Postpartum Post-traumatic stress disorder

Postpartum PTSD is a mental health condition that affects women following childbirth. The condition develops out of a traumatic experience that took place before, during or shortly after the birth. The long-term consequences of PTSD after childbirth can be devastating for the mother and her family. Women who have experienced PTSD may experience nightmares resulting in conditioned insomnia, difficulties with breastfeeding, impaired bonding with the child, difficult sexual relations with their partner, and poor sense of self-worth.

According to the HSE Specialist Perinatal Mental Health Services, one in five women experience mental health concerns in pregnancy or after birth. Depression and anxiety are the most common mental health issues in pregnancy affecting about 10 to 15 out of every 100 pregnant women.

Symptoms

Symptoms generally fall into 3 categories:

1. Re-experiencing: This can include physical sensations such as pain, sweating, nausea, flashbacks, and nightmares. You may have constant negative thoughts about your experience. You may repeatedly ask yourself questions that prevents you from coming to terms with the event.
2. Avoidance and emotional numbing: Trying to avoid being reminded of the traumatic event is another key symptom of PTSD. This usually means avoiding certain people or places that remind you of the trauma. It could also mean that you avoid talking to anyone about your experience. You may also attempt to deal with your feelings by trying not to feel anything at all. This is called emotional numbing and can lead to you becoming isolated and withdrawn.
3. Hyperarousal: PTSD can make you feel very anxious, and you may find it difficult to relax. You may be constantly aware of threats and feel easily startled. This state of mind is called hyperarousal. This can bring on feelings of irritability, angry outbursts, lack of concentration and difficulty sleeping.

Overall, women with full-blown postpartum PTSD will feel as though they are in a constant state of distress, which activates the brain’s “fight or flight” mode. This causes all the above physical, mental, emotional, and behavioural symptoms. Postpartum PTSD symptoms should be temporary, and they are highly treatable. However, if a diagnosis isn’t reached and treatment is not sought, postpartum PTSD can have devastating long-term effects on mental and personal health. The worst-hit areas are daily life functions and the maintaining of personal relationships.

Postpartum PTSD Causes and Risk Factors

PTSD, in general, is caused by experiencing one or several traumatic incidents that have imprinted the mind. In the case of postpartum PTSD, the traumatic incident that triggers these symptoms directly involves the pregnancy, delivery or another event relating to childbirth.

Traumatic experiences that may cause postpartum PTSD include:

• Difficult, long, and painful child labour
• The use of forceps or vacuum on the baby during delivery
• Having to undergo an emergency C-section
• Umbilical cord prolapse
• The baby being placed in a neonatal intensive care unit (NICU)
• A lack of support or communication during delivery that causes feelings of hopelessness and despair
• Any kind of physical condition such as postpartum haemorrhage, a hysterectomy, preeclampsia or eclampsia, severe perineal trauma, or any form of cardiac condition

Treatment for Postpartum PTSD:

Symptoms of postpartum PTSD are highly treatable. Many women who receive treatment for their trauma go on to live normal lives and never experience reminders and flashbacks of the event again.

It is important for women to recognize their symptoms and seek treatment so that they can overcome their fears, reduce the level of distress in their lives and ensure they bond with their child. Early treatment for postpartum PTSD also prevents the condition from manifesting itself in other destructive ways such as eating disorders, addiction, compulsive behaviour, or suicide. Psychotherapy options such as Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR) are highly effective forms of PTSD treatment. These can be conducted by psychiatrists, psychologists, or other mental health care professionals.

If you are experiencing postpartum PTSD, it is important to seek the advice of a physician or mental health professional as soon as you notice the signs and symptoms.

References
Post-traumatic stress disorder (PTSD) - symptoms - HSE.ie
10 things to know about perinatal mental health (hse.ie)
Mental Health in Pregnancy (hse.ie)
Post-Traumatic Stress Disorder (PTSD) Following Childbirth (womensmentalhealth.org)
Postpartum PTSD (Post-Traumatic Stress Disorder) - PostpartumDepression.org