
The symptoms are multiple: depression, sadness, flashbacks, reminiscences by the dozen every day. The mother turns off her emotions so as not to suffer. “She abandons the present and therefore her baby. Nightmares, sleep disorders contribute to her exhaustion. She may have avoidance behavior: not going to see the doctor so as not to have flashbacks”, explains Dr. Luis Alvarez, psychiatrist involved in this training.
“A PTSD in the mother leads to attachment disorders, developmental delay and depression in the baby. In adolescence, these children have a very increased risk of depression,” he warns.