PTSD After Childbirth

Do you have flashbacks or nightmares about your baby's birth? Do you have panic attacks? Do avoid your baby because he/she reminds you of your traumatic experience? Are you having fantasies about hurting the baby, or yourself? Do you have difficulty concentrating? Are you unusually irritable, angry or depressed? Or are you just numb and can't feel anything? Then you may have Post Traumatic Stress Disorder (PTSD) from your childbirth experience.

Jodi Kluchar, of PTSD After Childbirth, is here to share with you timely information about PTSD and what therapeutic options are available.

Jodi runs an informative website, www.PTSDAfterChildbirth.org, an educational blog, and an online support group.

Welcome Jodi!

Jodi: Thank you Tiffani! Thank you for inviting me to speak, it is an honor.

Tiffani: It is my pleasure to have you here today!

Jodi: What I wanted to talk about was the basics of PTSD after childbirth. First of all, there are a number of criteria that you must have to be diagnosed with PTSD. In a recent study, done by Childbirth Connection, 9% of women in the study met all the criteria and over 30% had some symptoms. Those symptoms include:

• Having experienced an event where you feel that your life or the life of your infant is in danger
• Intense fear or terror during the event
• A feeling of no control or helplessness over the outcome

• Then after wards, symptoms include:

  • A heightened startle response
  • Nightmares and/or flashbacks about the event
  • Avoidance of anything reminding you of the trauma, even the baby
  • difficulty sleeping
  • bursts of anger
  • loss of memory related to the event
  • a feeling of detachment from others
  • Depression and anxiety can also follow PTSD

  • Tiffani: May I interrupt with a question? Can you explain a heightened startle response? Perhaps an example?

    Jodi: Sure, it basically means being always on guard, like you are afraid something else is going to happen, you cannot relax

    Tiffani: In any situation? The reason I ask, is my last son nearly died when he was in the nursery less than 24 hours after his birth; ever since, I feel a constant anxiety about the well being of all my children.

    Jodi: It can happen in any situation, and especially if you go to your doctor, or have to go back to the hospital where the trauma happened. Do you ever feel like you need to avoid the hospital?

    Tiffani: No, but I might have a hard time revisiting the L&D unit.

    Jodi: I can understand, most women who had a negative experience there have trouble revisiting it. If you don't have any other symptoms of PTSD, it may be a general anxiety related to your son's birth, which can happen as well.

    Tiffani: How can women get help?

    Jodi: There are many treatment options available. Medication and Cognitive Behavioral Therapy can be used immediately after the traumatic event to give some relief.

    Tiffani: What types of medication are used?

    Jodi: Let me first say that anti-depressants (SSRI's) can make your symptoms worse, at least if used alone. Anti-anxiety medications and medications that work on multiple brain chemicals (SNRI's) can be combined for a better result. If you are not depressed, an anti depressant will not help you, it will simply heighten your anxiety.

    Tiffani: Can you give us an example of an SNRI?

    Jodi: Yes, an SNRI would be Effexor, Welbutrin....these work on multiple chemicals in the brain and are more effective especially when mixed with an anti-anxiety medication like Xanax. A formal diagnosis by a psychiatric medical professional is needed. It makes me so angry when OB's or GP's hand out Zoloft like candy without a diagnosis.

    Tiffani: I agree about the OB's and the GP's, they really need to make the referral to a specialist...perhaps even have a contract in place with a psychiatric nurse practitioner

    Jodi: I agree 100%. There also needs to be mandatory screening of new mothers before they even leave the hospital. A totally normal chart may not indicate trauma. It's very frustrating.

    Tiffani: What would you suggest as being a "best practice" before moms leave the hospital, those moms who have a "totally normal chart"?

    Jodi: When you are in the hospital before you leave, somebody should ask you how you feel about how the labor and delivery went. Did it go as planned? Were there any complications? Did you have to have an emergency c-section?

    Tiffani: And, overall, how do you feel about your birth experience?

    Jodi: Absolutely! The mother's midwife or OB should also be aware of any past mental health issues or childhood abuse because those are risk factors for experiencing trauma

    Tiffani: This would fall into good nursing practice with a psychosocial assessment

    Jodi: Right.

    Tiffani: Perhaps include a spiritual assessment?

    Jodi: Absolutely, I knew before I left the hospital that my birth experience did not go as planned. I had already started going over it in my head as to what could have been done differently.

    Tiffani: This happens to an enormous amount of women.

    Jodi: Especially when you have a number of medical interventions, necessary or not. I feel that once you start an intervention it leads to another and another.... but I digress. The mother needs to be asked how she feels about the birth, if she was scared, anxious, in fear of her life or the life of the baby, or just felt completely violated by the staff.

    Tiffani: Excellent points!

    Jodi: Thank you!

    Jodi: Some women who have experienced rape or sexual abuse in the past....feel like they are being raped again during childbirth, so SOMEBODY needs to assess the new mother before she leaves the hospital... bottom line.

    Tiffani: I agree....and then have a resource listing of supportive services available to the new family and make referrals.

    Jodi: Oh absolutely, don't just send her on her merry way. The hospital needs give her the tools so that she is able to take care of her baby. If she is avoiding the baby or feels no sense of attachment to the baby, she is going to feel like a failure as a mother.

    Tiffani: Looking at therapeutic options, what alternative therapies are available?

    Jodi: There are many alternative therapies available, some can be used directly after the trauma and some cannot be used until you are ready to face the trauma. For example, acupuncture can help alleviate the immediate symptoms of anxiety, depression and insomnia.

    Tiffani: Would acupressure also help?

    Jodi: Acupressure is similar to acupuncture, so I would think it would also work, but I would have to look it up to give you a definitive answer. Some people don't like to take prescription medication, so they may use herbal remedies like St. John's Wort. One very cool alternative therapy is Reiki, it's is a Japanese method of spiritual healing. I have a good friend who practices it and she has some wonderful success stories. There are so many that I can't get to them all today....but I would like to talk about EMDR therapy.

    EMDR therapy is relatively new; it works on the principles of REM sleep to help your mind reprocess traumatic memories into normal memory. This is not something you should do when the trauma is fresh, you need to be mentally well enough to be able to remember what happened, and a good EMDR therapist will screen you before performing the therapy. The last thing you want is to be worse off than when you started!

    Tiffani: Is there a website that readers can go to and get more info on EMDR?

    Jodi: Yes! www.emdria.org explains the therapy and even helps you find a certified therapist in your area! I went to an EMDR therapist and it has given joy to the memory of my son's birth that was never there before. It was absolutely amazing. I wrote out the experience on my website.

    Tiffani: Thank you so much for being our guest today for The Buoy for Perinatal Blues & Beyond Online Support Group. We certainly look forward to having you speak again on many more topics.

    Jodi: You're welcome. It was my pleasure and I'd love to come back!

    The Buoy for Perinatal Blues & Beyond is an online support group within the Pampered Pregger & Beyond Community. Membership is free and offers a wide variety of supportive resources for the perinatal momma.