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Postpartum Depression

Postpartum PTSD Versus Postpartum Depression

Is it "normal" postpartum depression, or something more serious?

According to Postpartum Support International (PSI)*, up to 6% of women who give birth later experience Post Traumatic Stress Disorder (PTSD).

Postpartum PTSD is very different from Postpartum Depression. The former occurs as a result of trauma (or perceived trauma) during delivery, while the latter happens because of hormonal changes in a woman's body as a natural result of giving birth. Nevertheless, these two conditions are linked together in some cases, and can certainly exacerbate one another. It's important to distinguish between the two so that you can seek the most effective means of treatment.

Postpartum PTSD happens most often when mothers give premature birth to infants who begin their lives in critical condition. According to a new study from the Stanford University School of Medicine **, "... over half the parents whose babies were in the NICU for an extended period of time either had Post Traumatic Stress Disorder (PTSD), or were at high risk for developing it."

Along with parenting premature babies who must endure Neonatal Intensive Care, PSI* also lists the following types of childbirth trauma that could potentially lead to PTSD:

  • Prolapsed cord
  • Unplanned C-section
  • Use of vacuum extractor or forceps to deliver the baby

Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery can also contribute to Postpartum PTSD.

In 1993 The Journal of Obstetric, Gynecologic, & Neonatal Nursing printed the results of a study conducted to conclude how mothers of premature infants were affected by PTSD.*** Out of thirty mothers who had given birth to premature at-risk infants, sixteen of them showed symptoms of PTSD and a whopping 24 reported "re-experiencing" and "avoidance" characteristics. These reactions were still happening six months after the expected birth date.

The trick is to distinguish PTSD symptoms from those of postpartum depression and regular healthy recovery from childbirth. PTSD symptoms are generally grouped into three categories: re-experiencing, avoidance, and increased arousal.
Here are some of the signals to look out for:

  • Intrusive re-experiencing of a past traumatic event (which in this case may have been the childbirth itself)
  • Flashbacks or nightmares about the childbirth experience
  • Avoidance of stimuli that remind the mother of the childbirth experience-including thoughts, feelings, people, places and details of the event
  • Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
  • Anxiety and panic attacks
  • Feeling a sense of unreality and detachment

The good news is that Postpartum PTSD is treatable and temporary. The key is to get competent professional help as early as you can. It's important to treat PTSD before it begins to manifest as something harder to treat-such as an eating disorder, addiction, compulsive behavior, chronic panic disorder, or suicidal tendencies. If in doubt, contact your health care provider for advice right away.

More information: does a nice job of differentiating between "normal" biological postpartum depression and birth-related PTSD, and provides more detailed information, a breakdown of PTSD symptoms, and a helpline for those in need:


*** Wiley Online Library

© Susanne Babbel Ph.D. MFT

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