What Is Postpartum PTSD? How To Find Support

When people think about mental health conditions related to pregnancy, their minds may jump to postpartum depression, now more often referred to as peripartum depression, to acknowledge the fact that depression can frequently happen during pregnancy. However, there are a number of additional pregnancy- and birth-related mental health disorders and subtypes. One type that may not receive as much attention is postpartum post-traumatic stress disorder (PTSD). 

Navigate symptoms of trauma after gestation and birth

Talk to a licensed therapist

What is postpartum PTSD?

What causes postpartum PTSD? 

A traumatic birth experience or pregnancy experience is often the direct cause of a person experiencing postpartum PTSD. These pregnancy and childbirth trauma events might include but are not limited to the following:   

• Being unprepared for difficult sensations, emotions, or medical interventions experienced during pregnancy, labor, or delivery
• Experiencing a loss of control during pregnancy, labor, or delivery
• Adverse reactions to fertility treatments
• Severe illness during pregnancy, including mental illnesses like peripartum depression or anxiety
• An intense fear of the baby’s death during pregnancy, labor, or delivery due to medical complications or another concern
• Being induced to go into labor for a medical reason
• Painful or lengthy labor
• No medical support during labor
• A lack of information or explanation about what is happening during labor and delivery, including situations where there is a language barrier
• Doctors, nurses, and other medical providers being dismissive or invalidating during labor and delivery
• Not receiving enough pain relief during labor; requests for additional pain relief being ignored
• Experiencing disrespect or medical maltreatment during labor and delivery
• Being coerced into undergoing invasive procedures during birth
• The doctor using forceps or suction during birth
• Needing to have an unexpected C-section while giving birth
• Giving birth alone
• Giving birth to a stillborn or deceased baby
• Experiencing birth complications, such as unusual or excessive bleeding, a vaginal tear, or a birth injury to you or the baby
• Watching your partner undergo a traumatic or medically intense birth and being unable or not knowing how to help
• Having a near-death experience during birth
• The baby passing away after giving birth
• Your partner dying during labor or delivery
• Being separated from the baby for any reason shortly after giving birth
• The baby having to be taken to the neonatal intensive care unit (NICU) immediately after giving birth
• Being ignored after giving birth
• You or your baby requiring emergency treatment

Risk factors for postpartum PTSD

Experiencing one or more of the above situations is no guarantee of developing PTSD symptoms during the postpartum period. Mental health professionals are still seeking to understand why some people may develop PTSD after surviving traumatic events while others do not. While more research may be advantageous, the following risk factors may heighten a person’s risk of developing postpartum PTSD:

• Previous trauma related to abuse, particularly sexual abuse or intimate partner violence
• History of mental health concerns
• Lingering injuries from a previous birth
• Experiencing a traumatic event during a prior pregnancy or birth, such as a difficult or incapacitating pregnancy, a stillbirth, or being invalidated or not receiving enough pain relief in a previous labor
• Neurohormonal factors
• A lack of social support
• Intense dread of labor
• An acrimonious relationship with the baby’s co-parent or the lack of a co-parent entirely
• Financial stress
• Insufficient prenatal care
• Social expectations that limit choices during pregnancy
• Lack of access to abortion and being forced to carry an unwanted pregnancy to term
• Low self-esteem
• Stress related to caring for other children
• Lack of educational attainment
• Living in a community where mental health concerns are stigmatized or not acknowledged
• Being in a heterosexual relationship where strict traditional gender roles are expected

While rates of postpartum PTSD may be more common in people with gynecological reproductive systems, any new parent can develop postpartum PTSD, regardless of their gender or sexual orientation. Men and LGBTQ couples can experience symptoms of the condition as well. 

Symptoms of postpartum PTSD

Because postpartum PTSD is a term used to refer to post-traumatic stress disorder caused by trauma associated with pregnancy or birth, it does not have a distinct symptom class separate from other forms of PTSD. However, PTSD symptoms may manifest in unique ways specifically related to parenting. Common postpartum PTSD symptoms include:

• Sweating, shaking hands, a pounding heart, and other physical manifestations of anxiety, often with no apparent cause
• Nightmares and other sleep disturbances, such as difficulty falling asleep, staying asleep, or sleeping in a way that leaves one feeling rested
• A sense of numbness
• Sudden intrusive recollections of disturbing thoughts, particularly those related to the pregnancy, labor, or birth
• Exaggerated or extreme startle response
• Feelings of hopelessness, despair, dread, regret, or embarrassment
• Avoidance of reminders of pregnancy, labor, or birth, which can prevent bonding with the newborn child
• Fear of the medical system, which may lead to skipping doctor’s appointments and a negative impact on the health of both the parent and the child
• For the birthing parent, there may be difficulty in breastfeeding

Treatments for postpartum PTSD

Although PTSD and postpartum PTSD can be serious conditions, they are often treatable or manageable with support. Mental health professionals may recommend the use of trauma-informed therapy to address post-traumatic symptoms. Trauma-informed therapies include the following modalities. 

Eye movement desensitization and reprocessing (EMDR) therapy

In EMDR therapy, a therapist employs bilateral brain stimulation techniques, such as alternatively tapping on the backs of their clients’ hands or slowly passing their fingers back and forth in front of their eyes while asking the clients to recall their traumatic memories. Bilateral brain stimulation is thought to incite a state of mind similar to rapid eye movement (REM) sleep. This technique may allow clients to reprocess or remember traumatic events without becoming re-traumatized.

Narrative exposure therapy

In narrative exposure therapy, clients work with the therapist to develop the story of their traumatic experience. Engaging with the experience in a narrative format may help the client create some distance between themselves and their trauma and learn to process it and integrate it in a healthy way that can alleviate PTSD symptoms. 

Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) is a widely used method of treating a range of mental health conditions, including PTSD. It focuses on the relationship between thoughts and behaviors. When focused on supporting a client with postpartum PTSD, trauma-informed CBT might focus on distorted or damaging beliefs parents may hold about their traumatic experience, such as thinking that birth complications were their fault. Reworking these thought patterns may help the person release the impacts of the trauma and move forward. 

Navigate symptoms of trauma after gestation and birth

Talk to a licensed therapist

Support options 

Having a form of PTSD, including postpartum PTSD, can make daily life seem scary or overwhelming. PTSD symptoms can make everyday tasks difficult, including leaving the house to attend a therapy appointment. In these instances, online therapy through a platform like BetterHelp may be a way for people with PTSD to talk to a therapist in a more accessible format. Through an online platform, clients can choose between phone, video, or live chat sessions and utilize resources like journal prompts, worksheets, and support groups from home. 

Research has shown that attending trauma-informed therapy online can be as effective as therapy attended in a traditional in-person setting. Researchers found that an online CBT program for people with PTSD enabled clients to trust their therapists more and reduced the number of PTSD symptoms they were experiencing.