WHEN BIRTH TRAUMA GOES BEYOND THE BABY BLUES; Ten Thousand Women a Year Develop Posttraumatic Stress Disorder after Difficult Childbirths - but There Is Hope in Sight, as Jane Phillimore Reports Illustration Shonagh Rae

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IT started so well. Rosie, a healthy 24-year-old, was about to have her first baby at home. But the baby was in a twisted position, which the midwives failed to notice. After hours of labour and two hours of pushing with no pain relief, Rosie was rushed to hospital. There she underwent an episiotomy and an unsuccessful ventouse procedure, followed by an emergency caesarean.

Four years later, she is still scarred by the trauma. 'I felt I was being assaulted while my partner stood by and watched,' she says.

'I thought my baby and I were both dying.' Rosie's story is harrowing, but its long-term effects have been even more painful to bear.

After the birth she had constant nightmares, panic attacks and flashbacks.

Her sex life didn't recover, and it took 18 months for her to bond with her son. 'I shut down - I don't even remember the first year of his life. I breastfed him for 15 months and hated every minute.' Two years ago, feeling desperate after being dismissed as hysterical by two unsympathetic GPs, Rosie rang her health visitor and screamed, 'I'm going to kill us both!' She was taken by the health visitor to a sympathetic doctor and was finally diagnosed with postnatal posttraumatic stress disorder (PN PTSD).

Rosie's case is not unusual: one to two per cent of mothers in Britain - around 10,000 a year - suffer from PN PTSD. In 2004 the Birth Trauma Association (BTA) was set up to raise awareness of the condition. 'The medical profession isn't generally aware that women can be traumatised by birth,' says Susan Ayers, a BTA board member and senior lecturer in health psychology at the University of Sussex. 'We associate PTSD with frightening events such as war, not an everyday occurrence such as giving birth. But when a birth goes wrong, it can become psychological and physical torture.

These women feel that their life or their baby's was threatened and they respond with intense fear, helplessness or horror.' Sufferers of PN PTSD start experiencing nightmares, flashbacks, and intrusive thoughts about the birth, and tend to be affected by symptoms of hyperarousal such as anxiety, anger and sleeplessness. They usually feel emotionally detached, wanting to avoid any place or person - even the baby itself - that reminds them of the birth. …