Perinatal Trauma and Loss Service (PETALS)

We recognise that you may experience overwhelming distress as a result of your perinatal journey. We work with women and birthing people who themselves have experienced perinatal loss and/or trauma in the perinatal period. This may mean that you are experiencing significant symptoms or difficulties and struggling with day-to-day functioning.  

Perinatal is the period of time from pregnancy until two years after birth. 

Perinatal Loss

In relation to perinatal loss, we work with people who have lost a baby under many circumstances. For example, either through unsuccessful IVF, early ending of pregnancy for any reason, early and recurrent miscarriage, still birth or baby loss in the first two years of a baby’s life. Losing a baby at any point and for any reason, can be incredibly painful. There is no ‘right’ or ‘wrong’ way to be feeling after these experiences. You may be struggling with a post-traumatic stress response, or you may feel stuck in the grief. 

Prolonged Grief

Following the loss of a baby the feelings of sadness and hopelessness are common and understandable. Over time, you may start to adapt, and slowly your life may begin to grow around your grief. When this doesn’t happen for many months or even years following the loss of your baby, you may become ‘stuck’ and be experiencing prolonged grief. You may find it hard to resume activities or interests and may struggle with day-to-day functioning.  

Some difficulties you may be experiencing relating to prolonged grief may include:  

• Intense yearning/longing for the baby 

• Pre-occupation with the thoughts, or memories of the loss of the baby and/ or excessive avoidance of reminders to the loss of the baby 

• Intense emotional pain  

• Emotional numbness as a result of the loss, and feeling that life is meaningless.  

If this is something you are struggling with our service may be able to help. 

Trauma 

We work with people who have a baby, however, have struggled with distress and trauma as result of their pregnancy, birth, or postnatal experience. This includes people who have been affected by significant hyperemesis and people who have been affected by their experience of Neonatal Intensive Care (NICU). Trauma like this can be painful.  

What is a trauma response?

Some people may have the above experiences and be able to continue and recover with their own internal resources and support systems. However, some people have such experiences and struggle with post-traumatic stress symptoms. These people may benefit from our service. 

If people have developed post-traumatic stress responses, they might notice flashbacks, (feeling that the trauma is happening right now), intrusive thoughts, images, and nightmares. They may notice intense distress at real or symbolic reminders of the trauma and physical sensations such as pain, sweating, nausea, or trembling. 

People might notice that they are more alert, on edge or hypervigilant and find it hard to settle or relax and feel panicked when reminded of the trauma. They can describe being easily upset, irritable or angry, finding it hard to sleep and concentrate and may find themselves checking their baby/children.  

People might notice that they avoid situations or reminders as a way of avoiding the memories and the feelings being brought up again. For example, avoiding pregnant people, anniversaries/significant occasions, hospital settings, procedures, intimacy, and pregnancy.

People can be left with feelings of guilt, shame, self-blame and difficulties with trusting people or professionals. 

Tokophobia (Fear of birth)

We work with women and people who experience what is often referred to as Tokophobia. This is a severe anxiety directly related to pregnancy, childbirth, and/or medical approaches or settings, which is significantly impacting on day-to-day life.

Due to the intense fear, people may avoid taking steps towards pregnancy, despite wanting to grow a family. People who do become pregnant find appointments frightening and try to avoid appointments in medical settings as much as possible. As the pregnancy progresses, the fear often worsens as people get closer to the birth. This is ok, it is not your fault.

We find that people can come looking for help quite late in pregnancy. We are here for you. However, we can help people to reduce some of this fear, so if you recognise these difficulties early on in pregnancy, please come to us earlier as we may be able to help you.

We recognise that each person’s situation and circumstances are unique to them. It is a person’s felt experience and the meaning that people take from events that can influence if it was experienced as traumatic.

We know that women and people may experience distress many years after the loss and/or trauma. Regardless of how long ago the loss or trauma occurred, if it is affecting you today, our door remains open. 

Support following a recent baby loss  

In terms of timings, we recognise that there are natural responses to trauma and loss, including grief, sadness, anger, and guilt. If you have found out that you have recently lost your baby, the days and weeks following this news may mean that you are feeling intense sadness, distress, confusion, disbelief, and shock. This is to be expected and understandable. This is what people experience in the acute stage of grief. If over some weeks, you wish for support, we would recommend contacting third sectors for peer support groups for example:  

• Manchester SANDS – https://www.manchester-sands.org.uk/  

• Finding Rainbows - https://findingrainbows.org/  

If further support is needed, you may wish to access bereavement counselling. 

• Talking therapies - https://www.nhs.uk/service-search/mental-health/find-an-NHS-talking-therapies-service/  

• Bereavement counsellors - https://greater-manchester-bereavement-service.org.uk/  

If over time you feel that you are stuck in the grief or your difficulties persist or worsen, our service may be able to help you. 

If someone is suitable for our service, we make contact with you and offer an initial meeting. This meeting is an opportunity to make sense of your needs. Many of our meetings take place virtually using video technology. We can also offer face to face appointments where this feels safe and appropriate, and this may be in a clinic venue, a children’s centre or your own home. 

We think about you within the context of the relationships of people around you. It is important that key people are involved in your care. You may wish to invite a partner or family member with you to your appointments or share information with them so they know what may help. We can think about this together.

You may have a baby/child or children in your care and wonder if they can attend appointments with you. We are keen to see you with your baby/child and we can discuss the options together. 

Therapeutic interventions 

We offer a range of talking therapies to women and birthing people, on a one-to-one basis and in group sessions, to help people move towards the life they want to be living. We work together to consider the options best for you. 

Cognitive Behavioural Therapy (CBT): Helps change patterns in thoughts, behaviour or actions and feelings.

Eye Movement Desensitisation and Reprocessing Therapy (EMDR): Reduces the distress of traumatic memories. It is less of a ‘talking approach’ than traditional therapies. It uses eye movements to process memories.

Compassion Focused Therapy (CFT): Helps people with shame and self-criticism. It uses thinking, behavioural and mindfulness techniques to increase compassion for self and others.

We recognise that each person and family are individuals with their own journeys. We can therefore work flexibly, drawing on a range of therapies to support you to move towards your goals. 

How to get the most out of therapy 

• Therapy is about talking about your difficulties and your experiences, which often understandably people tend to avoid due to how difficult they may be.
• Therapy involves working with a professional usually on a weekly/two weekly basis for an hour to an hour and a half towards your goals.
• It may involve learning strategies and skills to help you manage with your difficulties and consider how you interact with people around you.
• When engaging in therapy, often it is important to consider the timing of therapy as people can have multiple and conflicting priorities at times which may mean it is hard to put time aside and commit to therapy.  

We recognise that people may feel uncertain about getting help. These are some common thoughts that you may be having: 

• “I cannot trust services, the NHS or health professionals” 
• “Nothing will help me.” 
• “They won’t understand.” 
• “I should be able to move on from this.” 
• “I have a baby; I shouldn’t be feeling this way.” 
• “I don’t deserve help; this is my fault.” 
• “They might think I can’t look after my baby and take it away.” 
• “What will my family say if I reach out for help?” 

Many people have these thoughts, and many people may have anxious feelings about getting in touch with our service. Some people worry about talking about their trauma this is absolutely okay and understandable and often a result of the trauma. We will work hard to openly explore this in our sessions with you. We can work with you to build trust and help you live the life you want to be living.  

Regardless of your race, religion, age culture, ethnicity, sexual orientation, and beliefs we are an open service for all. 

If you feel you would benefit from support from our service, you can fill out a self-referral form and email this to us at PerinatalServicesMH@gmmh.nhs.uk.  

If you are a professional working with someone who you feel may benefit from our support, please seek consent from the individual before referring them to our service. Our professional referral form can be accessed on our website and emailed to us at PerinatalServicesMH@gmmh.nhs.uk.  

If you find yourself experiencing levels of distress that you feel you are experiencing a mental health crisis and would like to speak to someone, we would recommend you contact the GMMH helpline or Samaritans.  

GMMH 24/7 Mental Health Crisis Helpline  
Telephone: 0800 953 0285  
Website: https://www.gmmh.nhs.uk/247-helpline

Samaritans  
Telephone: 116 123 
Website: https://www.samaritans.org/