Postpartum Post-Traumatic Stress Disorder (PTSD)

Postpartum Post-Traumatic Stress Disorder PTSD

We have known for a long time that PTSD can affect pregnancy, and pregnancy can affect PTSD. What we have recently learned is that pregnancy can actually cause PTSD. This mental health condition even has a name: postpartum PTSD.

Postpartum PTSD is not rare. Studies suggest it may affect up to 10 percent of pregnancies. Because postpartum PTSD is a relatively new condition, it often goes undiagnosed or is confused with postpartum depression. This needs to change because postpartum PTSD is very treatable, and untreated postpartum PTSD can be very hard to live with. It can lead to other problems like eating disorders, depression, substance abuse, and suicide.

What Is Postpartum PTSD?

Postpartum PTSD is a mental health disorder characterized by re-experiencing a traumatic event, avoiding any reminders of the event, and being in a constant state of vigilance or anxiety because of the event. In classic PTSD, the event might be a car accident or a war experience. In postpartum PTSD, the event has something to do with pregnancy.

What Are the Causes?

The causes could be a real or perceived traumatic experience during pregnancy, during delivery, or shortly after delivery. This event triggers the body’s fight or flight reaction causing physical, mental, and emotional symptoms. These symptoms do not go away after the event. They keep coming back.

Anything during pregnancy that a woman feels threatened by can cause PTSD, especially if the threat includes a feeling of hopelessness or despair. One of the most common events is having a baby in neonatal intensive care. Women who give birth prematurely and have a baby in intensive care may have a rate of postpartum PTSD of close to 50 percent. Other pregnancy-related traumas that trigger PTSD include:

  • Early or late pregnancy loss
  • Long, difficult, or painful labor
  • A crisis that complicates pregnancy, delivery, or the postpartum period
  • C-section (especially unplanned or emergency)
  • Severe postpartum bleeding (especially if surgery is needed)

Postpartum PTSD is not rare. Studies suggest it may affect up to 10 percent of pregnancies. Because postpartum PTSD is a relatively new condition, it often goes undiagnosed or is confused with postpartum depression.

Who Is at Risk?

Any woman who has a frightening experience around pregnancy could be at risk, but some women are at higher risk. These risk factors include a history of:

Symptoms and Diagnosis

A mental health provider may diagnose postpartum PTSD. The diagnosis is based on the types of symptoms a person has and the fact that symptoms have lasted for longer than one month. These symptoms include:

  • Continually re-experiencing the fear and anxiety of the traumatic events (flashbacks)
  • Vivid memories or nightmares about the event
  • Needing to avoid people, places, or things that remind a person of the event
  • Being constantly on edge or afraid (hypervigilance)
  • Being easily startled or frightened
  • Panic attacks for no reason
  • Trouble sleeping, concentrating, and remembering
  • Feeling depressed

One of the difficulties is differentiating postpartum PTSD from postpartum depression. This can be especially hard if a person is suffering from both conditions, which may happen in up to 25 percent of woman.

Importance of Treatment

Recognizing postpartum PTSD is important for several reasons. The longer the condition lasts, the more ingrained it becomes. Early treatment is very effective. Untreated postpartum PTSD can lead to poor follow-up care, failure to breastfeed, failure to bond with the baby, and relationship problems with the partner. Women with this condition may hesitate to have another baby. Over time, if untreated, they may develop other serious mental health conditions.

Treatment for postpartum PTSD can include medication and psychotherapy. A psychologist or psychiatrist can give psychotherapy. A psychiatrist may prescribe an antidepressant medication called an SSRI. Psychotherapy – called cognitive behavioral therapy – focuses on reprocessing and reframing the traumatic event. Couples therapy may be an important part of treatment.

Hopefully, your pregnancy will not include any traumatic events. You can reduce your risk of postpartum PTSD by talking to your health care provider about any traumatic events in your past and how they have affected you. Let your provider know about any history of anxiety or depression. Take birthing classes to learn what to expect during labor and delivery. Being prepared will help you feel less threatened or helpless.

Finally, stay as healthy as you can. Keep all your prenatal visits, eat well, exercise regularly, and get enough sleep. If you experience symptoms of PTSD at any time, let your health care provider know. Ignoring these symptoms is the biggest mistake. Early diagnosis means early treatment and a good chance of moving on without long-term problems.

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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