Post Traumatic Stress Disorder is an anxiety disorder that can develop after exposure to a terrifying event or ordeal where grave harm occurred or was threatened (i.e.: to the women and/or her baby). PTSD is one of the most serious effects of trauma. We are familiar with PTSD in torture victims, combat soldiers, sexual assault victims and war survivors but PTSD after childbirth has a long history of dismissal. Current estimates of the number of women who develop all symptoms of PTSD after childbirth are about 6-7%. [Beck, C Birth Trauma: In the Eye of the Beholder Nursing Research 53(1):28-35 Jan/Feb 2004]. Far more women develop some of the symptoms of PTSD. All of these women suffer birth trauma. An Australian study found 1 out of 3 women reported a stressful birthing event with three or more trauma symptoms when interviewed 4-6 weeks after a vaginal delivery. [Creedy et al Childbirth and the Development of Acute Trauma Symptoms: Incidence & Contributing Factors Birth 27(2), 104 – 111] To put this into perspective, the rate of PTSD in the regular Canadian Forces is estimated to be 2.8% overall and 4.7% in soldiers with 3 or more deployments. [Canadian Community Health Survey: Canadian Forces Supplement on Mental Health 2002]
It is important to note that most women are not asked about trauma symptoms after childbirth. If the birthing industry cared about this, or wanted the extent of the problem known, this would occur. If all women were asked I think the problem of full and partial PTSD after childbirth would be revealed as a larger problem than these studies reveal.
Women traumatized by their birth experience can experience both acute and chronic (life-long) trauma symptoms.
Symptoms of PTSD include:
· Re-experiencing aspects of the trauma (nightmares, flashbacks, intrusive memories)
· Avoidance of anything likely to remind them of trauma (TV shows about childbirth – however unrealistic, medical professionals, necessary medical care)
· Hyper vigilance - sudden startle reactions, anger, inability to trust, being ‘on guard’ for other situations that could be hurtful, worry
People who suffer trauma symptoms can also have insomnia, emotional detachment (tuning out), loss of libido and the inability to enjoy aspects of life that were enjoyable before. When talking about traumatic childbirth it is not unusual for women to use the same language as sexual assault victims. They talk about violation, assault, invasion, torture and rape. A more complete list of trauma symptoms is included on the ‘HELP’ page.
Chronic stress leads to physical problems: decreased resistance to infection, heart disease, headaches, immune system problems, chest pain, shortness of breath and gastrointestinal problems to name a few. Alcohol and substance abuse are common coping mechanisms and depression is a common symptom as well. Depression and traumatic disorders are both normal, human reactions to trauma but they are distinct problems and they can co-exist. PTSD is often misdiagnosed as depression.
Birth Trauma Canada recognizes that loved ones who attend women during childbirth can be traumatized as well. They often feel guilty for not protecting them or being better advocates. Sometimes this is justified and sometimes they are trying as hard as they can given the circumstances. Relationship breakdown is common after a traumatic birth experience.