Posttraumatic stress, a trauma-induced condition that causes flashbacks, anxiety, and depression, is commonly associated with military, veterans, and crime victims.

But an increasing number of women are experiencing symptoms of PTSD as a result of childbirth experiences.

As many as one in three women may experience some trauma during or related to childbirth, and thousands develop birth-related PTSD each year.

New mothers experiencing PTSD may have more difficulty caring for their children and may be more hesitant to seek help out of fear of being labeled bad mothers.

Causes

Childbirth can be a frightening and painful experience even in the best of circumstances, but some factors increase the likelihood that a woman will develop PTSD. Common risk factors include:

• An excessively difficult birth

• A stillborn or unhealthy baby

• Feeling out of control during the birth process

• Excessive obstetrical interventions

• Physical problems, particularly bowel and bladder problems, resulting from birth

• A history of anxiety or depression

• Feeling unprepared for childbirth or parenthood

• An uncomfortable or frightening birth location

Symptoms

PTSD caused by childbirth manifests similarly to PTSD caused by other trauma, and may result in flashbacks, anxiety attacks, nightmares, hypervigilance, and a strong startle reflex.

People with PTSD may find that certain situations, smells, or sights retrigger their traumatic memories.

Additionally, mothers who experienced trauma during childbirth are at increased risk of postpartum depression and may feel guilt about their parenting skills.

Prevention

While some birth-related traumas — such as stillbirth and some medical complications — cannot always be anticipated or prevented, most trauma is preventable.

A 2004 study published in Nursing Research found four factors that greatly increased a woman’s risk of birth-related trauma regardless of other risk factors.

By working to minimize these factors, doctors, nurses, and caregivers can greatly reduce the incidence of birth trauma:

• Communication
Women who feel that their caregivers did not take the time to communicate important medical information, or who feel that their caregivers were unwilling to listen to them, are much more likely to experience PTSD. Communication is important in helping women feel like they have choices about their births.

• Compassionate care
Women who feel that their doctors do not care about them as people were at increased risk of PTSD. When women feel that they are little more than birthing vessels, birth can feel like a physical violation.

• Safe care
While childbirth is a risky undertaking, the overwhelming majority of women need not fear complications.

Women who feel that their doctors did not provide them with competent medical care, particularly if they or their babies suffered complications, are more likely to view their births as traumatic.

• The ends justify the means
In recent years many women, nurses, and doctors have criticized the heavy medicalization of childbirth, and have pointed to the fact women aren’t always given the chance to give informed consent to procedures.

When women feel that their doctors treated them as if the ends justified the means by ignoring their wishes, performing unwanted or painful procedures or ignoring their feelings about birth, they may feel that they lost control and physical autonomy during birth, leading to PTSD.

Treatment

PTSD is highly treatable, and women who have traumatic births can go on to have happy birth experiences. For many women, regaining control during a second birth can help them move past their feelings of trauma.

But PTSD is a real medical condition that, in most cases, requires treatment. Treatment varies depending on the woman, but a combination of psychotherapy and medication can be effective.

Eye movement desensitization and reprocessing is a form of therapy that empowers trauma victims to reprocess their experiences in a healthier way. This treatment can be highly effective for women experiencing birth-related PTSD.

References:

Beck, C. T. (2004). Birth trauma: In the eye of the beholder. Nursing Research, 53(1), 28-35. Retrieved October 10, 2012, from
http://www.ncbi.nlm.nih.gov/pubmed/14726774

Cohen, T. (n.d.). Why having a baby's like being a in a terror attack: One in three mothers 'suffers post-traumatic stress' Mail Online. Retrieved from
http://www.dailymail.co.uk/health/article-2186007/How-giving-birth-leave...

Griebenow, J. J. (n.d.). Healing the trauma: Entering motherhood with posttraumatic stress disorder (PTSD). Midwifery Today. Retrieved from
http://www.midwiferytoday.com/articles/healing_trauma.asp

Edited by Jody Smith