Birth Trauma. Two words that feel like they should not be paired. Birth trauma is yet another paradoxical experience in the mud that is mothering. Birth “should” be joyous, peaceful, supported, and maybe (a little) painful. Drugs or the body’s natural endorphins can numb the pain. My mom always says, “You forget the pain of child birth.” But, what if you can’t? What if the pain, emotional or physical, creates anxiety or panic, insomnia, flashbacks, or nightmares?
The prevalence of Postpartum Post-Traumatic Stress Disorder is debatable. I have read it occurs in anywhere from 1.5-17% of women, but 25% have symptoms. This is tricky territory because many providers do not recognize postpartum PTSD so mothers will often receive a postpartum depression or anxiety diagnosis. What I see in my practice is a very obvious correlation that is quite common. The experience of any trauma is entirely defined by the individual. So, one mother might have a similar experience as another and deem it traumatic. The level of traumatic response is also variable. Regardless, the experience of trauma can taint the experience of parenting and lead to increased postpartum emotional complications.
Postpartum PTSD can be caused by a number of experiences in childbirth. Here are just a few:
• Stillbirth/infant death
• Inadequate medical care
• Emergency C-section
• Rapid delivery
• Inadequate pain relief
• The baby being in the NICU
• Prolapsed cord
• The use of vacuum or forceps
• Feelings of powerlessness, poor communication, or lack of support and reassurance during the delivery
• Women with a severe complication or injury during pregnancy or childbirth
• A history of trauma, such as rape or sexual abuse
Symptoms of postpartum PTSD may include:
• Intrusive re-experiencing of a past traumatic event (which in this case may have been the childbirth itself)
• Flashbacks or nightmares
• Avoidance of stimuli associated with the event, including thoughts, feelings, people, places and details of the event
• Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
• Anxiety and panic attacks
• Feeling a sense of unreality and detachment
Cheryl Beck lists the most common themes related to birth trauma. According to Beck, many times when a mother experiences birth as traumatic, it was considered routine by providers. This is an interesting list because it indicates how much the potential experience of trauma can be avoided. The themes point to being treated with a lack of compassion, respect, and care:
1. To Care for Me: Was That Too Much To Ask? Women did not feel supported, heard, or respected by their providers.
2. To Communicate With Me: Why Was This Neglected? Providers talked in front of these mothers as if they were not there or failed to communicate with them.
3. To Provide Safe Care: You Betrayed My Trust and I Felt Powerless
Unfortunately, medical mismanagement is something I hear about quite frequently. Providers are unsure of what to do and make mistakes.
4. The End Justifies the Means: At Whose Expense? At What Price? Because the baby arrived safely and healthy, the traumatic experiences were ignored or glossed over. Celebrating the baby was more important than addressing the trauma.
Birth Trauma is a larger, more systemic issue than I have time to address in this post. My goal is to educate moms, partners, providers, and friends on the concept of birth trauma. Mothers often ignore the experience of a traumatic birth. I hear so frequently, “At least my baby is healthy.” Is that all that matters? Mom has to be healthy too. At least if they are in my office, I know they are attempting to get their needs met and we can begin to resolve the trauma. There are amazing interventions like Brainspotting, EMDR, Emotional Freedom Technique, and talk therapy that can help mothers heal the wounds of trauma. Postpartum PTSD is treatable and things can get better.
Nichole Jones, LPC is a Psychotherapist and Therapeutic Yoga instructor in Longmont, CO. She treats moms with Postpartum Depression, Anxiety, OCD and
PTSD using Brainspotting, EFT, talk therapy, and yoga techniques. For more information on Nichole visit http://www.nicholejones.com.
Postpartum Support International: http://www.postpartum.net/learn-more/postpartum-post-traumatic-stress-disorder/
Beck, Cheryl Tatano. Birth Trauma: In The Eye of the Beholder. Nursing Research: January/February 2004, Vol. 53, Issue 1, pp. 28-35.
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