What is Postpartum Post-Traumatic Stress Disorder?

Postpartum post-traumatic stress disorder arises when the childbirth experience is lived with fear and distress. Learn more.

Pregnancy, childbirth, and postpartum are natural processes for which a woman’s body is prepared, and which should be manageable and even positive experiences. However, in some cases, these moments are experienced as very negative, distressing, and likely to threaten the integrity of oneself and the baby. And in this context, postpartum post-traumatic stress disorder can be triggered.

We can’t lose sight of the fact that giving birth is an extremely intense event, full of uncertainty, and in which numerous and shocking physical and emotional processes take place. If the birth wasn’t respected, if the woman didn’t receive empathic attention, or wasn’t well prepared psychologically to face it, the experience can be very traumatic.

The consequences of this disorder impact not only on the mother’s well-being, but also on the functioning of her family, and even on her ability to bond with the baby. Therefore, it’s essential to take appropriate measures to prevent and adequately address this problem.

Here we explain what are the signs, so that you can recognize this condition in time.

What is postpartum post-traumatic stress disorder (PTSD)?

Postpartum PTSD is one of the most frequent psychiatric conditions among women who’ve just given birth.

It’s estimated that one in three women may experience the birth of their children as a traumatic event and present symptoms related to it. In fact, 6% of postpartum women go on to develop the full clinical picture, which can be extremely disabling and have serious consequences.

This disorder occurs when the mother experiences childbirth as an event capable of endangering her integrity or that of her baby. She feels that her life or that of her child is in danger as a result of undignified or inadequate treatment, or she perceives a feeling of helplessness and lack of total control.

The symptoms of postpartum post-traumatic stress disorder are similar to those derived from any other situation experienced as trauma, but in this case, they revolve around the experience of giving birth. Thus, the main manifestations are the following:

• Nightmares, flashbacks, and intrusive memories about the moment of childbirth.
• Repeated efforts to avoid any person, situation, or stimulus reminiscent of that traumatic moment. For example, the woman can’t attend her obstetric check-ups or even refuses to be alone with her baby.
• Sleep disturbances, concentration difficulties, and episodes of exaggerated startling occur. In addition, her mood is irritable or anxious.
• The woman may experience disinterest, detachment, and apathy, as well as affective blunting.
• Physical sensations, such as palpitations or difficulty breathing, are common at the time of recalling childbirth.

Why does postpartum post-traumatic stress disorder occur?

Unfortunately, many women experience childbirth as a negative or traumatic experience, although not all of them are triggered by this disorder.

So, what leads some mothers to develop symptoms? In general, the presence of certain risk factors such as the following:

• History of psychiatric problems, depression, or anxiety disorders.
• History of abuse, serious illness, or various stressful life events.
• Previous traumatic obstetric experiences, such as instrumental deliveries and emergency cesarean sections.
• High stress, fear, and worry during pregnancy in relation to childbirth. This can happen in first-time mothers, due to uncertainty and lack of information and preparation for this moment. However, in those who’ve already had more children, it may also be due to a previous bad experience.
• Lack of support during the postpartum period and difficulties in processing what happened (a birth that didn’t meet expectations).

Prevention and treatment

Postpartum post-traumatic stress disorder is a very disabling disorder and a major cause of suffering and distress. However, there’s little awareness around it (unlike postpartum depression) and it often doesn’t receive the attention it deserves.

The woman who suffers from it may feel anxiety, anger, guilt, and great sadness, and may even have difficulty establishing a healthy bond with her baby or planning future pregnancies. In short, not only her person but all family dynamics are affected.

To prevent this problem from continuing, it’s essential that health professionals respect the birthing process, provide families with dignified, humanized, and empathetic treatment, and don’t infantilize or invalidate women during childbirth. Obstetric violence is more common than we think and can have serious emotional consequences.

In addition, as much as possible, it’s important for women to go to childbirth informed and prepared. This will help them to empower themselves, face the event with more protagonism, have an idea of how everything may happen, and make pertinent decisions. Women should maintain control over the process whenever possible.

On the other hand, once postpartum PTSD has been triggered, it’s crucial not to look away and to seek psychological care as soon as possible. Trauma-focused psychotherapy, EMDR, and cognitive behavioral therapy have been shown to be effective interventions, but more research is needed. And, of course, greater alarm and better attention to this hidden and silenced disorder.