When things don’t go to plan: Post-traumatic stress disorder after birth
Post-traumatic stress disorder (PTSD) refers to a range of symptoms or reactions that you can develop if you have personally experienced or witnessed a traumatic event. For some people, childbirth can also fit into this category.
A traumatic event is one in which you, or others around you, may have felt threatened or unsafe and leads you to feel intense fear, helplessness or horror. Both men and women can experience PTSD after experiencing or watching a birth.
I was not fully in touch with reality for the last 8 hours or so of labour. I don’t know how common this is, but I was terribly traumatised and had no opportunity to debrief or ask questions. I never saw the obstetrician who was there. My partner was also traumatised and his memory of events was poor. We found it hard to piece together what happened and timeframes. I obsessed about it for months afterwards.
What are the symptoms of post-traumatic stress disorder following birth?
If you have PTSD following the birth, you may find yourself experiencing the following types of difficulties:
Re-living the birth/traumatic event
Through unwanted and recurring memories, including vivid images and/or nightmares. This may cause you to experience intense emotional or physical reactions, such as sweating, heart palpitations or panic when reminded of or discussing the birth or events.
Being overly alert or wound up
Being overly alert or would up can lead you to experience sleeping difficulties, irritability and lack of concentration, becoming easily startled and constantly on the lookout for signs of danger.
Avoiding reminders of the event
Some parent find themselves wanting to deliberately avoid activities, places, people, thoughts or feelings associated with the birth or aftercare event because it brings back painful memories.
Feeling emotionally numb
You may find yourself losing interest in day-to-day activities, feeling cut off and detached from friends and family, or feeling emotionally flat and numb.
Who is at risk?
Post traumatic stress disorder following birth can happen to anyone, particularly those who have experienced:
- A previous traumatic or difficult birth
- Rape or sexual assault in the past – as birth can remind them of their previous experiences where they felt sexually violated, assaulted or invaded
- Intimate partner violence and other traumas
For these reasons it is important to discuss this with your obstetrician, midwife or birthing professional prior to the birth, or those involved in your delivery at the time of birth – so they can be extra sensitive to your experience and supportive.
If you can identify with these symptoms, there are effective treatments available to help you recover from PTSD and allow you to move forward from the traumatic experience.
Treatment of PTSD following a traumatic birth can involve a range of approaches which are effective whether or not the event was recent or occurred a long time ago.
Psychological treatment for PTSD following birth
Trauma-focused cognitive behavioural therapy (CBT)
This treatment can help you to identify distressing thoughts, painful memories and feelings that you may hold from the birth, and give you tools and strategies to confront and come to terms with what has happened so that you don’t feel as distressed by them.
Treatment also generally involves giving you strategies to help you to relax, and stop the anxious feelings that you may be experiencing, as well as helping you identify and address situations that you may be avoiding. This can include for example, avoiding intimacy, talking about the birth or delaying a future pregnancy.
Eye movement desensitisation and reprocessing (EMDR)
This is a technique used specifically to treat PTSD by getting you to recall distressing images while using an external stimulus, such as eye movement or tapping. As with CBT, this treatment works by helping you to process distressing memories, reduce their lingering effects and allow you to develop effective coping strategies.
Medical treatment for PTSD following birth
Antidepressant medication, particularly selective serotonin re-uptake inhibitors (SSRIs) are helpful for the treatment of PTSD. This type of antidepressant can be safely used whilst breast-feeding.
Even if you don’t have depression, antidepressants can help make feelings associated with trauma more manageable.
This post was originally published at COPE and is republished here with permission.
For more information on PTSD and other emotional health challenges that can arise in pregnancy and early parenthood, visit cope.org.au. To find a list professionals specialising in PTSD in your area, search the e-COPE directory.