A Guide To Postpartum PTSD

What is postpartum PTSD? 

Postpartum post-traumatic stress disorder (P-PTSD) is a mental health condition caused by trauma during delivery or postpartum (post-birth). A wide range of traumas can cause P-PTSD during the birth process, including:

• Unplanned C-section

• Baby in a neonatal intensive care unit (NICU)

• Feelings of not being listened to during the birth process

• Severe physical complications such as a tear or hysterectomy

These issues are more likely to give you P-PTSD if you have already experienced previous trauma, especially sexual trauma.

Symptoms of P-PTSD can vary but will usually include re-experiencing the traumatic event. This can include nightmares or flashbacks, which can lead you to avoid stimuli associated with the event. 

This is particularly hard for new parents when their newborn requires frequent attention. It can also lead to anxiety, panic attacks, or a sense of unreality and detachment. These symptoms can make daily life more difficult.

How common is P-PTSD? 

You aren't alone if you or a loved one are currently experiencing P-PTSD. 

In one study¹ followed 212 pregnant women, 12.7% had postpartum PTSD symptoms directly after childbirth, and 13.6% had postpartum PTSD symptoms six months after birth. 

These statistics are from a study on first-time mothers, so it doesn’t include P-PTSD in women who have previously had a traumatic birth experience, which may increase the likelihood of PTSD. 

Birth can be a highly stressful situation, where things going wrong can severely affect emotional well-being. It isn’t surprising that P-PTSD can occur before, during, or after childbirth. 

P-PTSD can be very serious, so you should get checked by a medical health professional if you think you have the disorder.  

Risk factors for P-PTSD

If you are anxious or fearful about giving birth, it might be helpful to understand some of the things that can lead to postpartum PTSD: 

One risk factor is social isolation after birth. A lack of support from friends and family can make you more likely to develop P-PTSD. 

Another risk factor is a history of abortion or infertility, likely because of the associated anxiety and higher prevalence of risk to the pregnancy and birth. A history of infertility carries a ten-fold risk of P-PTSD. 

At birth itself, P-PTSD risk can increase after prolonged labor or when the mother perceives that there were complications. This can occur even if those complications were minor from a medical point of view. 

It’s vital that someone at risk of P-PTSD has a strong support network to assuage any fears as they come up. Higher anxiety levels at the time of delivery are another risk factor. 

How is postpartum PTSD different from postpartum depression? 

Postpartum depression² (PPD) is another mental health disorder women face after childbirth. One study found that PPD occurred 23.5% of the time, while P-PTSD had a prevalence of 6.1%. PPD is different from P-PTSD.

PPD is a major depressive episode that begins at or within four weeks after birth. Many women struggle during the postpartum period (the fourth trimester).

One of the reasons for this is because of PPD. While feeling down with the “baby blues” after birth is normal, when your symptoms continue past or start after two weeks, you may have PPD.

The cause of PPD is currently unclear, with many potential contributing factors, such as a history of mental illness and a recent stressful life event. On the other hand, P-PTSD occurs due to a traumatic event related to birth. 

Symptoms of PPD that are different from P-PTSD include: 

• A change in appetite

• Guilty intrusive thoughts (thoughts which you can’t control)

• Intrusive thoughts of self-harm or harm to the baby

• Obsessive worrying

• Feelings of intense hopelessness

However, PPD also shares some symptoms with P-PTSD, including feeling withdrawn, having difficulty sleeping, and having a lack of bonding with the newborn.

How is P-PTSD treated?

P-PTSD varies from person to person, which means it can last a month to a year. 

However, it is treatable. Although it’s scary to experience, it shouldn’t be something to worry about around the time of delivery. Treatment for P-PTSD is known as postpartum care and is usually put in place as a preventative strategy (before developing P-PTSD). 

The months after childbirth are critical. You’ve just had a strenuous and emotional experience, followed by all the feelings associated with taking home a little human you are responsible for. 

Unsurprisingly, this time is essential to optimize long-term health and well-being. 

Within three weeks of giving birth, you should contact a healthcare provider specializing in postpartum care³ to develop a plan for ongoing care. After this, you’ll have a comprehensive assessment after 12 weeks, giving your healthcare provider a full understanding of your physical, social, and psychological well-being. 

This will lower P-PTSD risk factors and show your healthcare provider if any symptoms are arising after birth. 

Essentially, you will discuss: 

• If you are sleeping well

• Your support network

• Contraception

• Infant care and feeding

• Other family dynamics

All of these factors will help your provider give you a recommendation for ongoing care postpartum. 

It’s important to note that this type of care can be expensive and is yet to be included in healthcare policies as funded care. So, if you can’t afford to follow up with a doctor, it’s essential to check in with yourself and your loved ones to keep your mental health a priority after birth. 

The lowdown

Mental health is not always a priority in the postpartum period. However, a large number of women have postpartum post-traumatic stress disorder as a result of the difficulties surrounding birth. 

You can prevent this disorder with a positive support network and frequent care after delivery. If you’re concerned you’re at risk for P-PTSD, speak to your healthcare provider and your loved ones.