Becoming a mom is often a time of great joy. But even in the best of circumstances, pregnancy, delivery, and the postpartum period can be overwhelming and sometimes even traumatic.
It’s common — and not surprising — that many moms of new babies feel stressed, sad, and anxious in between those moments of happiness and excitement. Having a newborn can be challenging, so bouts of mixed emotions are completely normal. Sometimes, though, the postpartum ups and downs go well beyond what’s expected.
Though conditions like postpartum depression (PPD) and postpartum anxiety have gotten a fair amount of attention in recent years, mood disorders like postpartum post-traumatic stress disorder (P-PTSD) haven't. But PTSD after giving birth is still very real, and can take a toll. Here's more about postpartum PTSD.
What is postpartum PTSD?
Though not as well-known as some other mental health struggles, postpartum PTSD can be difficult and unsettling for the new moms who suffer from it. And the condition does sometimes affect the way they experience motherhood and care for their new babies. Its onset may be tied to some sort of traumatic birth experience.
The American College of Obstetricians and Gynecologists (ACOG) estimates that 3 to 16% of new moms have severe traumatic stress responses in the postpartum period.[1] In fact, more than a third of moms who recently delivered babies describe those births as traumatic.
Like war veterans with PTSD — who are haunted by intrusive memories and flashbacks of traumatic experiences on the battlefield[2] — moms with postpartum PTSD look at childbirth as a source of severe pain and anxiety, and tend to suffer from classic symptoms of post-traumatic stress disorder.
What causes postpartum PTSD?
Postpartum PTSD is triggered by a traumatic event or events — real and perceived — during pregnancy, labor, delivery, and/or the postpartum period.[3]
A mom-to-be may look at her severe morning sickness, fertility treatments, or serious pregnancy complications as traumatic. Some women might also experience trauma during childbirth if their labor was long and painful; they wound up having a C-section after trying to deliver vaginally; or there was a complication like a cord prolapse or serious bleeding.
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Trauma can also stem from a home birth that ended at the hospital because of complications; delivering a premature baby; breastfeeding difficulties; and other challenging situations that arise during labor, delivery, and beyond.
Not all moms who have tough childbirth experiences will develop PTSD, but some do. Experts believe that postpartum PTSD can sometimes be triggered by the feeling of a lack of control.
Often, moms-to-be have idealized expectations of having a perfect pregnancy or a perfect delivery, with their exact wishes spelled out in their birth plans. Some of these moms have a particularly hard time accepting that things don’t always go as expected, especially when it comes to having babies and becoming a parent.
And while many women do end up with the pregnancies and births they'd hoped for, there are also unexpected events (serious or minor) that catch some new parents off-guard.
So when a pregnant mom delivers early, has to rush to the hospital to make it there before baby's birth, or has an unplanned C-section, for instance, expectations might be shattered, and she may have a hard time coming to terms with it all.
What are the symptoms of postpartum PTSD?
Some signs and symptoms of P-PTSD can include:
- Intrusive thoughts. Postpartum PTSD can leave a new mom with disturbing, intrusive flashbacks and nightmares that vividly replay (and possibly magnify) the traumatic experience.
- Avoidance behaviors. P-PTSD sufferers may experience avoidance behaviors — distancing themselves from anyone or anything that reminds them of the traumatic situation. That could include trying to avoid their babies, doctors, and any thoughts about childbirth. New moms with postpartum PTSD may also struggle with painful feelings of isolation, potentially causing them to feel detached from their babies and other people.
- Anxiety and panic attacks. Moms with postpartum PTSD may have panic attacks, an exaggerated startle response, and/or frequent feelings of being on edge.
- Depression and fatigue. People with postpartum PTSD may also feel depressed or have difficulty sleeping, which can lead to daytime fatigue.
Just know that while these symptoms can be upsetting and hard to manage, they're also the very common responses to trauma. If you’re experiencing symptoms of P-PTSD, you’re not alone, and help is available.
How is postpartum PTSD different from PPD?
Because postpartum PTSD is often not included in the standard screening for postpartum mood conditions and women who have it may also be depressed, many are misdiagnosed as having PPD.
Though the conditions overlap and PPD can exacerbate P-PTSD (or vice versa), they're actually quite different. Postpartum PTSD happens as the result of a trauma or perceived trauma, while PPD is linked to hormonal changes after delivery, sleep deprivation, and stress related to caring for a newborn.
In order to ensure that you get the right treatment for PTSD after birth, it’s important to be able to distinguish between the two conditions and work with your health care provider to determine what you're dealing with.[4]
What are the risk factors for postpartum PTSD?
Not every new mom who has had a complicated pregnancy or childbirth will develop P-PTSD. But there are some women who are more susceptible to it.
You may have a greater risk of PTSD after childbirth if:
- You have a history of depression, anxiety, or another mental health condition, or have had a prior trauma.
- You are extremely fearful about labor and delivery.
- You have a history of infertility. Some studies suggest that women who have gone through fertility treatments also have higher risk of postpartum PTSD.
How is postpartum PTSD treated?
The good news is that postpartum PTSD is treatable, so if you’re having any of these symptoms, don’t wait to get professional help. You’re not alone, and you’re not to blame. Feeling this way is understandable when you’ve gone through a traumatic birth experience (real or perceived).[5]
There is support available to help you overcome the challenges you’re facing now and accept the reality of what happened. The following two resources are a great place to start for those suffering from P-PTSD:
Postpartum PTSD can be treated with the following — either in combination or as a single treatment:
- Therapy (psychotherapy, cognitive behavioral therapy, or group therapy, for instance). Therapy can help a new mom reprocess the traumatic experience(s) and gain a better understanding of why she reacted the way she did. Therapy also helps reframe the experience in a better light.
- Eye movement desensitization and reprocessing therapy (EMDR). This involves bringing distressing memories to mind while a therapist uses an external stimulus, such as tapping on the knee or guiding your eye movements. The tapping helps the brain remember it is in the present, not in the world of flashbacks, and trains the brain to reinterpret the memories and keep them in the past. Positive memories are identified and eye movements are linked to those positive memories. This can reduce the lingering effects of the traumatic memories, while also helping in the development of effective coping strategies.
- Medication. Your practitioner may suggest medication to help alleviate the symptoms of PTSD.
- Alternative medicine (CAM) therapies: This might include hypnosis or acupuncture.
Without treatment, new moms suffering from postpartum PTSD are less likely to receive follow-up medical care, less likely to breastfeed, and more likely to have challenges bonding with and caring for their newborns.
Even with professional help, be sure to tap into your own support network — even if you feel detached. Your partner, family, and friends may not completely understand what you’re going through, but try to talk to them anyway so they can be there for you while you’re recovering.
Remember to let yourself go through whatever you’re going through so you can get past what happened. Over time, and with plenty of help and support, you will heal and feel like yourself again.
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