Birth trauma? Maternal PTSD?


The August 5, 2008 Wall Street Journal ran a short article on a new postpartum illness akin to PTSD. The author, Rachel Zimmerman, reports that though”PTSD is commonly associated  with combat veterans and victims of violent crimes, but medical experts say it also can be brought on by a very painful or complicated labor and delivery in which a woman believes she or her baby might die.”

While Postpartum depression has received more attention of late (the paper reports the NIH statisticof 15% of mothers affected), there is some speculation that as many as 9% meet criteria for PTSD, and most of these who have given birth to children with serious and immediately life-threatening health issues. These find themselves re-experiencing the traumatic birth, avoidance of places that bring these flashbacks up, and persistent symptoms of increases arousal and hyper-vigilance. Per the article more states are now trying to screen and/or education new moms to this problem. NJ requires all mothers to be screened for depression prior to discharge.

As an adoptive father, I recall well the anxiety and hyper-vigilance of bringing home our first child when he was 4 days old. I didn’t sleep for days, or so it seemed. I worried about his breathing. I felt like I had lost my independence for the rest of my life (I was the stay-at-home dad at the time). It was an overwhelming time for us. And we were healthy, he was healthy, and we were not recovering from the trauma of even a normal birth.

So, I can well assume that if you add all of the normal birth trauma plus medical crises, helplessness, etc. that these experiences can result in symptoms like PTSD. I would suspect, however, that for most people these symptoms would dissipate quickly, especially if the medical crises passes in a day or two. So, we should be careful not to overreact to transitory symptoms and medicate everyone with a struggle. If it is PTSD, then the symptoms should persist for more than a month.

7 Comments

Filed under Anxiety, Depression, Post-Traumatic Stress Disorder, Psychiatric Medications, Psychology

7 responses to “Birth trauma? Maternal PTSD?

  1. Interesting.

    I would venture a guess that I had some PTSD symptoms after the birth of my twins. Active labor at 26 weeks, 6 weeks of complete hospital bedrest, emergency c-section, preemie twins in NICU for six weeks…then all the care and feeding of preemie twins when they came home.

    It was intense to say the least.

    Intense enough that four years later, when I had my third son, I needed to switch doctors. Going to his office at the hospital with all our “drama” was causing panic attacks. Literally. At his urging, I switched doctors and hospitals, had a relatively easy pregnancy, and uncomplicated birth.

    (And considering we had a very good outcome — two perfectly healthy boys — I can only imagine how much more difficult it would have been if there had been ongoing medical problems!)

    I never thought of any of this as PTSD…just a normal response to a difficult situation. Maybe it’s unique in that I don’t have to be pregnant / give birth on an ongoing basisi!! (Thank goodness!)

  2. Jess

    Interesting post. I can’t speak from experience at all, but I had always heard that there was some chemical that caused mothers to have a sort of post-birth “amnesia” about the pain and stress involved. So much so that anecdotally women have told me that they are surprised by the intensity of the birth experience if they have a second child. They describe it as being all new again… as if the first birth experience has been essentially forgotten. However, if you add in a severe threat to the mother or child, I can imagine that that would change the equation.

    On another (unrelated?) note, I’ve never quite understood exactly what is meant by the portion of the curse where God says, “I will greatly increase your pains in childbearing; with pain you will give birth to children.” It does seem clear that something changed from pre-Fall to post-Fall, though.

    If PTSD is involved, I would tend to agree with you, Phil, that it seems wise to wait to see if symptoms persist before medicating. But this is from a childless non-psychologist lay-person, so I definitely know not wherof I speak!

  3. Scott Knapp, MS

    In an OT Pentateuch class I had at PBU, my prof revealed to us that two aspects of a woman’s relationship with her children were affected by the Genesis curse. First was a the physical act of giving birth (“I will greatly multiply your pain in childbirth”), which from my first hand experience (twice) of watching my wife give birth to my two sons, I can affirm looks excruciating. The second was the wear and tear of relational disappointment of raising and launching children into the world (“In pain you will bring forth children”). As their dad, I’m all about putting my sons into situations that test their mettle, pose some contained risk, and challenge them to grow…and I accept the risk on my part that my choices of challenge may blow up in my face! My wife is much more about nurture, protection and safety for our sons…my letting our 3-year-old climb up the chain ladder on the jungle gym at the park, while I relax on the park bench and observe, sends my poor wife into anxiety fits! I can relieve a substantial part of that anxiety if I stand behind him and hold the back of his pants, and guarantee safe ascension…I’d rather he not only climb the ladder, but develop the confidence to tackle bigger ladders on badder jungle gyms down the road, something my presence behind him won’t (in my opinion) facilitate. Being my wife and co-nurturer of our boys takes a tremendous toll on my honey…in reality I contribute to the toll of the curse by doing what guys do! If her pain would have culminated in and ceased after the physical act of giving birth to our boys, her life would have been so much easier…the cost for being the warm nurturer my boys need a mom to be is to suffer emotional bombardment every time my boys fall off jungle gyms, get detention at school, explore underage drinking or indulge in illicit sex, our out-right rebel and destroy their lives and futures. Those things take their toll on me as their father, to be sure…but something about that awful curse makes the price of being their Mother different and peculiar, and something I as a man just won’t fully grasp, no matter how many times she tries (exasperatedly, sometimes) to explain it to me! (sigh….)

  4. Jess

    Scott,

    I don’t know whether to laugh or cry or both! Thanks for your insights, both theological and personal.

    Your post made me think especially of Mary, the mother of Jesus. She is often referred to as “most blessed” among women but in this sense, perhaps, she was the “most cursed” of women.

    Thanks again…

  5. Sara's mom

    I can say that PTSD from child birth is real. I have spent the last 3 years (since the birth of my daughter) trying to deal with flashbacks, anxiety and panic attacks anger and depression. Besides the lack of sleep a newborn brings all the above has also deprived me of sleep. Add to that losing my mother to cancer, selling the house I love and moving next door to inlaws I can only truly say that its by the grace of God I’m not insane. Since you claim to be a Christian I will add that not until this fall when I had an amazing encounter with God have I been able to go sleep at night. I did not seek professional help because my previous fears of doctors (of being violated by doctors ) were all confirmed in my delivery experience. I had hoped that I would be proven wrong but once again the medical profession proved itself to be one of ignore and criticize and degrade the patient and her concerns while following procedure so the hospital doesn’t get sued. Thanks to the medical community I paid $10000 for the most degrading, demoralizing and traumatic experience of my life.

  6. Tina

    Here’s one for you. Supposing you’d grown up the only daughter of a chronically verbally abusing & episodically physically abusing father who was a misogynisitc pastor. And then you’d been an agnostic for awhile. And then you had a re-conversion experience and thought you were destined to be a missionary. Only before you did that, you met & married a man who is a pastor—the sort who for a long time thought that parishioners who created conflict just needed “time” to rise to “their better selves.” And you found yourself an easy target for blame because you were more “the bundle of energy”, which is not necessarily a trait that encourages placidity. But supposing, in spite of that, you were actually the more empathetic person in the partnership. And suppose that marital partnership had gone on for nearly 20 years. And, then, suppose that you suspect you have religiously-CAUSED PTSD, only you can’t find answers. Because the only literature talks spirituality helping alleviate PTSD or clergy causing PTSD through sex scandals. What about parishioners who cause it in clergy families? And the only thing close is a book about “Alligators” in the parish, but it doesn’t even address PTSD. And, maybe, just maybe, you want some solid answers to end the tears, the anger, the disturbed sleep, the chronic “numbness” towards life, the sense of “oh, no” any time any new conflict erupts, even in a new parish…but there were no answers coming.

  7. Maria

    I have had six pregnancies and three live births. Each birth a tramatic experience, each birth a mystical experience and a chance to grow spiritually. I almost lost my life giving birth to my first child 32 years ago, giving birth naturally by happenstance rather than choice. My oldest daughter was born in transit to the delivery room (having been left to labor alone in a small room) and I bleed uncontrollably and lost conciousness for hours. My second live birth followed a termination and a miscarriage, and was a medical marvel. My daughter, now 19 was born after a long labor eased by an epidural, 2 hours of intense pushing and a vacume assisted delivery. The pain and fear was erased by the profound joy I felt at my childs safe arrival. Months later we found out the reason for the tramatic delivery, her head was enlarged because of a very large brain cyst and hydrocephalous, controlled after 14 surgeries over the course of her lifetime. My son was born after another miscarriage, and the entire pregnancy was tramatic. His birth was complicated with a cord wrapped around his neck times two. I am a successful professional woman, but my children, and now grandchildren are my greatest treasures. And yes, I see a therapist every week for PTSD. Life is fragile and every birth are miracle. Women are marvels of strength and resiliency, and all mothers regardless of their status should be recongnized in daily life as heros for daring to concieve and give birth. While childbirth and even pregnancy can be tramatizing, god rewards each of us with a gift at it’s conclusion. No matter what the outcome, the experience is one of lifes greatest spiritual journies.

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