Postnatal PTSD: A guide for health professionals

02 December 2022
Volume 30 · Issue 12

The title is explicitly clear and by the end of the book you will know about postnatal post-traumatic stress disorder (PTSD) from a variety of angles. Postnatal PTSD is a relatively new concept, having been written about since the mid- 1990s, making this book a useful resource for all midwifery practitioners, including students and obstetric colleagues, in a time when mental health conditions are being more widely recognised and discussed.

Some of the information in the book is not easy to read; reading that midwives being unkind leading to postnatal PTSD made me reflect on my care and the care I give. The overall book is easy to read, with clear chapters and subsections. The book could be read cover to cover or dipped into for specific knowledge using the subject index. The book not only investigates the birthing person's perspective but also the family's, and looks at how postnatal PTSD can influence bonding and relationships.

The book provides important and direct messages to the reader about how healthcare professionals can support women and how we can work together to prevent trauma occurring. There is sensitivity to the needs of healthcare practitioners, recognising that they themselves may have experienced trauma. The suggestions to reduce trauma seem easy to address. For instance, one is a simple request to improve communication, encouraging practitioners to reflect on the care they provide. This could lead to a positive change while also recognising current working conditions and constraints.

The chapters are written in clear, understandable language, including a large amount of content in an easy-to-read style. The book uses individual experiences to highlight important points, and these experiences do not distract or fragment the work.

The authors have association with the Birth Trauma Association and one is a perinatal mental health midwife; they often allude to an unpublished survey of association members from 2020 or comments from the association's website and Facebook page. There is plenty of research to back up these unpublished data, and their use adds to the narrative. The research is a mixture of current quantitative and qualitative studies, with a focus on research and information from the UK.

The authors do make a note on the terminology used throughout the book, using ‘woman’ while recognising that there is a growing number of people giving birth who may not identify in this way. It would have been useful if the book had included a chapter on the experiences of these individuals. However, the research base in this area is relatively small.

The authors briefly discuss trauma-focused and -informed care, a developing field. With the NHS recently defining what trauma-informed practice is, there could have been further exploration of this in a bid to prevent trauma and re-traumatisation.

The book has a chapter focusing on Black, Asian and minority ethnic birthing people, recognising the issues around grouping people when they may have little in common with each other. They are not a homogeneous mass and there needs to be recognition that they may have differing vulnerabilities. The chapter begins with the increased risk of morbidity and mortality for both the birthing person but also the baby, and progresses to mental health and birth experiences.

The book finishes with a chapter on trauma in health professionals. The authors recognise that being present at a traumatic birth may cause distress and this is often ignored or forgotten. This trauma can also result from witnessing or being involved in poor care resulting in a moral injury, which can lead to PTSD but also staff withdrawing or switching off. The authors suggest that self-care is important, but there is also the recognition that workload, workplace culture and support from management is key to coping with these experiences.