Postpartum post-traumatic stress disorder (PTSD)

PTSD after childbirth

Recognizing PTSD Awareness Day , the maternal side of it and the effects post-traumatic stress has on the lives of mothers impacted by it.

Childbirth could be experienced as distressing or even traumatic for some women. A traumatic childbirth could cause psychological distress, intense fear, or helplessness for the parturient and increases the risk of anxiety, depression and even post-traumatic stress disorder (PTSD), if not dealt with it might affect them for the rest of their lives.

One study showed that about 45% of women experienced traumatic childbirth and up to 4–6% of women developed PTSD following childbirth.

Giving birth can be one of the most painful experiences in a woman’s life, yet the long-term effects that trauma can have on millions of new mothers are still largely ignored.

PTSD after child birth

For some moms, birth and new motherhood experience is far from the pretty pictures we see on social media and tv ads. In reality they are going through struggles, mentally, physically and socially.

From pregnancy/birth complications to emergency birth, baby loss, postpartum depression, tough deliveries, loneliness and social pressure all add on to become a stressful burden women carry on their backs, stay in the back of their minds and affect their mental state to cause conditions like PTSD which is rarely recognized or talked about.

A human’s body reaction to stress isn’t very specific, we need to understand that our bodies can’t distinguish between sources of stress. So whether the stressor is the sound of gunfire or a baby wailing for hours on end for months, the internal stress reaction is the same. The bottom line is that any traumatic or extraordinarily stressful situation can indeed cause PTSD.

Postpartum mothers without a strong support network are certainly at risk.

If you haven’t heard of postpartum PTSD, you aren’t alone. Although it’s not talked about as much as postpartum depression, it’s still a very real phenomenon that can occur.

Post-traumatic stress disorder (PTSD) is caused by a real or perceived trauma during delivery or postpartum.

Why you haven’t heard about new moms dealing with Postpartum PSTD?

It’s not surprising, research into the area is limited and, to date, it has largely focused on the importance of the type of delivery. It is clear, however, that there are risk factors for Post Natal PTSD which include a very complicated mix of objective (e.g. the type of delivery) and subjective (e.g. feelings of loss of control) factors.

Most women’s health practitioners are quick to label a new mom’s anxiety and fears as postpartum depression. The reason PTSD for new moms isn’t diagnosed is because it hasn’t been studied enough.

Traumas that might cause Postpartum PTSD:

  • Prolapsed cord
  • lengthy or very painful labor
  • Feelings of loss of control
  • Traumatic or emergency deliveries, e.g. emergency cesarean section
  • Use of vacuum extractor or forceps to deliver the baby
  • Birth complications
  • Baby going to NICU
  • Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery
  • Lack of information or explanation
  • Lack of privacy and dignity
  • Fear for baby’s safety
  • Women who have experienced a previous trauma, such as rape or sexual abuse, are also at a higher risk for experiencing postpartum PTSD.
  • Poor post-natal care
  • Women who have experienced a severe physical complication or injury related to pregnancy or childbirth, such as severe postpartum hemorrhage, unexpected hysterectomy, severe preeclampsia/eclampsia, perineal trauma (3rd or 4th degree tear), or cardiac disease.

postpartum PTSD

Symptoms of postpartum PTSD

  • Intrusive re-experiencing of a past traumatic event (which in this case may have been the childbirth itself)
  • Flashbacks or nightmares
  • Avoidance of stimuli associated with the event, including thoughts, feelings, people, places and details of the event or brings up memories of the event (such as your OB or any doctor’s office)
  • Irritability, difficulty sleeping, hypervigilance, exaggerated startle response
  • Anxiety and panic attacks
  • Insomnia
  • Feeling a sense of unreality and detachment
  • Obsessing over anything that has to do with the baby
  • Detachment (feeling that things aren’t real)
  • Difficulty bonding with the baby

Many women who do not have PTSD, suffer from some of the symptoms of PTSD after undergoing difficult birth experiences and this can cause them genuine and long-lasting distress. These women are also in need of support.

Recommended treatment for Postpartum PTSD

Treatment starts with a thorough assessment by a trained mental health provider.

  1. Get assessed by someone who specializes in maternal mental health for a correct diagnosis to be made.  Therapists unfamiliar with postpartum PTSD might inadvertently recognize the symptoms as postpartum depression or anxiety. Although some of the symptoms are similar, the underlying experience of a birth trauma calls for a different treatment approach.
  2. Both medication and therapy are evidence-based recommendations for treating birth trauma. Seek help, talk to your partner, trusted family & friends and ask them for standing by your side while you get professional help.

Avoiding a Subsequent Traumatic Birth

  1. Include your partner in this process. While it might seem obvious to some, others may feel isolated by their initial trauma and not realize the important role a partner can play in providing support and mitigating a subsequent traumatic experience.
  2. Hire a doula. Having a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible helps alot! If for some reason the birth is not going according to your ideal plan, a doula will intervene during labor with the intention of alleviating the trauma to reduce a woman’s chances of developing PTSD.
  3. Take a childbirth education class. It’s important for women (and their partners) to be educated about what is supposed to happen during childbirth and what happens in the body during the birthing process. Childbirth classes also help to inform expecting parents about options during birth including: pain management, birthing positions, and how to cope with complications during birth.
  4. Develop a written birth plan with your birth team. Discuss and include the interventions you are open to, those you want to avoid. Explore your back up plan. Remember to plan for the postpartum period and to consider the support that will help ease your adjustment to motherhood, or to mothering an additional child.
  5. Talk to someone you trust. Work through any past traumas with a therapist, or at the very least discuss your history with your care providers to best prepare for the experience of labor and birth.  Meeting with a psychotherapist or body worker specializing in perinatal mental health allows you to focus on beliefs, emotions, sensations and any past experiences that may influence your upcoming birth.

Postpartum mood and stress disorders like postpartum anxiety, depression and blues can manifest in so many ways. spread the word and information out there so mothers stop disregarding their own emotions, and trust their instincts. Regardless of a strong bond, don’t ignore the voice that says there is something wrong. Don’t hide in the dark.

Read real mom postpartum experiences and how they overcame the struggles of birth & postpartum periods.

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