Overlooked and Under-treated: Postpartum PTSD

Pregnancy and childbirth can be a joyous and exhilarating time. However, for some women, fertility struggles, high-risk pregnancies and unexpected childbirth experiences result in psychological trauma. Throughout the past quarter-century, research examining the impact of childbirth on maternal mental health has yielded valuable insights for understanding Postpartum Depression (PPD). Thankfully, PPD has become increasingly well-documented and recognized by the obstetric and psychiatric communities, and (for better or worse) has been much-publicized by the celebrity set. Worryingly though, less is known about another, equally troubling postpartum occurrence: the development of Posttraumatic Stress Disorder (PTSD) following childbirth. 

Women suffering from postpartum PTSD present with a set of symptoms similar to that of other traumas – symptoms of avoidance, re-experiencing, and hyperarousal. For example, ‘avoidance’ may take the form of requesting a tubal ligation to prevent subsequent conception, abstaining from sexual intercourse, using multiple forms of birth control simultaneously, terminating subsequent pregnancies, or requesting an elective C-section for subsequent deliveries.  Symptoms of ‘re-experiencing’ may include intrusive flashbacks of the birth, nightmares of dying during childbirth, experiencing birth-associated pain during intercourse, and re-living the traumatic birth on anniversary dates. ‘Hyperarousal’ may take the form of chronic muscle tension, a hyperactive startle response, or the experience of panic symptoms when faced with reminders of the delivery – particularly during gynecological exams and visits to doctors’ offices or hospitals. Further, the physiological arousal of posttraumatic stress may also intensify postpartum sleep disturbance and fatigue, and cause a mother to be overly anxious about the health and safety of her baby.

At Cognitive Therapy for Women Psychological Services (CTWPS), we comprehensively assess and monitor women for all forms of psychological distress as they navigate the journey through pre-pregnancy, pregnancy and the postpartum period. We seek to provide a safe place where you are free to explore your personal experience (be it traumatic or fantastic), without fear of shame or judgment. 

Through our work together, we will help you identify your thoughts and beliefs about your experiences that may contribute to increased feelings of sadness, fear, anxiety or depression.  Trauma naturally creates distortion in our thinking and in our emotional life. We support and challenge you to untangle and dismantle the parts of your personal narrative that do not currently support you well. While it may be natural for your mind to be pulled toward negative thoughts as a form of protection - we will help you master skills to shift these negative thoughts, and to move you away from fears and anxieties. It takes time and commitment to do this work – no doubt – but at CTWPS, we are committed to being your witness, your guide and your biggest cheerleader as you navigate the emotional complexities of your reproductive experience.