“Being a mother is learning about strengths you didn’t know you had and dealing with fears you didn’t know existed.” This quote by Linda Wooten highlights the challenges and gifts of motherhood that should be centered this Maternal Mental Health Awareness Month. One aspect of maternal mental health awareness involves birth-related post-traumatic stress disorder or postnatal PTSD, a condition characterized by experiencing traumatic events during labor or childbirth. According to Postpartum Support International, approximately nine percent of mothers develop postnatal PTSD after a variety of shocking, unexpected, or traumatic experiences during the birthing process.

Causes

There are a plethora of factors that can cause the development of postpartum PTSD. Some causes include experiencing a difficult labor with a painful and long delivery, having to have an unplanned Cesarean section or C-section, or requiring some other kind of emergency treatment. Postnatal PTSD can be related to not only the mother’s experience of childbirth but also witnessing their baby face complications as well, including the experience of baby loss. Just as other forms of post-traumatic stress disorder are not always immediate and obvious, the development of postpartum PTSD can occur over a long period of time.

Misconceptions

Misconceptions surrounding postnatal PTSD can make it difficult to seek resources and treatment as well as add to internalized shame around the experience. Some people may mistakenly believe that having a baby will make up for or negate the trauma; nevertheless, even something like celebrating the child’s birthday can be challenging because it is also a trauma anniversary. This can create complications in the mother’s relationships including with the relationship between mother and child. In addition, there may be comorbidity with other postpartum issues such as postpartum depression and postpartum anxiety. Postnatal PTSD can also be further complicated by child loss during labor and delivery. As a result, mothers can experience a plethora of emotions ranging from anger and disappointment to grief and despair when the childbirth experience was not what they hoped for or expected.

Signs and Symptoms

Signs and symptoms of postpartum PTSD can manifest in a myriad of ways; however, regardless of the presentation of this condition, every mother deserves compassionate, quality care. Some individuals may experience vivid flashbacks of the traumatic birth experience; this creates a feeling of reliving the trauma as if it is currently happening since our brains can’t tell the difference between memory and the here and now. Intrusive thoughts and images may occur alongside nightmares and insomnia. When reminded of the trauma through real or symbolic triggers, people may experience intense distress and physical symptoms such as pain, sweating, nausea, and trembling. People might notice they are hypervigilant, jumpy, panicky, or consistently feeling on edge which can result in feeling more easily angered, irritable, or aggressive. Some may even cope through self-destructive or reckless behaviors such as substance use in order to avoid difficult feelings, memories, and beliefs. It is common for individuals experiencing postnatal PTSD to avoid certain situations associated with their trauma, have difficulty concentrating or remembering details from the event, be unable to express affection to others, and feel emotionally and physically numb or detached from their body and surroundings. Survivors may also struggle to navigate through newly developed difficult belief systems of distrust, feeling perpetually unsafe, misunderstood, and a deep-rooted, toxic shame and blame cycle.

Treatments

Mental health therapeutic approaches such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing Therapy (EMDR) have been proven to help heal from traumatic experiences and PTSD symptoms. Medication may also be necessary to supplement this process. It is imperative for those struggling to identify their triggers, give themselves time and space to heal, and utilize their support systems. If peer support is not enough, mothers may consider professional resources such as those offered by Embrace Therapy – a mental health agency which prides itself on honoring maternal mental health information, support, and care.