At the time of this writing, mothers all over the country and the world are getting pregnant and giving birth during a global pandemic. These are unprecedented times, and new mamas are navigating pregnancy and childbirth where environmental factors are affecting and changing birthing experiences. Women may dream about their newborn baby’s birth for many years, with hope, excitement, and expectation for this life-changing moment in their lives. Today, expectant mothers must deal with the complications COVID-19 creates for their birthing experiences and any unexpected birth trauma that may arise. Women, in great numbers, endure many types of traumatic birthing experiences every day. What happens when the experience is not what you had hoped it would be? What happens if the memories of giving birth to your precious baby are not that of joy, but fear, sadness, or loss?

Who is Impacted by Birth Trauma?

Studies show that 4% of women develop Post Traumatic Stress Disorder (PTSD) during pregnancy and postpartum following a traumatic birth or pregnancy (Dikmen Yildez et al., 2017). In the US, 157,000 women are affected every year (Ayers, 2007). According to Postpartum Support International studies also show that 10% of women develop postpartum anxiety (2020) https://www.postpartum.net/. 

Types of Birth Trauma 

Types of birth trauma may include the experience of an unplanned or emergency c-section, traumatic or emergency delivery, stillbirth, very long or painful labors, high levels of medical intervention, separation from babies at birth, mother’s fear for baby’s safety or their safety, having a baby with unexpected or expected health problems, having a premature baby, or a baby that has to stay in the NICU, and all put moms at greater risk of developing PTSD and anxiety (Birth Trauma Association). Birth trauma is a key indicator of the onset of postpartum depression, PTSD, and anxiety in women. Although obstetricians and nurses have become well versed in screening for and addressing postpartum depression, PTSD and anxiety symptoms often go unscreened and undetected unless the new mom brings it up. Moms who have had these experiences may be unaware of the potential effects of birth trauma and fail to notice the signs. It’s essential for a new mom to know what PTSD and anxiety symptoms are, how they may be presenting, and how to advocate for their mental health if they experience some of these symptoms.

Do you have PTSD related to your birth?  Common features, according to the Birth Trauma Association:

  • An experience involving the threat of death or serious injury to self or baby. 
  • Intense fear, helplessness, or horror was felt during the experience.
  • Persistent re-experiencing of the event. This may include recurrent intrusive memories, flashbacks, and or nightmares.
  • If there are things that remind you of the distressing event, you may feel distressed, anxious, or panicky.
  • Avoidance of anything that reminds you of the trauma. (Or, obsessive thoughts of the trauma)
  • Feeling the need to avoid reminders of the memories. 
  • May have difficulty sleeping and concentrating—anger, irritability, and hypervigilance (feeling jumpy).  

Do you have postpartum anxiety related to birth? Here are some common characteristics.  Please keep in mind that all parents experience some worry about the addition of a new child.  (American Psychiatric Association, 2013; Birth Trauma Association)

  • Constant or near-constant worry that feels consuming
  • Feelings of dread about things you fear will happen.
  • Sleep disruption (when the baby is sleeping peacefully) 
  • Racing thoughts

Physical symptoms include:

  • Sweating 
  • Fatigue
  • Heart palpitations
  • Hyperventilation
  • Shakiness or trembling 

Take the Time to Identify Symptoms

Please take the time to check in with yourself and identify any PTSD or anxiety symptoms you may have due to birth trauma. The effects of persistent symptoms can have a cascading impact on you and the rest of your family. Maternal PTSD and anxiety can affect baby/mother attachment and bonding (Ballard, 1995), breastfeeding, parenting older children, and children’s emotional health (Dennis, Falah-Hassani & Shiri, 2017). Evidence also suggests that experiencing a traumatic birth can negatively affect the quality of your relationship with your spouse or partner (Delicate et al., 2018). Maternal mental health is vital for an emotionally healthy family unit (Robinson et al., 2019). 

Best Treatments

The Birth Trauma Association, through research and study, has concluded that Postnatal PTSD is best treated with psychotherapy (2020) https://birthtraumaassociation.org.uk/#, specifically, with eye movement desensitization and reprocessing (EMDR). EMDR is an evidence-based therapy that is one of the most effective treatments for PTSD symptoms (2020) https://www.emdria.org/about-emdr-therapy/. There is more information on what EMDR is and its effectiveness on the EMDRIA website. https://www.emdria.org/about-emdr-therapy/

There is HOPE!

There is hope, redemption, and opportunity in counseling to feel redeemed, connected, and transformed in working through birth trauma (Thomson & Downe, 2010). Until there is more awareness of what birth trauma is and the implications on maternal mental health, it’s important for mothers to know the signs of PTSD. Please advocate for yourself and seek the help of a physician and counselor.

References

American Psychiatric Association. (, 2013). Diagnostic and statistical manual of mental health disorders (5th ed.).

Birth Trauma Association (2020),  https://birthtraumaassociation.org.uk/#

Ballard, C. G. et al. (1995) Post-Traumatic Stress Disorder (PTSD) after childbirth. British Journal of Psychiatry. 166: 525 – 528

Cipolletta, S. When childbirth becomes a tragedy: What is the role of hospital organization? Journal of Health Psychology[s. l.], v. 23, n. 7, p. 971–981, 2018. DOI 10.1177/1359105316660182. Disponível em: https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=psyh&AN=2018-23510-008&site=ehost-live&scope=site&custid=nwcoll. Acesso em: 8 set. 2020.

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