Kuan Lee 
When people think of posttraumatic stress disorder (PTSD), they often picture a shell-shocked veteran. While this is certainly PTSD, there are many other events that can trigger it, such as labor.
While labor can be a beautiful experience, it isn’t that way for everyone. If a mother or her baby has a complication—or even anxiety surrounding birth—it can lead to intense negative thoughts, feelings and flashbacks.
In this post, we’ll discuss what postpartum PTSD is and how to treat it.
What is PTSD?
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that is developed from a traumatic experience. The type of trauma experienced can vary widely, but can include:
- Natural disasters
- Sexual assault
- Violent assaults
- War
- Events experienced by someone else that affects you (ex. police officers knowing details of a crime)
- Miscarriage (one study surveyed woman who miscarried and sadly, almost half had PTSD)
PTSD symptoms include:
- Intense and unpleasant thoughts and feelings about the incident
- Reliving the experience through flashbacks or nightmares
- Avoidance behaviors (to stop symptoms from being triggered)
- Negative reactions to triggering events (ex. loud noise, physical contact, etc.)
- Depression
- Anger
- Fear
To be diagnosed with PTSD, a person needs to experience the symptoms for more than a month. Untreated, it may last months or years.
According to the American Psychiatric Association, PTSD affects about 3.5% of U.S. adults. Women are also twice as likely to have it.
What’s Postpartum Post-Traumatic Stress Disorder?
According to Postpartum Support International, 9% of women experience postpartum PTSD after giving birth. It’s usually brought on by a real or perceived trauma, including:
- Unplanned C-section
- Unexpected birth where you’re unable to make it to the hospital
- Baby that needs to be transferred to the NICU
- Prolapsed cord
- Lack of support or poor communication during delivery
- Experiencing a pregnancy-related complication, such as severe preeclampsia or unexpected hysterectomy.
With that being said, not every woman who has a negative birth experience will get PTSD. There are some risk factors:
- A history of mental health challenges (ex. anxiety, depression, etc.)
- A prior trauma (as discussed in the first section)
- Women who have an intense fear of childbirth
- Social isolation
- Previous infertility
- Previous abortions
If you have postpartum PTSD, you may have the following:
- Intrusive thoughts about the traumatic experience
- Nightmares or reliving it visually in your head
- Avoiding triggering details of the experience (ex. avoiding doctors, avoiding questions about your labor, wanting to avoid your baby, etc.)
- Panic attacks or anxiety
- Feeling unattached or unable to bond with your baby
- Insomnia
- Sadness
- The feeling of being “on edge” or easy to startle
It’s important to note that although you may experience the above symptoms, you may still be able to live a “normal” life. For example, mothers can return to work, breastfeed and parent, seemingly with ease. While no one on the outside knows anything is wrong, you may wonder why everything is more overwhelming.
In addition, while postpartum PTSD can cause bonding issues between mother and child, it doesn’t always. You may still feel a strong maternal sense yet experience symptoms.
PTSD or PDD?
Since some symptoms are the same, sometimes new mothers are wrongly diagnosed with postpartum depression (PPD) rather than PTSD. Here’s the difference:
- PTSD occurs from a real or perceived trauma, PDD does not.
- PDD occurs from hormonal changes or from emotional difficulty adjusting to motherhood.
- A mother can have both PPD and PTSD. If so, one condition may make the other worse.
How Does Labor Affect Those Already Diagnosed with PTSD?
We understand how labor can contribute to PTSD, but what if you already have the disorder? Does pregnancy make your condition better or worse? While the answer to that question is different for everyone, researchers have discovered some interesting findings.
You may assume that the added stress of having a baby will make PTSD worse, but that isn’t always the case. In a 2016 study of 319 women, more than half had high PTSD symptoms in the first part of pregnancy. As they got closer to birth, these women experienced a decline in symptoms. However, women with low symptoms had about the same level as their pregnancy progressed.
“We hope our results give a message of hope that women who have a past diagnosis of PTSD aren’t all headed for a worsening while they’re pregnant,” Maria Muzik, the psychiatrist who led the study, said.
PTSD got worse for one in four women, particularly those who:
- Suffered a new trauma during pregnancy
- Had the most worry surrounding giving birth
- Had worse experiences with PTSD symptoms
- Had post-birth issues
Why Does Pregnancy Make PTSD Better for Some and Worse for Others?
While there’s a number of factors that come into play, researchers noted that those with the strongest social support networks appeared to be the most protected against their condition worsening. That means it’s important to have a strong circle of family and friends around you during pregnancy.
Even if you don’t think you have PTSD, it can often go undiagnosed because there’s so many causes. Since social support has many other benefits—such as lowering the risk of depression, stress and improving pregnancy outcomes—stretching your network is a good idea regardless. Here’s 10 ways to get social support.
How to Treat PTSD
Treating postpartum PTSD is critical for several reasons:
- Women with PTSD are less likely to breastfeed (and there’s a ton of benefits your baby receives from breastmilk)
- PTSD can make it difficult to bond with your baby, leading to infant attachment issues
- Intense thoughts and feelings can lead to challenges with your partner or in your family dynamic
- It can make you less likely to want to get pregnant again (if you previously wanted a bigger family)
If you think you have PTSD, you should talk to your doctor who can refer you to a mental health professional. They will be able to diagnose you and provide a course for treatment. If it’s been less than a month since your symptoms have started, the doctor may instead treat the depressive symptoms and monitor you to see if they persist.
Although reaching out for help can feel awkward, remember that you’re not alone and many other new mothers have experienced the same thing. It does not make you a worse mother and it’s not your fault. While you can’t go back and change the traumatic event that caused this, you have the power to move through it in a positive way.
If you haven’t given birth yet, it’s never too soon to seek help. If you’ve already had your baby, you may also consider reaching out to Postpartum International for support.
Treatment may take the form of therapy, medication or a combination of both.
Therapy
There’s different types of therapy your provider can use. For example:
- Cognitive-behavioral therapy (CBT)—CBT focuses on the relationship between your thoughts, feelings and actions. A therapist can help you regulate your emotions and develop coping strategies to lessen the impact of the trauma.
- Eye movement desensitization and reprocessing (EMDR)—Another common type of therapy for PTSD is EMDR. You’ll be asked to focus on your trauma event while you watch or listen to something the therapist is doing. This could include something as simple as them waving a hand or making a sound. While you may not have to speak about your specific trauma, you’ll be given the goal of thinking about something positive while recalling the event. Over time, this can help to reprogram the way you think of the triggering situation.
- Group therapy— Talking about your experiences in a group of other people or moms can help you see that you’re not alone. There’s typically a group leader (usually a trained professional) who leads the discussions and teaches coping mechanisms. Group therapy tends to be cheaper. Also, some communities offer postpartum support groups for free.
Your therapist will learn about your trauma and decide which therapy is best for you. Whichever the method, PTSD therapy generally focuses on re-framing the trauma, such as retelling the birth story while honoring your intense feelings about it. Unlike medication, learning coping mechanisms can stop symptoms in the future, making it a long-term solution.
Medication
Anti-depressants and anti-anxiety medication are often used short-term to help a person overcome PTSD symptoms. Generally, medication is used to provide relief to intense thoughts and feelings. It’s often used to stop the condition from getting worse while beginning therapy.
If you’re still pregnant or breastfeeding, your options for medications may be more limited. Talk to your doctor about safe alternatives.
Do you have any tips for those suffering from postpartum PTSD? If so, share them in the comments below. If you have any new mother friends, be sure to share this post with them, too!
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