What Is Postpartum PTSD? How To Find Support
Overlooked mental health issues during and after pregnancy
When people think about mental health conditions related to pregnancy, their minds may jump to postpartum depression, now more often referred to as peripartum depression, to acknowledge the fact that depression can frequently happen during pregnancy. However, there are a number of additional pregnancy- and birth-related mental health disorders and subtypes. One type that may not receive as much attention is postpartum post-traumatic stress disorder (PP-PTSD).
What is postpartum Post Traumatic Stress Disorder (PTSD)?
What causes postpartum PTSD?
A traumatic birth experience or pregnancy experience is often the direct cause of a person experiencing postpartum PTSD.
Potential traumatic events during pregnancy and childbirth
These pregnancy and childbirth trauma events might include but are not limited to the following:
- Being unprepared for difficult sensations, emotions, or medical interventions experienced during pregnancy, labor, or delivery
- Experiencing a loss of control during pregnancy, labor, or delivery
- Adverse reactions to fertility treatments
- Severe illness during pregnancy, including mental illnesses like peripartum depression or anxiety
- An intense fear of the baby’s death during pregnancy, labor, or delivery due to medical complications or another concern
- Being induced to go into labor for a medical reason
- Painful or lengthy labor
- No medical support during labor
- A lack of information or explanation about what is happening during labor and delivery, including situations where there is a language barrier
- Doctors, nurses, and other medical providers being dismissive or invalidating during labor and delivery
- Not receiving enough pain relief during labor; requests for additional pain relief being ignored
- Experiencing disrespect or medical maltreatment during labor and delivery
- Being coerced into undergoing invasive procedures during birth
- The doctor using forceps or suction during birth
- Needing to have an unexpected C-section while giving birth
- Giving birth alone
- Giving birth to a stillborn or deceased baby
- Experiencing birth complications, such as unusual or excessive bleeding, a vaginal tear, or a birth injury to you or the baby
- Watching your partner undergo a traumatic or medically intense birth and being unable or not knowing how to help
- Having a near-death experience during birth
- The baby passing away after giving birth
- Your partner dying during labor or delivery
- Being separated from the baby for any reason shortly after giving birth
- The baby having to be taken to the neonatal intensive care unit (NICU) immediately after giving birth
- Being ignored after giving birth
- You or your baby requiring emergency treatment
Mental health risk factors for postpartum post traumatic stress disorder (PTSD)
Experiencing one or more of the above situations is no guarantee of developing PTSD symptoms during the postpartum period. Mental health professionals are still seeking to understand why some people may develop PTSD after surviving traumatic events while others do not. While more research may be advantageous, the following risk factors may heighten a person’s risk of developing postpartum PTSD:
- Previous trauma related to abuse, particularly sexual abuse or intimate partner violence
- History of mental health concerns
- Lingering injuries from a previous birth
- Experiencing a traumatic event during a prior pregnancy or birth, such as a difficult or incapacitating pregnancy, a stillbirth, or being invalidated or not receiving enough pain relief in a previous labor
- Neurohormonal factors
- A lack of social support
- Intense dread of labor
- An acrimonious relationship with the baby’s co-parent or the lack of a co-parent entirely
- Financial stress
- Insufficient prenatal care
- Social expectations that limit choices during pregnancy
- Lack of access to abortion and being forced to carry an unwanted pregnancy to term
- Low self-esteem
- Stress related to caring for other children
- Lack of educational attainment
- Living in a community where mental health concerns are stigmatized or not acknowledged
- Being in a heterosexual relationship where strict traditional gender roles are expected
Postpartum PTSD: A traumatic stress risk for all new parents
While rates of postpartum PTSD may be more common in people with gynecological reproductive systems, any new parent can develop postpartum PTSD, regardless of their gender or sexual orientation. Men and LGBTQ couples can experience symptoms of the condition as well.
Symptoms of postpartum PTSD
Because postpartum PTSD is a term used to refer to post-traumatic stress disorder caused by trauma associated with pregnancy or birth, it does not have a distinct symptom class separate from other forms of PTSD. However, PTSD symptoms may manifest in unique ways specifically related to parenting.
Common postnatal PTSD symptoms
- Sweating, shaking hands, a pounding heart, and other physical manifestations of anxiety, often with no apparent cause
- Nightmares and other sleep disturbances, such as difficulty falling asleep, staying asleep, or sleeping in a way that leaves one feeling rested
- A sense of numbness
- Sudden intrusive recollections of disturbing thoughts, particularly those related to the pregnancy, labor, or birth
- Exaggerated or extreme startle response
- Feelings of hopelessness, despair, dread, regret, or embarrassment
- Avoidance of reminders of pregnancy, labor, or birth, which can prevent bonding with the newborn child
- Fear of the medical system, which may lead to skipping doctor’s appointments and a negative impact on the health of both the parent and the child
- For the birthing parent, there may be difficulty in breastfeeding
Treatments for postpartum PTSD
Although PTSD and postpartum PTSD can be serious conditions, they are often treatable or manageable with support. Mental health professionals may recommend the use of trauma-informed therapy to address post-traumatic symptoms. Trauma-informed therapies include the following modalities.
Eye movement desensitization and reprocessing (EMDR) therapy
In EMDR therapy, a therapist employs bilateral brain stimulation techniques, such as alternatively tapping on the backs of their clients’ hands or slowly passing their fingers back and forth in front of their eyes while asking the clients to recall their traumatic memories. Bilateral brain stimulation is thought to incite a state of mind similar to rapid eye movement (REM) sleep. This technique may allow clients to reprocess or remember traumatic events without becoming re-traumatized.
Narrative exposure therapy
In narrative exposure therapy, clients work with the therapist to develop the story of their traumatic experience. Engaging with the experience in a narrative format may help the client create some distance between themselves and their trauma and learn to process it and integrate it in a healthy way that can alleviate PTSD symptoms.
Cognitive-behavioral therapy (CBT)
Cognitive-behavioral therapy (CBT) is a widely used method of treating a range of mental health conditions, including PTSD. It focuses on the relationship between thoughts and behaviors. When focused on supporting a client with postpartum PTSD, trauma-informed CBT might focus on distorted or damaging beliefs parents may hold about their traumatic experience, such as thinking that birth complications were their fault. Reworking these thought patterns may help the person release the impacts of the trauma and move forward.
Acceptance and Commitment Therapy (ACT)
ACT helps clients accept their thoughts and feelings rather than trying to change them. For postpartum PTSD, it encourages accepting the emotions tied to the trauma and focusing on actions aligned with personal values, helping individuals live meaningful lives despite emotional challenges.
Support options for postpartum stress disorder
Having a form of PTSD, including postpartum PTSD, can make daily life seem scary or overwhelming. PTSD symptoms can make everyday tasks difficult, including leaving the house to attend a therapy appointment. In these instances, online therapy through a platform like BetterHelp may be a way for people with PTSD to talk to a therapist in a more accessible format. Through an online platform, clients can choose between phone, video, or live chat sessions and utilize resources like journal prompts, worksheets, and support groups from home.
Online trauma-informed therapy
Research has shown that attending trauma-informed therapy online can be as effective as therapy attended in a traditional in-person setting. Researchers found that an online CBT program for people with PTSD enabled clients to trust their therapists more and reduced the number of PTSD symptoms they were experiencing.
Takeaway
What are the symptoms of PTSD after giving birth?
Post-traumatic stress disorder can develop after any traumatic situation, and a traumatic childbirth has been shown to trigger symptoms in around 4-5% of mothers, and 1% of birth partners. Postpartum PTSD symptoms may include:
- Flashbacks or nightmares around the event
- Hyperawareness, feeling “on edge”
- Difficult beliefs and feelings (like nowhere is safe, you can’t trust others)
- Detachment, avoidance, or dissociation
- Anxiety and panic attacks
- Difficulty sleeping
What is the difference between trauma and PTSD?
Trauma is an experience that results in fear, dissociation, or confusion, and can impact long term functioning. Traumatic experiences may lead to the development of PTSD, a mental health condition that is a physical and mental response to trauma.
What are the 5 symptoms of PTSD?
Post traumatic stress can develop in those who have suffered trauma, and may include a combination of the following:
- Exposure to trauma, including things like sexual assault or witnessing a death
- Intrusion symptoms such as nightmares or recurring flashbacks
- Avoidance of situations, places, or people that remind the person of the experience
- Altered mood
- Altered reactivity
How to cope with postpartum PTSD?
Postpartum PTSD can be diagnosed and treated by a perinatal mental health professional. Talk therapy and support are typically the treatment options for those experiencing PTSD. CBT and EMDR are common evidence-based approaches that can help the patient process their feelings and learn effective coping strategies. It is also important to ask for help. Emotional and practical support from family members and friends can allow a new mother to have the time to participate in self-care practices like getting exercise and rest, and heal from past trauma.
What does PTSD from birth look like?
Postpartum PTSD can be a response to the psychological distress occurring during traumatic experiences occurring in the perinatal period. Birth trauma can include things like postpartum hemorrhage, high risk births, long or particularly intense and painful labor, or premature birth. While it is a different condition from perinatal depression, there can be overlaps in symptoms and these conditions can exacerbate each other.
Women suffering from postpartum PTSD may notice that they worry excessively about the health of their child. Many women ruminate on negative thoughts, and have nightmares and flashbacks to birth or traumatic moments after. Postpartum PTSD can be a serious condition, but it is treatable with professional help. Effective treatments include talk therapies like CBT to challenge negative thoughts, identify what triggers PTSD and process feelings around these scenarios, and learn healthy coping skills to manage stress. Support groups, and support from family members and friends can also be a part of PTSD treatment. Self-care and healthy lifestyle practices are typically recommended.
How long does PTSD last after pregnancy?
This can depend on a number of factors, including whether an individual seeks treatment from a mental health professional. Emotional support is also important for new mothers. You don’t have to have a medical education to help, simply offer your time and support.
That being said, if treated, postpartum PTSD is considered a temporary condition. However, if untreated it can continue to interfere with life and relationships.
What does PTSD trauma look like?
PTSD trauma is any event that causes a reaction of fear or fear that causes distress to reoccur in an individual’s life. PTSD trauma may be physical, emotional, or sexual abuse. It can be witnessing or experiencing a scary event like a mugging or a natural disaster. It can be a product of war or displacement or homelessness. It can also develop after a difficult pregnancy or delivery.
Why do I have PTSD but no trauma?
Past trauma can sometimes be difficult to spot, because it is so normalized. For example, many wouldn’t think of birth as a traumatic experience, but it is for many. In the case of postpartum PTSD, many mothers may experience symptoms but not understand why they are happening. However, a particularly long or painful birth process, a difficult pregnancy, or sickness in the mother or baby after birth can lead to PTSD.
Is PTSD the same as stress?
Stress can be a contributing factor to PTSD, but it is not the same thing. PTSD is a mental health condition with a series of symptoms that are a stress reaction to scary or painful experiences.
How do I know if I've got PTSD?
If you experience recurring negative thoughts or stress related to a particularly scary or painful time, and they are interfering with your daily life or relationships, you may be experiencing PTSD. You may also notice that you become hyper vigilant, or have a tendency to avoid certain people, places, or things that remind you of an experience.
If you have a family history of PTSD or other mental health disorders, you may also be at higher risk of developing PTSD.
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