Beyond Depression – Navigating Postpartum PTSD

When you think about a mental health problem related to pregnancy, you probably think of post-partum depression. However, a growing amount of research is showing that depression is just one in a group of mental health disorders that occur after or during pregnancy, including postpartum anxiety disorder and postpartum post-traumatic stress disorder, also called childbirth-related PTSD (CB-PTSD).

CB-PTSD, is a recent discovery. It does not yet have its own diagnosis. It is considered a sub type of PTSD. A growing body of research suggests that CB-PTSD is much more common than expected.

 How Common is CB-PTSD?

PTSD unrelated to childbirth affects about 10 percent of women during their childbearing years. Previous research on CB-PTSD suggested that it was usually associated with a real or perceived trauma in pregnancy and that the frequency was somewhere around 10 percent of pregnancies.

However, a recent study from Massachusetts General Hospital and Harvard Medical School suggests that CB-PTSD is much more common than that, and not always related to a traumatic pregnancy. In a study of over 500 women, the study found that 25 percent of women had symptoms of PTSD after giving birth to a healthy full-term baby.

 Who Is at Risk for CB-PTSD?

Although the Harvard study suggests that even a normal pregnancy can be stressful enough to cause PTSD symptoms, there are some risk factors that are supported by research. Childbirth-related is a better term than postpartum, because about 20 percent of PTSD symptoms occur before birth, and loss of a pregnancy is another frequent cause. In fact, a study from Britain, published in the journal BMJ Open, found that over one-third of women who experienced an early pregnancy loss developed PTSD symptoms.

Other risk factors include:

  • Having a history of PTSD, depression, or anxiety before pregnancy
  • Having a stressful or traumatic pregnancy
  • Having a baby that has medical problems
  • Lack of support during pregnancy
  • Needing an emergency C-section

What Are the Warning Signs?

 It is important to know the symptoms of PTSD and to report them to your health care providers during or after pregnancy. All the studies agree that CB-PTSD is underreported and underdiagnosed. There are four basic symptoms to watch for. You may:

  • Have flashback to traumatic memories through unwanted thoughts or dreams
  • Go out of your way to avoid anything related to the pregnancy, such as hospitals, doctors, or places and people
  • Have unwanted changes in your mood or your thinking, including memory lapses, difficulty concentrating, depression, anxiety, detachment, anger, or negativity
  • Be constantly on high alert (hypervigilant), experiencing panic attacks, or feeling fearful and anxious

How to Navigate CB-PTSD

The first thing is to be aware that CB-PTSD is common. Talk to your health care providers if you may be at risk or if you have any of the warning signs. The best way to prevent CB-PTSD is to have a healthy pregnancy with support and good prenatal care. That includes good nutrition, exercise, and sleep.

Treatment for CB-PTSD is very successful, but you can’t navigate this condition alone. Untreated CB-PTSD can lead to poor bonding with your baby, inability to breastfeed, and damage to relationships with your loved ones. Untreated CB-PTSD can lead to long-term loss of physical and emotional health.

Since about one-fourth of women with CB-PTSD experience significant depression, treatment may include an SSRI antidepressant. Working with a mental health provider is the most important part of treatment. Many types of psychotherapy are effective, and may include couples therapy or a support group.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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