Today, Sport Relief are holding a UK Moment in Need day for perinatal mental health. One of the key issues to be discussed is the need for a stronger male support system to cope with the aftermath of traumatic births.
Jason Duncan, a 26-year old fireman and support worker, is used to distressing situations in his day job. However, after the traumatic birth of his daughter, his life – private and professional – has suffered. Duncan has since been diagnosed with PTSD.
“My experience of a traumatic birth is what led me to develop PTSD,” Duncan tells me, “and the fallout from this initial event has created problems for me in almost all areas of my wider life.
“Two years ago, I witnessed my girlfriend go through major blood loss and pass out in the operating theatre. I realise that the medical professionals were too busy trying to save my girlfriend and child, but I was left in a room – on my own – for nearly an hour, without any updates, information, or access to my family.
“So, obviously, I presumed the worst, and I was left with those feelings of grief and helplessness for what seemed like forever – and this was compounded by the fact that I simply didn’t have any idea what was happening. I didn’t know if the baby was even going to be alright.”
Duncan, who has been competing for a promotion within the fire department, feels that the mental health issues with which he has been struggling are hindering his chances at success.
“I knew I was in trouble soon after the birth, but didn’t know the specifics of my condition until months later when I had treatment for anxiety,” says Duncan. “I told the doctor I had been having nightmares and experiencing negative mood swings every since my daughter’s birth. It was causing me to become angry – and I didn’t know where to direct that anger.
“I wasn’t getting enough sleep. And I was so worried that my girlfriend would get pregnant again that we stopped having sex.
“I never thought these feelings and flashbacks could have been PTSD,” reasons the fireman, “as it was something I had only heard of in soldiers. But I knew I was in trouble soon after the birth, and eventually – when it became clear that my anxiety and anger was affecting my work – I was referred to a doctor by my workplace counsellor. It was then I began treatment for anxiety.”
Duncan is an advocate of male perinatal resources – such as those provided on a limited level by Fathers Reaching Out – and hopes that Sport Relief’s current campaign will help further address the gender imbalance of postnatal care.
“In the aftermath of the traumatic birth, I was never asked if I needed help,” explains Duncan, whose daughter has not suffered any problems since birth. “Yet my girlfriend was offered and given support at every turn and had her anxiety diagnosed earlier. As a result, I am still worried if we decide to have another baby next year, because I still have unresolved issues from my daughter’s birth.”
Dr Anna Machin, a researcher of psychology and the neurobiology of human social relationships at the University of Oxford, advises any men who have feelings of depression or anxiety after witnessing a traumatic birth to speak up – as only when the problem is widely recognised can provisions be made for the masses.
“The first port of call is your GP, but they are not terribly well set up for the diagnosis of PTSD – particularly not for men who have been traumatised by birth. Or perhaps try speaking to your health visitor, who visits your partner and baby. They are actually there for the whole family, so speaking to them may help.
“At present there are not tools designed specifically to diagnose PTSD following birth. Instead we have to adapt those used for other cases of severe trauma.
“Depending upon the severity of your PTSD it can be very hard to deal with – especially when you are also caring for a new baby and therefore surviving on little sleep. However, if the father doesn’t face his issues, it could be detrimental for the child later in life. There is now a growing body of evidence that paternal mental health has a significant effect on child development, particularly with respect to behaviour and verbal skills in later childhood.”
So what causes PTSD in men after they witness a particularly difficult delivery?
“PTSD is caused by the experience of severe trauma and is your brain’s way of trying to compute the trauma and deal with it,” explains Machin. “So, any situation which is deeply traumatic can cause this – such as experiences in war, bad car accidents and also witnessing a traumatic birth.
“In traumatic births the mother and baby are often at risk, and the father may witness significant loss of blood or attempts to resuscitate mother or baby. Birth is an alienating experience for many men, as they feel completely out of control and unable to assist or help their loved one.”
Brian Gent, a university lecturer, faced this problem during the delivery of his daughter. “The fear and helplessness was devastating,” says Gent. “I was truly terrified, and had no idea what would happen next.
“I was holding one of my wife’s legs, with a younger midwife holding the other one. The doctor pulled the baby in a way that looked unbelievably hard and then cut my wife as the head emerged. I will never forget the snapping sound the skin made or the scream that came from my wife. It was such a scream of utter shock and pain beyond imagining. As I was right there, holding her leg, I saw the whole thing.”
Dr Machin recognises how feeling like ‘the odd one out’ in a delivery room can also add to the trauma for male partners: “Healthcare practitioners, through no fault of their own, sometimes simply do not have the time to keep the father informed of what is going on. As a result, for some fathers birth can be like having front row seats at a slow motion car crash involving someone you love – without the ability to help them.
“And this exclusion can also be seen in men’s access to subsequent support. They are often simply left to deal with the aftermath themselves. And whilst this subsequent trauma comes in different gradations of severity – some men may just repeat the intrusive film loop in their head every night as they fall asleep, whilst others find it hard to operate all the time – there is the possibility for all that it can lead to extreme anxiety and depression, self-medication and an inability to maintain a normal family life.”
Gary suffered from PTSD following the birth of his daughter, and spoke to the Birth Trauma Association about how he now feels distanced from the child who caused his wife such pain.
“Now my wife is getting better,” Gary tells the BTA, “I’ve started finding time to look after myself, and I’ve started seeing symptoms in myself that are similar to that of my wife’s post-natal depression or, probably more realistically, Post Traumatic Stress Disorder.
“Sometimes I feel detached from my daughter, and I’ve even had thoughts of harm to her or myself. And dreams and flashbacks of the birth are becoming increasingly vivid. Only I know what I feel and I cannot truly share these feelings as my wife believes it to be too personal for other people to know, so I can only talk to her. However, because I don’t want her thinking that she made me ill, I can’t even tell her everything.
“Men often become left out and put to one side, even though it is well documented that fathers can fall foul of these problems. I feel that the need for paternal support is often overlooked.”
Dr Machin, who has extensively studied the father-infant relationship, also believes that male postnatal conditions require further attention.
“This is an area of urgent need of research, but we seem to need to convince people that it is of importance not only to the fathers but also to the partners and children. In these times of cuts in funding it is hard to get people to focus on the mental health of fathers because we prioritise mothers. But we need to look at the wider picture of unresolved mental health issues in parents, and realise that any problems suffered by these adults only increases the risk of poor mental and physical health in their growing children.”