AS anyone who has ever given birth, been at a birth or watched 30 seconds of One Born Every Minute will know, giving birth or being present when someone else is doing so can be pretty traumatic.

And for some women, as well as their partners and even medical professionals, in around 20 percent of cases, rather than being little more than a bad memory, this traumatic experience can develop into post traumatic stress disorder (PTSD).

This can leave sufferers experiencing years of panic attacks, often without realising what's triggering them, as well as other symptoms, such as sleeplessness, hyper-vigilance, nightmares, angry outbursts, attachment issues with their child and difficulty concentrating.

So says Kirsteen Anderssen, a qualified midwife and birth trauma resolution practitioner.

Kirsteen, 45, from St Denys, became interested in the links between giving birth and PTSD some 15 years ago, when she was training to be a midwife.

"I became curious about a link based on what I was seeing on the wards and started to wonder if we as professionals were contributing to trauma responses in our patients, or if we could do anything to prevent them," she says.

"I wrote my dissertation on PTSD in childbirth, and there was very little about it in the midwifery literature at the time."

After working as a caseload midwife in Thornhill for two years, seeing around 40 women at a time through their pregnancy and labour, she went on to work as a family nurse, working with teenage mothers until their children were two.

Kirsteen retired from the NHS last year and decided to train as a birth trauma resolution practitioner.

"Birth trauma can be caused by all sorts of different things, such as fear of your baby's death, stillbirth, fear of your own death, long difficult labours, short, intense labours, sick babies and so on," says Kirsteen, who is herself a mother of two.

"Less obvious causes might be a lack of continuity of care, poor communication, not feeling heard, pain not being taken seriously, and non-consensual intervention.

"This can lead to PTSD or sub-threshold trauma symptoms, which means that someone is suffering from the symptoms but not at a level for a PTSD diagnosis."

Kirsteen adds that not only women who give birth suffer from birth-related PTSD. Other triggers may be miscarrying, termination, failed IVF cycles or witnessing childbirth.

"Up to 20,000 UK women a year fit the criteria of PTSD as a result of childbirth, and the Birth Trauma Association says that as many as 200,000 women may suffer from symptoms," she says.

Kirsteen explains the neuroscience behind PTSD.

"When people go through a traumatic experience, in four to six weeks, the brain will process it and store it as a normal bad memory in 80 percent of cases. But for 20 percent of people, the trauma response is set off and the memory sits in the part of our brain which deals with the fight or flight response, so anything that reminds them of the trauma, even something like the midwife having had red hair and then seeing someone with red hair in the supermarket, can set off a panic attack.

"If untreated, people tend to develop avoidance tactics," she adds.

"So that can be things like being dependent on sleeping pills or developing agoraphobia."

Kirsteen adds that symptoms can last not just years but decades after the traumatic experience. She has seen clients who are suffering symptoms 18 years later and knows of people being seen some 40 years later.

"Even decades later, it can still feel as raw as the day it happened, due to how it's been stored in the brain," she adds.

Kirsteen says that there are a number of treatments that can help, including cognitive behaviour therapy (CBT) and eye movement desensitization and reprocessing therapy (EMDR), as well as birth trauma resolution therapy.

"With Birth trauma resolution therapy, we can see big changes in one to three sessions," she says.

"We use reduced arousal to allow the trauma to be processed and stored as a normal memory. It's not forgotten, but the brain doesn't have a flight or fight response to it anymore.

"I had one client who was pregnant with her second baby. She was considered high risk and it was recommended that she gave birth on the labour ward, but she had panic attacks every time she tried to go to the ward and was unable to make clear decisions regarding her care.

"After three sessions, she was able to go into hospital without having panic attacks, write a birth plan, consent to medical interventions and she ended up having a lovely birth in hospital," says Kirsteen.

"Another woman had had a horrendous first experience and had perceived that she or her child might die and had become hyper-vigilant towards her child and also felt she couldn't have a second child.

"She became able to remember the birth without having a trauma response and is now open to the idea of having a second child.

"Another client was a man who had been very traumatised by witnessing his partner giving birth and it had impacted on his intimate relationships. He has been able to repair and build his relationship."

Kirsteen adds that PTSD symptoms are often misdiagnosed as post natal depression, and that people are often not aware that what they are experiencing is PTSD or what its cause might be.

"There is a questionnaire on the website which lets people see if their symptoms suggest PTSD.

"I'm finding a surprising number of people who do have symptoms. When I was training I put a shout out on my Facebook page for people to come and be student case studies, and I was shocked by the speed and number of responses, and that's been repeated elsewhere.

"A lot of people do seem to be suffering. It's a big need, unfortunately."

* You can contact Kirsteen by emailing or on Facebook under Southampton Birth Trauma Resolution.