Postpartum Post-Traumatic Stress Disorder

Postpartum post-traumatic stress disorder (PTSD) is an anxiety disorder that often follows threat of death, serious injury, or trauma to the parent, infant, or someone close to the parent. It is estimated that up to 16% experience severe traumatic responses during the postpartum period [1] and approximately 3-9% meet criteria for a PTSD diagnosis.

Symptoms

  • Nightmares
  • Flashbacks
  • Anger/irritability
  • Sleep disturbances
  • Difficulty concentrating
  • Helplessness
  • Anxiety/panic
  • Hyper-vigilance
  • Avoidance of reminders (e.g., people, place, thoughts, objects) and distressed when reminded of the trauma
  • Negative changes in thinking
    • e.g., believing the world is dangerous, not able to remember details of the trauma, feeling detached, persistent negative mood, lack of interest in previously enjoyed activities, feeling the trauma is your fault.

Risk Factors

PTSD is triggered by traumatic events. Therefore, any perceived or real trauma that affects a person could lead to signs and symptoms of PTSD or a diagnosis. Some examples of trauma women experience with respect to having a baby are:

  • Hyperemesis gravidarum
  • Prolapsed cord
  • Unplanned C-section
  • Infant loss or stillbirth
  • Hemorrhage
  • Severe tearing
  • Baby being admitted, or medivaced, to the NICU
  • Use of vacuum or forceps
  • Long and painful labor
  • Unexpected delivery at home
  • Intended home birth, but needed to be transferred to the hospital
  • Lack of support or poor communication during labor and birth

In addition, those who have a:

  • history of mood and anxiety disorders
  • a previous history of trauma (e.g., abuse, sexual trauma, medical trauma, car accident)
  • Social isolation
  • Previous abortion
  • History of infertility [2]

Again, it’s important to note that it’s the parent’s perception of their pregnancy, birth, and postpartum experience that contributes to PTSD. Kate Kripke, LCWS writes:

… we know by now that it is not the specifics of the birth events that can lead a mom to be traumatized, but her perception of these events.  On paper, a birth might look “perfect” when, in reality, a mom may be walking away from her experience with some significant post-traumatic stress.  Physicians, midwives, doulas, nurses, spouses, partners, and family members may assume that all is fine and dandy for a mom after she delivers a healthy newborn when, in reality, her perception is very, very different [3].”

Treatment

PTSD is highly treatable. Treatment varies depending on the individual, but may include:

Psychotherapy (trauma focused)

  • Cognitive Behavioural Therapy (CBT)
  • Group Therapy
  • Eye movement desensitization and reprocessing (EMDR) 

Medication

  • Medication may be suggested by your health care provider to manage some of the symptoms of PTSD, such as depression, sleep disturbances, and anxiety.

If any of these signs and symptoms or are concerned, please reach out to your health care provider and/or a mental health professional.

If you are in need of immediate assistance, please contact your health care provider, 911, go to your local hospital, contact Crisis Services Canada, or National Suicide Prevention Lifeline.

Get Help

DISCLAIMER: The content of Postpartum Support Yukon’s website, posts, and blogs does not constitute medical advice, nor is it an emergency service. If you have concerns about any health or medical condition, diagnosis, or treatment, you should consult with a licensed healthcare provider. If you are experiencing a medical emergency, please call, or go to, your health care provider, local emergency department, 911 or your local emergency number immediately. Postpartum Support Yukon is intended for informational purposes only.

References

  1. Optimizing postpartum care. ACOG Committee Opinion No. 736. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;131:e140–50
  2. Montmasson, H., Bertrand, P., Perrotin, F., & El-Hage, W. (2012). Predictors of postpartum post-traumatic stress disorder in primiparous mothers. Journal de gynecologie, obstetrique et biologie de la reproduction, 41(6), 553-560.
  3. Kripke, K. (n.d.). Postpartum PTSD: Risk factors & symptoms. Postpartum Progress. Retrieved from https://postpartumprogress.com/postpartum-ptsd-risk-factors-symptoms