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A 2006 study, “Listening to New Mothers,” conducted by Childbirth Connection and Lamaze International, polled new mothers immediately after childbirth and six months later. During the study, the researchers asked the mothers to answer a series of 17 questions that make up the Post-Traumatic Stress Disorder Symptom Scale. The study found that approximately 18 percent of new mothers experienced symptoms of post traumatic stress disorder, with 9 percent meeting all the criteria for the disorder. However, post traumatic stress disorder after childbirth is still a very understudied condition, so those numbers could be higher.
Post traumatic stress disorder typically can set in immediately following birth or up to several months later. In some cases, it may not present until years down the road. Women tend to experience post traumatic stress disorder differently than men. While men may become angry and feel out of control, women tend to feel jumpy, frightened, or have difficulty expressing any emotion at all. Women may also become depressed or anxious because of the disorder. Other symptoms include flashbacks, nightmares, and avoiding reminders of the experience.
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Many different factors play a determining role when it comes to post traumatic stress disorder after childbirth. While one woman may experience a significantly traumatic birthing experience and come through it without further issues, another may go through a seemingly mild experience and develop the disorder. Massachusetts General Hospital for Women’s Mental Health suggests that anxiety during late pregnancy is the strongest predictor of the disorder, especially because it can lead to other problems during the pregnancy. For example, women suffering from anxiety during the third trimester may be more likely to give birth prematurely and deliver a baby with low birth weight. Anxiety during the first two trimesters does not seem to have quite as negative an impact, unless it is extremely severe.
Whether anxiety is a precursor to the event or not, a difficult delivery can increase the risk of the disorder, especially if the woman believes her life of that of her baby’s is in danger. Hormone levels and emotions run high during delivery, and coupled with an imminent threat, they can leave a long-lasting impression on a new mother. Emergency cesarean sections, very long and painful labor, or traumatic injuries during delivery are all potential risk factors. Delivering prematurely, especially if the baby requires long-term hospitalization, can cause devastating effects on the psyche as well. Essentially, any childbirth experience that causes extreme feelings of stress or terror can lead to post traumatic stress disorder.
Post-traumatic stress disorder after childbirth is not always related to a negative labor and delivery experience. In fact, a study performed by Dr. Marsha M. Cohen and colleagues at the Centre for Research in Women’s Health in Toronto found that, in many cases, the prevalence of post traumatic stress disorder following childbirth is related more to stressful life events and depression than to the actual childbirth experience. In these cases, the tendency towards post traumatic stress disorder is already present, but the difficult delivery or intense experience acts as a stressor that triggers the symptoms.
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New Mothers Speak Out
US Department of Veterans Affairs: Women, Trauma, and PTSD
Medscape Today: Posttraumatic Stress Disorder after Pregnancy, Labor, and Delivery
MGH Center for Women's Health: Anxiety During Pregnancy Predicts Worse Outcomes