Fathers and PTSD

This article is part of the Traumatic Birth Prevention & Resource Guide by PATTCh. Access the complete guide to learn more about traumatic birth and find resources for women and families.

By Walker Karraa, MFA, MA, CD(DONA)

A 2012 study published in the Archives of Disease in Childhood: Fetal Neonatal Edition contributes to the growing awareness that partners are negatively impacted by traumatic childbirth. The first study of its kind, Being there: a qualitative interview study with fathers present during the resuscitation of their baby at delivery (Harvey & Pattison, 2012) is a retrospective analysis of semi-structured interviews with 20 fathers who had witnessed the resuscitation of their baby immediately following delivery. While small in number, this study sheds invaluable light on the experience of fathers in the presence of trauma in childbirth.

Semi-structured, private interviews were audiotaped with consent, and the transcripts were analyzed for thematic content using the NVIVO-7 software in sequence. Analysis generated four themes (1) preparation; (2) knowing what happened; (3) his response; and (4) impact on him (Harvey & Pattison, 2012, p. F2).

Theme One: Preparation

While over half of the fathers (n =12) had been given information prenatally regarding potential causes and instances for neonatal admission for their baby, none of the fathers had'  been given information about newborn resuscitation. Fathers did not realize before birth that their baby might require this level of support at delivery, and most were only told by health care professionals (HCP) immediately before the birth that their baby would require resuscitation, if at all. Information was often vague, not forthcoming, or overheard and second-hand.

Theme Two: Knowing What Happened

The majority of fathers were unaware of the type of resuscitation given at time of interview, were unaware at the time, and had not been subsequently told. Contributing factors to the theme of not knowing what happened were his position in the room, and not having asked HCP directly what was happening during or after the event. Most fathers did not view the resuscitation due to obstructed view, or being focused on partner. When fathers attempted to stand up to see the baby, they were told to sit down. Those who did posed questions went unanswered, and still other fathers only learned about what was happening through cross-conversation among staff. Does this sound familiar to anyone?

Theme Three: His Response

Themes of conflict between partner and baby emerged from the father's experience.  All fathers expressed doubt regarding their focus of concern, their partner or their baby. Many fathers reported that they thought either or both would die. In the interviews themselves, recalling the event caused fathers to become visibly upset. One father stopped the interview process momentarily during this line of inquiry.

Continued distress occurred for fathers regarding the conflict of whether to stay with partner or go to their baby being resuscitated. Most reported wanting to go to their baby, but felt they should stay with partner for reassurance. In some cases, staff contributed to this conflict by telling fathers to stay put. A variety of coping strategies were employed by fathers to endure the event but most commonly emotional-controlling strategies were used, where they avoided looking at the baby, tried not to think about what was happening, leaving the room, or self-reassurance that there would be a positive outcome.

Theme Five: Impact on Him

• There was general lack of memory of the event. While none reported regretting being there, all fathers reported feelings associated with the birth in terms such as: worried, distressed, petrified, scared, panic-stricken.
• None of the fathers reported feeling supported from HCP's during resuscitation
• The majority of fathers who wanted to discuss their experience with someone after did not do so.
• None of the fathers were given an opportunity to discuss the event with HCP's afterward
• Some reported symptoms of post-traumatic stress such as flashbacks, nightmares, agitation and hyper vigilance.

Conclusion and Discussion

The authors concluded:

There is a growing awareness that meeting the needs of fathers facilitates their involvement in the lives of their children. Supporting fathers before, during and after newborn resuscitation could be a step towards achieving this. (Harvey & Pattison, 2012, p. F5).

Hopefully this study will generate increased awareness the largely overlooked partners' experience of traumatic events in childbirth.

Resource

Harvey, M., & Pattison H. (2012). Being there: a qualitative interview study with fathers present during the resuscitation of their baby at delivery. Archives of Disease in Childhood: Fetal Neonatal Edition Arch Dis Child Fetal Neonatal Ed (2012). doi:10.1136/archdischild-F2 of F5 2011-301482.

Walker Karraa is a doctoral student at the Institute of Transpersonal Psychology. She is a birth doula, maternal mental health advocate, and researcher. She currently writes for the Lamaze research blog, Science and Sensibility. She presents at conferences, trainings, and organizational retreats pertaining to perinatal psychology, postpartum mood disorders, childbirth education, and labor support. Walker also is the President of PATTCh, a not-for-profit dedicated to the prevention and treatment of traumatic childbirth.

PATTCh is a not-for-profit, multidisciplinary organization dedicated to the prevention and treatment of traumatic childbirth. Our mission is to develop cross-disciplinary relationships, research, and programs that:

• prevent PTSD following childbirth through education, interdisciplinary collaboration, and multidisciplinary research;
• educate perinatal care providers and paraprofessionals in the prevention and treatment of birth and reproduction related trauma;
• encourage the development of culturally appropriate therapeutic approaches to post-traumatic stress symptoms following childbirth;
• promote healthy birth practices for all women and families;
• promote evidence-based research regarding PTSD secondary to childbirth;
• increase global awareness of the prevalence, risk factors, and effects of PTSD secondary to childbirth; and
• support collaboration and understanding among all stake-holders, including: researchers, policy makers, medical and mental health care providers, educators, community members, volunteers, women, and families.