In Postnatal depression, Postpartum

Becoming a new parent is typically portrayed as a time of incredible happiness. A new journey filled with excitement, love, and lots of emotion. But even under the best conditions, it can be overwhelming. It’s fairly common for new parents to go through times where they feel stressed, down, or anxious. These feelings are completely normal – being a parent is no walk in the park. However, in some instances, these postpartum ups and downs go beyond what is expected.

The safe delivery of a baby is a time remembered with great joy by most. But not every parents’ birth experience is a happy one. According to research, an estimated 9% of women and 5-10% of men experience postpartum post-traumatic stress disorder (P-PTSD) after childbirth.

Postpartum post-traumatic stress disorder occurs as a result of birth trauma. The birth trauma that we refer to can be real or perceived, physical or emotional. When an expecting parent experiences a traumatic birth, they may develop P-PTSD.

Postpartum PTSD is a devastating condition that can leave a new parent feeling extremely distressed, depressed, anxious and alone. Here at Urban Hatch, we want to raise awareness about the condition amongst the public for two reasons:

  1. To eliminate the stigma and taboo on the topic – so that all the P-PTSD sufferers know that there are others who also suffer from the condition and treatment is possible.
  2. To educate so that the family and friends of P-PTSD affected new parents understand that birth trauma is a real condition and are aware of what symptoms to look out for.

The difference between postpartum PTSD and postpartum depression

Many of our readers know about postpartum depression and might assume that postpartum PTSD is the same thing. But it’s not. In fact, the two conditions are very different. P-PTSD is the result of birth trauma (or perceived trauma) while postpartum depression occurs as a result of hormonal changes in a woman’s body caused by giving birth. In men, postpartum depression can be a result of feeling discouraged, depressed, exhausted, or overwhelmed by the pressures and obligations of new parenthood.

Postpartum PTSD is very similar to other forms of PTSD. It develops out of a traumatic experience that occurs before, during, or shortly after giving birth. The traumatic incident could have been real or it may have been perceived. Either way, it results in a chronic mental illness that creates anxiety or panic-like symptoms, which causes those affected to live in a state of constant fear or danger.

What Causes Postpartum PTSD

More than one third of new mamas suffer from birth trauma. It may occur before or during pregnancy, like severe morning sickness, or it can occur during labor and delivery. Unfortunately, mothers may develop postpartum PTSD as a result of this traumatic event.

Here are a few of the most common causes of birth trauma:

  • Delivering a premature baby
  • Baby having to be transferred to the NICU after birth
  • Birth complications including; unplanned C-section, postpartum hemorrhage, cord prolapse, prolonged labor, and/or severe perineal tear
  • Fast labor where the mother or partner didn’t have time to process the experience
  • An experience that ended up being very different from what was hoped for

Approximately 5-10% of dads experience postpartum PTSD due to witnessing situations where they feel out of control, fearful, or unable to help. They may see stressful sights, medical procedures, lot of blood or other traumatic event during the delivery or after. 

Symptoms of Postpartum PTSD

Women and men with birth trauma may feel helplessness, fear, or horror about their experience. Moreover, they will suffer from recurrent, overwhelming memories, flashbacks and nightmares about the birth, and feel anxious, panicky, or distressed when exposed to things that remind them of the event. These are called triggers and can pop up unexpectedly.

Common symptoms of postpartum PTSD include insomnia, panic attacks, aggression, irritability, detachment from relationships, being easily startled, anxiety, avoiding baby, recurrent flashback or nightmares, and avoiding anything related to the birth i.e. not wanting to talk about it.

Without treatment, the condition can become increasingly severe. This is why screening for postpartum PTSD is so important. The Edinburgh scale is often used to screen new mamas for postnatal depression, while The City Birth Trauma Scale was developed a couple of years ago with the aim to screen new mums for P-PTSD. However, screening for P-PTSD is not common practice currently. Screening for new dads isn’t really done at all.

This makes it really important for anyone who works with new parents to be familiar with the condition. They need to keep an eye out for the red flags and refer to a professional when necessary.

How to prepare for giving birth

Anyone can experience birth trauma, no matter how well or how ill prepared. However, in our experience as midwives, there are a number of things that can be done as part of birth preparation:

1. Ditch the birth plan. Instead think about your birth preferences or birth wish list. Birth plans can easily set you up for feeling like a failure.

2. Spend less time thinking about non-essential ‘stuff’ your new baby needs and more about the support you and your partner may need after birth.

3. Book in a birth debrief a few months after birth. We call our labour and birth debriefs ‘birth reflection sessions.’ These sessions provide a safe space for the new mama and/or her partner to share how they felt and feel about their experience. Every birth experience deserves reflection.

4. Move away from aiming for the perfect birth experience. Instead, aim for a positive experience where the outcome is a healthy mother, healthy baby(ies) and a process where her and her partner feel supported.

5. Empower yourself with essential knowledge about labour and birthing – delivered by experienced midwives or obstetric nurses.

6. Learn about the best practices to communicate with your medical team.

7. Don’t forget about partners – opt for childbirth education and support that is inclusive

7. Organise postnatal support – personal and professional

Treatment options for Postpartum PTSD

If you already have postpartum PTSD, there are a few ways to treat the condition – so be sure to consult with a professional. It’s important for new parents to know that they are not alone and that help is out there. The most common treatment options include:

  • Psychotherapy options including Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR)
  • Medication
  • Complementary and Alternative Medicine as supportive treatments

If you or any of your loved ones suffer from postpartum PTSD, it’s important to seek help as soon as possible. We want all the mothers and fathers out there to know that they are not alone. Managing such a condition is not easy but treatment can better equip you to deal with the symptoms.

Urban Hatch

Urban Hatch is the online destination for mums-to-be and new mothers to receive support, guidance and care. Our mission is to help you and your partner thrive at parenthood from bump to birth and beyond.