In 2004, Cheryl Beck, a DNSc, CNM, FAAN, Researcher and Author, published a study entitled Post-Traumatic Stress Disorder Due to Childbirth: The Aftermath. Her goal of the study was to describe what the mother’s experiences of PTSD were after having been through a traumatic childbirth. She concluded that,
“Mothers with post-traumatic stress disorder attributable to childbirth struggle to survive each day while battling terrifying nightmares and flashbacks of the birth, anger, anxiety, depression, and painful isolation from the world of motherhood.”
Beck’s study was small and therefore not conclusive but if is very interesting. It included 38 women from different countries, but it found five underlying themes: intrusive, recurring flashbacks and nightmares of the event; a feeling of numbness, like the mother was a “shadow” of “her old self”; an incessant desire to talk about her birth and wanting to have her questions about it answered; a spiral of increasing anger, anxiety and depression; and a feeling of isolation from motherhood itself.
The first theme identified was that of flashback and nightmares. Women who experienced PTSD had terrifying flashbacks of the birth during the day, sometimes describing themselves as “in a movie” that kept playing again and again. Sleep was no better for them. Many experienced terrifying nightmares of their births - some to the point that they did not even want to sleep anymore! This lead to problems in their relationships with their babies and husbands, particularly with sexual intimacy.
Secondly, women reported feeling like they were a shadow of their former selves and “too numb to try to change” - a sort of dissociation from themselves. For some, this began immediately after delivery and continued once the woman went home. For others, it didn't start until they were home. Some women described this numbness as forcing themselves through their lives, either void of emotion or afraid of and smothering it.
The third theme dealt with wanting to know the details of their births, have their questions about it answered and wanting to incessantly talk about their experience. As it was put by Beck,
“Mothers who experienced PTSD had an intense need to know the details of their traumatic births and to get answers to their questions. These women obsessed over what had happened and why it had happened.”
The way women went about seeking answers to their questions varied. For some, it meant talking to their care providers. For others, it meant pouring over their hospital records, scouring the internet for information or even revisiting the delivery room. Whatever way they searched for answers, their need was intense, consuming and insatiable. They also wanted to talk and talk...and talk about their traumatic experiences, and many were taken aback and dismayed when their family, friends and care professionals quickly tired of listening. They felt hurt at a perceived lack of empathy and, consequently, further isolated.
Fourthly, women with childbirth PTSD suffered distressing anger, anxiety and depression on a daily basis. The anger was directed at many people - often inwardly at themselves. They blamed partners, doctors, doulas, nurses and family members. Sometimes this anger caused significant marital strife. The feelings of anger did not dissipate with time. Years later, women still found themselves angry at and mistrustful of doctors.
For many, the anxiety started on the delivery bed and from there turned into full fledged panic attacks. This manifested itself in different ways for different women. For one, intercourse caused her so much anxiety that she spent the next 9 years in a mostly non-intimate relationship. For another, hospitals or doctors visits brought on the attacks.
The depression that some women experienced was bad enough to lead them to contemplate suicide. One woman in the study expressed it like this,
“I wanted to kill myself...Death seemed like a wonderful idea. I’d fight with myself while driving, ‘Put your foot on the brake, the light’s red. No, don’t put your foot on the brake,’ and so it went on.”
The fifth and final theme found in Beck’s study was isolation from the world of motherhood. As the study put it,
“The tightening grip of PTSD after childbirth choked off three lifelines to the world of motherhood: the woman’s infant, the supporting circle of mothers, and hopes for any additional children.”
Many women found it hard to connect to their baby - sometimes even to realize that it was theirs. For some, this feeling lasted for years. One mother found it excruciatingly hard to celebrate her son’s birthday and could not force herself to tell him that she loved him.
According to this study, PTSD also isolated women from other mothers and their babies. They disliked being around mothers who had not experienced a traumatic birth - sometimes to the point that they avoided other mothers all together. Many struggled with the decision to have more children or not. For some, the thought of having another child was so unbearable that they had a tubal ligation. Whether they opted for more children or not, all the women were afraid of birthing again and the ones who did go on to have more children prepared themselves with what Beck described as “ironclad” birth plans.
In summary, the five themes identified in Beck’s study were ongoing flashbacks and nightmares, a feeling of numbness, a desire to talk about and understand the traumatic birth, a dangerous spiral of anger, anxiety and depression and isolation from the world of motherhood. Although this study was small, its findings should be further investigated and appropriate cures studied. Women need to know that they are not alone in their PTSD, that their symptoms are “normal” and that there is hope for them.
If you’ve experienced birth trauma, did any of these themes sound familiar? I was amazed at how accurate the findings were to my personal trauma!
To read more of Cheryl Beck's seminal work on birth trauma and postpartum mood disorders, check out http://www.motherwoman.org/cheryl-tatano-beck/.