A recent study talked about post-traumatic stress disorder (PTSD) after giving birth. There was a tiny statement in the document that led a media frenzy that claimed that unmedicated births caused PTSD. This is a small study of women (102) and a total of 7 mothers had PTSD. What the study said was that 80% of mothers who developed PTSD did not have medication, 5 women of 7.
My initial thought when I saw this was I wondered if the mothers actually chose to have an unmedicated birth or were forced to have an unmedicated birth because of the lack of availability of epidurals or other medications or because their labor didn't allow for it, for whatever reason. As I've worked with women who really were traumatized by birth, those who were unmedicated did NOT choose to be unmedicated. There are reasons why an epidural can't be given. Penny Simkin spoke to this thought in a blog post on Science & Sensibility for Lamaze International.
Simkin summed up my feelings nicely, "In spite of the flaws of this study, the authors offered some valuable conclusions, pointing out 'the importance of inquiring about previous pregnancy and birthing experiences and the need to identify at-risk populations and increase awareness of the disorder.' Despite the shortcomings of their study, this advice is on target, as has been confirmed over and over again in the literature on traumatic birth."
So instead of getting into the sensationalism of these articles all over the media, let's talk about how to help mothers who have PTSD, for whatever reason, after giving birth. Other research shows that moms are more likely to have symptoms of PTSD if they experienced:
- Lack of choice for options in care
- Perceived lack of communication from medical staff
- Fear of unsafe care
- Lack of continuity in providers
- Others
Have you experienced any of these in previous experiences? Has anyone asked you about your previous pregnancy or birth experiences?
Related:
- Prevention and Treatment for Traumatic Childbirth (PATTCh)
- Natural Childbirth - Major Cause of Post-traumtic Stress Disorder?
- 7 Reasons You Can't Have an Epidural
Polachek I, Harari L H, Baum M, Strous RD, (2012) Postpartum Post-Traumatic Stress Disorder symptoms: The Uninvited Birth Companion. Israel Medical Association Journal 14: 347-353.
Interesting – as a doula to primarily military spouses in the 80′s the vast majority of women went unmedicated. The only option to a unmedicated birth were IV narcotics which did little to nothing for pain and simply made the Moms rather loopy. Spinal anesthesia was available at civilian hospitals but not in the military ones where I primarily supported women. If you needed a section and the US rate was about 16% back then I never knew of a military spouse having one though I am sure some did you had to have general anesthesia. While some labors were rough I did not know of any women with PTSD or even PPD and I generally stayed in contact for several months and in some cases longer (spouses were often deployed and connecting from time to time was a plus) after birth.
I am 62, and was diagnosed with PTSD about 2.5 years ago. In recent months it has become apparent that the second of my three deliveries, about 30+ years ago, caused a case of birth PTSD. I had an episiotomy with absolutely no medication, and delivered on my left side. The unmedicated vaginal slicing was done as the baby was being born. Baby #2, the only one of my three, had failure to thrive syndrome, weighed 14 pounds at age 1. She resisted nursing for a year. A couple of months before birth #3 my blood pressure soared. One year ago I followed my blood pressure the two months before the anniversary of birth #3. It still soars for that entire time.
I’ve had a heart attack, so have the meds to treat it. On the exact anniversary of the day I left the hospital with my third and final child, knowing I would never have to go through this again, my blood pressure dropped, and my symptoms abated, as they have on that day for many years. Psychotherapy has helped me, generic PTSD counseling not as much. Birth PTSD is real.