We have all heard of postpartum depression, but were you aware that postpartum Post Traumatic Stress Disorder (PTSD) is a thing? Roughly 2 to 6 percent of women will develop PTSD after delivering their child. That’s right, the same condition that affects combat soldiers and victims of violent attacks can also mar the fourth trimester.
PTSD can be conceptualized by four groups of symptoms: avoidance, intrusion, cognition, and mood. Avoidance symptoms include evading external things that remind one of birth as well as thoughts about the delivery. Intrusive symptoms are things like uninvited thoughts about the birth, nightmares about it, and flashbacks. Cognitive symptoms include not remembering parts of the delivery (that one would normally remember) and exaggerated beliefs about the event and consequences. This could be a belief like their child will be irreparably damaged by being placed in a NICU and not having skin-skin contact right away. Blaming one’s self for a disability caused to her infant from a difficulty delivery is a common but false and exaggerated belief as well. Mood symptoms include irritability, anhedonia (lack of pleasure), and feeling isolated from others.
The actual events of the birth are not necessarily proportional to the chances of having PTSD. Women who have had past mental health issues, a prior diagnosis of PTSD, or a negative view of childbirth are more likely to develop it. Please understand, having PTSD (or any mental health issue) is not a sign of weakness. Women in the postpartum period have it particularly rough because everyone expects them to be a happy, glowing new mom. For many, that is simply not realistic. For all or us, the fourth trimester has its ups and downs. This is true for every stage of life.
By definition, one must perceive the events of her delivery as being traumatic in order to develop PTSD. Interestingly, this does not always correlate to an actual emergency or traumatic situation. One large study found that the majority of women who had postpartum PTSD had normal vaginal deliveries.
Of course when women experience disturbing events during birth like emergency cesarean sections and/or prolonged labors as well as instrumental deliveries (forceps or vacuum), they tend to view the birth as traumatic. This does not mean that they will develop PTSD. They may have some symptoms though, that warrant treatment. In short, some women are more prone to developing PTSD based on past experiences and anticipating a negative outcome whether an outsider would view their birth as traumatic or not. Conversely, having what an observer would consider a traumatic birth does not necessarily mean one would develop PTSD.
One way of coping with a traumatic delivery is writing about it. Two researchers followed 12 women who wrote a narrative about their traumatic birth to be shared on the Traumatic Birth Association website. The women were interviewed after writing the narrative and then one month after it was posted online. All of the women viewed the writing exercise positively. Overall, they enjoyed helping others and benefitted from organizing their thoughts and experiences into a narrative. Writing about it helped them distance themselves from the experience. Writing a birth story can be cathartic whether it is shared with others or not.
The DSM-V, which is the bible of the mental health world, details the specific criteria needed to meet the PTSD diagnosis. Only a qualified mental health professional can make that call. However, if you are feeling any of these symptoms, it is important to reach out for help. You can find a therapist on the Psychology Today website. Some women are more comfortable starting with a new mom’s group. Many hospital’s host theses and they are usually facilitated by a nurse. Sometimes they are called breast feeding support groups but typically you don’t have to be breastfeeding to go. You can call the mother baby unit after you are discharged to find out about them. Your OB or midwife can also assist you. They commonly treat postpartum mental health issues. They can do an initial evaluation and refer you to a mental health professional if needed. It is important to seek treatment. You deserve the same attention and care that you are giving your newborn.
What was your birth like? Did you have a traumatic delivery or PTSD symptoms afterwards? Share in the comments below.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
Blainey, S. H., & Slade, P. (2015). Exploring the process of writing about and sharing traumatic birth experiences online. British Journal Of Health Psychology, 20(2), 243-260. doi:10.1111/bjhp.12093
Garthus-Niegel, S., von Soest, T., Vollrath, M. E., & Eberhard-Gran, M. (2013). The impact of subjective birth experiences on post-traumatic stress symptoms: A longitudinal study. Archives Of Women's Mental Health, 16(1), 1-10. doi:10.1007/s00737-012-0301-3