Birth Trauma – is it okay to debrief? How do you know if it is PTSD?

Hello lovely birth professionals. Do you ever wonder if you are doing the right thing when you listen to some-one’s traumatic birth story? I want to talk to you about a little something that can really help reassure us that it’s usually okay to offer a debrief – despite what the research says, and what NICE say.

If the person WANTS to debrief, is CHOOSING to debrief, then you are probably on safe territory. This is because if she is choosing to talk it through with you, the chances are that she probably does not have full blown post traumatic stress disorder. How do we know this?

Well, in order to meet the criteria for a diagnosis of PTSD, there are three aspects that need to be present. Two of these are well known about. The third one not so much. But it is very important.
The first aspect that needs to be present for a diagnosis of PTSD is “reliving”. This involves the traumatic memory coming back into your present life when you don’t want it to. It includes symptoms such as flashbacks, nightmares, being triggered, sudden images and memories popping to mind when you don’t want them to and so on. It’s very distressing and can leave the person feeling scared and out of control.

The second aspect that needs to be present for a diagnosis of PTSD is “arousal”. This involves arousal of the nervous system, and involves symptoms of anxiety and agitation, such as panics, sleeplessness, anger, irritability, crying a lot, jumpy, nervous, nightmares and so on. Again, it is very distressing.

But here’s the crunch: you can have both of those things happening (arousal and reliving) and not have PTSD. Why? Because both of those would be expected in ANYONE who had been through an experience in which they felt horrified, or terrified, or that their life was at risk. It’s normal. But we tend to recover, with time, with love and with rest. PTSD can develop when we don’t recover spontaneously. And one thing that happens when we don’t recover, is something called “avoidance”. Avoidance is the third aspect that is necessary for a diagnosis of PTSD. Avoidance is when the person works hard to not think about what happened, to avoid reminders of it (such as places, people or television programs), to not talk about it, to get drunk instead, or keep super busy, or drink caffeine to avoid going to sleep (because when your head hits the pillow, is when the reminders come back).

Can you see where I’m going with this? If the person has full blown PTSD, they are not going to choose to talk it through with you, by way of a debrief. So, if the person has chosen to talk it through with you, it is unlikely that you will do any harm, presuming that you listen compassionately and non-judgmentally. Which I’m sure you do.

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