Postpartum PTSD

Sometimes childbirth doesn't go according to plan. Postpartum PTSD is when you have continued distress after a traumatic childbirth experience.

Postpartum means after childbirth.

PTSD stands for post-traumatic distress disorder. It's a stress or anxiety disorder which can happen after you go through an event that was:

• distressing
• frightening
• very stressful
• traumatic
• threatening

For some women, childbirth becomes one of the most traumatic experiences of their lives. Your non-pregnant partner can also experience psychological trauma following birth.

Postpartum PTSD can happen to up to 1 in every 10 women 4 to 6 weeks after childbirth.

You have the right to trauma informed care. This can help prevent further distress.

Some symptoms related to postpartum PTSD are:

• feeling dazed or lost
• re-living your childbirth experience
• blocking your memories of the birth
• high levels of stress
• feeling negative
• low mood or withdrawal from others
• pain that doesn't get better

These feelings are common soon after giving birth. Many people need time to adjust to becoming a parent.

If you have postpartum PTSD, your symptoms will get worse. They will continue to have an impact on your life for 4 weeks or more. You may have:

• flashbacks or nightmares
• hypervigilance (being overly careful)
• intrusive memories
• difficulty bonding with your baby
• fear of sexual intimacy
• feeling emotionally numb and empty
• anxiety or depression

It's different to postpartum psychosis, which is when you have sudden severe symptoms soon after birth.

Postpartum PTSD can happen after a traumatic birth event. Even if clinical staff considered your birth 'normal', your experience may still have been physically or emotionally difficult. If your birth trauma is not treated, it can turn into PTSD.

If your birth trauma is not treated, it can turn into PTSD.

Birth experiences that can lead to PTSD include:

• birth injury to the mother — this can be physical damage to your perineum or pelvic floor, or emotional damage
• obstetric violence — when a healthcare professional causes harm during your pregnancy or birth
• emergency caesarean — an unplanned and urgent surgery for you or your baby's safety

You are more likely to experience childbirth as traumatic if you have:

• a history of previous trauma
• another mental health conditions

You are more likely to have postpartum PTSD if your childbirth included:

• extreme pain
• loss of control
• fear of death for you or your baby

PTSD is a mental health diagnosis. It's more than feelings of distress after a difficult experience. A doctor or psychologist can diagnose it.

See your doctor if you are:

• not adjusting to becoming a parent
• keep reliving the birth or having flashbacks
• not able to care for yourself or your baby
• feeling very depressed and anxious

When to seek urgent help

Debriefing by talking about what happened can help stop your distress from getting worse. You should have the opportunity to talk to a trained counsellor about what has happened.

Talking about what happened can help you to:

• lower your distress
• acknowledge your grief
• fill memory gaps in your birth story
• understand the reasons for any medical interventions during your labour
• talk about unmet expectations
• allow your emotions to come out
• learn how to look after your health

You can have psychological therapy (talking therapy) to treat postpartum PTSD.

• Cognitive therapy (CT) or trauma-focussed cognitive behaviour therapy (Opens in new tab) (CBT) helps you change negative thought patterns.
• Cognitive processing therapy (CPT) helps you identify unhelpful thoughts and beliefs and replace them with balanced thoughts.
• Eye movement desensitisation and reprocessing (EMDR) helps you process information about your distressing experience.
• Present-centred therapy or counselling helps with any daily challenges that you might be facing.

If you can't get an appointment to see a psychologist face-to-face, you can try online therapy. One online method is called guided internet-based trauma-focused CBT.

Psychological therapy for postpartum PTSD should not be a single session where the focus is on re-living the experience.

Self-care for postpartum PTSD

Try to look after yourself by:

• eating well
• getting enough sleep
• resting when you can
• reducing other sources of stress
• keeping a list of people you can ask for help
• taking time out to do something you enjoy, even if just for a few minutes

Medicines for postpartum PTSD

There are no specific medicines for postpartum PTSD.

However, your doctor or psychiatrist may consider prescribing an antidepressant such as a selective serotonin reuptake inhibitor (SSRI).

Medicines work well when they are combined with CBT.

If you are breastfeeding, tell with your doctor before starting new medicines.

Other treatments for postpartum PTSD

A psychiatrist may suggest electroconvulsive therapy (Opens in new tab) (ECT) or neurostimulation therapy, if medicines and therapy aren't working for you.

Find out about mental health resources for men (Opens in new tab).

The distress of a traumatic birth can affect your ability to breastfeed and bond with your baby.

You may have a fear of childbirth if your postpartum PTSD is not treated.

PTSD is often not diagnosed or treated correctly.

Will I have postpartum PTSD again after a future pregnancy?

If you have a history of trauma, you are more likely to find childbirth traumatic or distressing.

Your midwife or doctor will ask questions to find out if you are likely to need psychological support during pregnancy. Tell them about your wishes for labour and birth.

Check that your healthcare team will support shared decision-making when you are in labour. Learn about what might happen during labour and birth. Know your rights when having a baby.

Attend your antenatal appointments so that the midwives can understand your history. If you have a fear of childbirth, you can ask your midwife or doctor about planning a caesarean section.

Tell your partner or someone close to you so that they can help you notice any signs of distress. Get support early.

A positive birth experience after a traumatic one can be healing.

To help lower your chance of having post-traumatic stress, get care as soon as you can after you go through a distressing event. Some midwives are trained counsellors. They can help by talking through your birth story.

Ask for help before you leave the hospital, or when your midwife does the first home visit.

They can help you find a psychologist or mental health professional to work with you.

Having a supportive partner or family member attend antenatal care can also help.

Speak to your doctor, midwife or psychologist (Opens in new tab) about your symptoms or any questions you have.

Read more about mental health and wellbeing during and after pregnancy.

These services can offer advice and help you find local mental health services:

• Visit Medicare Mental Health (Opens in new tab) to find a local service or call them on 1800 595 212.
• ForWhen (Opens in new tab) is a service for new and expecting parents — call them on 1300 242 322.
• Visit Beyond Blue (Opens in new tab) for mental health support or call them on 1300 224 636.
• Call the PANDA (Opens in new tab) helpline on 1300 726 306 or fill out their mental health checklist.
• Birth Trauma Australia (Opens in new tab) offers a safe space to share your experience of childbirth and get support.