Written by Psychologist, Nikolina Miljus
When childbirth doesn’t go as planned, or medical factors outside anyone’s control make it life-threatening, the birth experience can sometimes lead to post-traumatic stress disorder (PTSD).
We take a look at symptoms of childbirth PTSD and factors that influence whether the difficult labor will become traumatic.
PTSD after childbirth
Childbirth is a process that moves ahead without your control, and critical medical emergencies do happen.
Difficult births, like the ones that were induced or ones involving emergency C-section, assisted delivery, tears, and other physical consequences for the mother and the baby, don’t always lead to trauma.
The critical element of any traumatic experience is feeling like your life or that of someone close to you is in danger.
When this experience is too intense, and the threat to your or your baby’s life becomes overwhelming, there is a chance for PTSD symptoms to arise.
Even though PTSD is usually linked with war trauma, it’s important to note that PTSD symptoms can follow any traumatic event that was so intense that your coping capacities were overwhelmed.
This is not a sign of your weakness but instead, a sign of how physically and emotionally strong the traumatic event was.
An in-depth study of childbirth-induced PTSD demonstrated that up to 16% of women experience some of the postnatal PTSD symptoms related to childbirth, while 6.3% of women encounter acute PTSD after the birth.
Women with previous traumatic experiences are more likely to feel their symptoms re-emerging after traumatic childbirth.
But women with no history of mental health disorders or traumatic experiences can experience postnatal PTSD when faced with traumatic birthing experience.
How can you recognize childbirth PTSD?
Complicated childbirth during which you felt that your or your baby’s life was in danger can leave a profound impact on how you feel and think in days and weeks post-labor.
The symptoms of post-traumatic stress disorder vary from women to women since we all react to high levels of stress differently.
While some women are more likely to direct their emotions outward and focus on action in whatever form available, others are more likely to withdraw emotionally and “suffer in silence.”
The following symptoms are typical for childbirth PTSD:
- Emotional numbness and feeling detached from the people closest to you.
- Feeling anxious, tense and “on edge.”
- Intrusive, vivid memories of the traumatic childbirth that feel like you are re-experiencing the trauma again that are out of your control.
- Insomnia or nightmares involving traumatic memory.
- Inability to remember willingly the labor, people and events involved.
- Avoiding all possible reminders of the traumatic event.
- Difficulty concentrating, feeling ‘absent-minded’ or overwhelmed with fear.
- Feeling guilty, insecure and blame yourself.
- Mood shifts, from depressed and hopeless to angry and impulsive seemingly without a cause.
- Difficulty bonding with your baby or your partner due to the traumatic childbirth.
The signs of childbirth PTSD are usually most intense in the days and weeks after the labor.
Since physical trauma, the pain and worry for your baby take over your focus immediately after the childbirth it might be more difficult to recognize the psychological signs of PTSD.
Your pregnancy hormones are still high in the first weeks after the delivery, so that can make your emotions more intense and unstable.
To complicate things even more, the symptoms of childbirth PTSD often are mixed up with symptoms of postnatal depression.
Though these two conditions can be related, childbirth PTSD requires a specific trauma-oriented treatment.
Risk factors associated with childbirth PTSD
The level of threat to your and your baby’s life is not the only factor that makes a labor a traumatic experience.
In fact, the level of medical emergency rarely comes up as the only contributing factor to childbirth PTSD.
The negative subjective experience of childbirth far more often shows up as a vital element that made a birthing experience traumatic.
1. The negative subjective experience of childbirth
It often turns out that the reality of what happens in the delivery room and your expectations of what the labor will look like end up being completely different.
Even though medical emergencies during the labor on their own can make the childbirth traumatic, the medical and emotional support you have during the birth can make a huge difference in how you cope with this experience.
The level of pain and the sheer length of the physical effort during the labor can exhaust your emotional capacity to cope with emergency events.
The common notions to “just be strong” and “millions of women have already gone through this”are very harmful when you find yourself in this position, adding blame and guilt for being “weak.”
If on top of all this the medical staff around you shows little understanding for your fears, and you feel like you are entirely powerless, not knowing what will happen next, the likelihood for birth trauma rises.
The midwives and medical staff see childbirth every day, but your experience is uniquely yours.
Sometimes even an innocent remark may seem harsh or hurtful, not to mention the situations when you simply don’t have enough information about what is happening with your body.
The lack of privacy, feeling like your body is exposed and “handled” can make you feel disrespected, and can add feelings of shame and humiliation to already an overwhelming mixture of emotions you’re encountering during the labor.
2. Maternal mental health
Your mental health during the pregnancy is closely related to how you’ll experience the childbirth.
Women who encountered birth trauma (or experienced other traumatic events) previously are more likely to re-experience the trauma with later pregnancies, if they don’t get adequate support and counseling.
Finding yourself again in a situation in which your or your baby’s life is in danger, and you’re more or less powerless to control it, reawakens the PTSD symptoms.
Antenatal depression and the history of mental health issues in the past are also likely to make you more susceptible to perceiving the childbirth as traumatic, as are pregnancy specific fears.
3. Level of support
Difficult childbirth is a reality many women face unprepared since there is no good way to prepare for the unexpected.
The level of emotional support during the labor you have either from your partner, close family member, doula or midwife can help you cope with the traumatic experience more successfully.
Having someone close to reassure and comfort you, even to cheer you on extends your coping capacity and enables you to get through physical and psychological efforts of labor.
Why getting treatment for childbirth PTSD is important
Birth trauma means that it can be more difficult to bond with your baby.
Unprocessed trauma also increases the likelihood that you might encounter depression, anxiety or relationship issues, both with your partner and your baby.
The intense fear and trauma can make it almost impossible to even consider another pregnancy, as the idea of going through the experience again awaken intense symptoms.
Women who suffer childbirth PTSD symptoms often face misunderstanding even from other women.
Finding out you are not alone and that there are treatment options available can be a life changer in this situation.
There are support groups available online and offline as well as professional counselors trained to deal with trauma.
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387093/
- Prevention and Treatment of Traumatic Childbirth – http://pattch.org
- Birth Trauma Association – https://www.birthtraumaassociation.org.uk