Postpartum PTSD: Trauma during Childbirth

Postpartum post-traumatic stress disorder (PTSD) is one type of perinatal condition that can develop after childbirth. Surveys show that approximately 1 to 15% of women develop postpartum PTSD, but up to 35% of women may experience some symptoms of the condition. 

There are two types of postpartum PTSD. The first type can happen after a woman experiences a traumatic birth during which the baby and/or mother’s life are threatened. The second type of postpartum PTSD happens when a woman has had a previous trauma, such as past physical, emotional, or sexual abuse, and experiences PTSD symptoms related to the previous trauma after giving birth. This article will focus on the first type of postpartum PTSD, but the information found in the Getting Help section below applies to both types. 

Experiencing a traumatic birth can trigger symptoms of postpartum PTSD.

What is postpartum PTSD?

Postpartum PTSD is a perinatal mood and anxiety disorder (PMAD), which is a mental health condition that occurs in pregnant or postpartum women. It is a set of symptoms that develop following exposure to a traumatic event.

Signs and symptoms

To be diagnosed with PTSD, you must experience the following for at least one month:

  • Exposure to a stressful, traumatic event

A person either experiences or witnesses an event in which their own or a loved one’s health, safety, or life is threatened. Different events may feel traumatic to different people. Women may experience having an unplanned cesarean (c-section) or serious complications during birth as traumatic. A woman may experience her birth as traumatic even if her doctor does not see it that way. 

  • Intrusive thoughts about the trauma

Trauma survivors may find themselves reliving the trauma through upsetting memories, nightmares, and flashbacks. When faced with reminders of what happened, they may have overwhelming physical and emotional reactions. 

  • Avoidance of reminders of the trauma

Survivors may try to avoid any memories, thoughts, feelings, or reminders of the traumatic event. Women who experience traumatic births may also have a hard time talking about what happened.

  • Changes in thoughts, feelings, and mood

After a trauma, people may feel negative, isolated, and blame themselves for what happened. Survivors may have a hard time remembering certain aspects of the trauma. They may also feel less interested in activities that were once enjoyable.

  • Arousal and reactivity

Following a trauma, people may feel more irritable, on edge, and engage in risky or destructive behaviors. They may find that they startle more easily and have difficulty with concentration and sleep. 

PTSD does not necessarily develop right after a traumatic event. Some people may go through a trauma and develop signs of PTSD months or even years later. This is called “delayed expression.”

Dissociation

Some people who develop PTSD may also experience dissociative symptoms. Dissociation is a lack of connection between a person’s thoughts, feelings, memories, and identity. People with PTSD may experience one or both types of dissociation:

  • Derealization is a feeling that the outside world is unreal. People may feel as though they are in a dream-like state.
  • Depersonalization is a feeling of being detached from your own body or mind. People may feel like an outside observer of their own bodies. 

The impact of postpartum PTSD

Postpartum PTSD can be debilitating for mothers and affect many areas of their lives. If you have postpartum PTSD, you may also experience depression, anxiety, and other emotional issues. Studies on this condition show that it can affect your ability to bond with your baby, marriage and other relationships, and sex life. Women with postpartum PTSD may avoid any reminders of the trauma, such as going to the OBGYN. This can stop mothers from getting the proper care that they need. Women may also feel anxious or avoid future pregnancies because of their fear of experiencing another traumatic birth. 

Am I at risk of postpartum PTSD?

Anyone who experiences a trauma during pregnancy or childbirth is at risk of developing postpartum PTSD. Certain factors may increase the risk of a woman developing this condition, including:

  • Current or past depression, anxiety, or other mental health issues
  • History of previous trauma, including past sexual abuse
  • Experiencing medical issues during pregnancy or childbirth, such as preeclampsia, postpartum hemorrhage, or cardiovascular (heart) disease 
  • Experiencing complications during delivery, such as umbilical cord prolapse, use of vacuum or forceps, or an unplanned c-section 
  • Giving birth prematurely
  • Having a baby who spends time in the NICU
  • Having an infant with medical complications

Fortunately postpartum PTSD is a treatable condition. With support and help you can recover. Read on to learn more about treatment options. 

Getting treatment for postpartum PTSD can help you feel more connected and present for your baby.

Getting help for postpartum PTSD

For many new mothers, getting help for postpartum issues is difficult when you also have a child(ren) to care for. However, postpartum PTSD is a condition that can get worse over time. If you’re struggling, consider the following forms of help. 

Psychotherapy

Psychotherapy is an effective treatment for postpartum mood and anxiety disorders and PTSD. It involves speaking with a mental health professional who can help you process the trauma and develop coping skills. This form of treatment can be helpful in mild to severe cases of postpartum PTSD, but is especially recommended if:

  • Your symptoms last for several weeks or longer and don’t seem to be improving
  • You do not have a good support system
  • You are having suicidal thoughts or urges to harm yourself, others, or your baby

There are many different approaches to psychotherapy for treating postpartum PTSD, including cognitive behavioral therapy (CBT), exposure therapy, and eye movement desensitization and reprocessing (EMDR). The most important part of psychotherapy, though, is finding a therapist that makes you feel comfortable and safe. The relationship between a therapist and client is the most critical component of successful therapy. 

To find a local therapist that specializes in postpartum issues, you can ask for referrals from your OBGYN, physician, or health insurance company or conduct an online search. Postpartum Support International’s Online Provider Directory provides a listing of local therapists that specialize in women’s health.

Medication

For moderate to severe cases of postpartum PTSD, psychiatric medication may be beneficial. You can speak with your primary care doctor, OBGYN, or psychiatrist about the risks and benefits of taking medication. If you’re currently breastfeeding, your doctor will take this into consideration, since certain medications can pass into your breast milk. If you decide to take medication, your doctor will discuss how you can safely do so while breastfeeding. 

Support groups

Support groups can be an important resource for new mothers. Research studies show that social support can help women cope with the transition to parenthood. These groups are made up of women struggling with similar issues. They provide an opportunity to share your own experiences in a safe, non-judgemental environment. 

Support groups are available in face-to-face and online formats. To find a local face-to-face support group, you can do an online search in your area or ask your OBGYN or physician. Postpartum Support International (PSI) offers a helpine, online directory of local groups, and online support meetings. Solace for Mothers is an organization that offers online support specifically for women who have experienced traumatic births. 

Mindfulness

Mindfulness is the ability to be aware of the present moment. It involves letting go of thoughts about the past or future and instead focusing on your breath. Mindfulness is a skill that we all possess, but we must practice it to get better.

If you have PTSD, you may find yourself focused on the past or future. You may feel constantly on edge, irritable, and anxious. Mindfulness can help decrease the release of stress hormones in the body, which can reduce symptoms of PTSD

Mindfulness can be done in many forms: sitting, lying down, walking, or during yoga. If you would like to start a mindfulness practice, you can start by taking a class or listening to a guided meditation video online.

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Postpartum PTSD is a serious condition that can affect your ability to feel calm, adjust to motherhood, and bond with your baby. If you think that you or someone you know may have postpartum PTSD, do not hesitate to seek professional help or support through an in-person or online group. Taking action to help yourself can mean the difference between continuing to struggle and getting better. 

Resources:

Postpartum Support International – Postpartum post-traumatic stress disorder

Solace for Mothers – Healing after traumatic childbirth 

postpartum PTSD

The Mindful Mommy

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