A new study suggests that for as many as 1 in 13 women, the experience of childbirth is as traumatizing as being in combat. Childbirth as horrible as war? The bringing of life as horrible as the taking of it? What is going on here????
McGill researchers in Canada found that a significant minority of women experience post-traumatic stress disorder (PTSD) in the weeks after giving birth– they may not be able to sleep, have terrible flashbacks and nightmares, they may avoid emotional connection or anything that reminds them of birth, including the baby. The report, published in the Journal of Psychosomatic Research, also suggests that as many as 17% of women experience milder versions of these symptoms.
“…there are things that can happen in the birthing process that can make a woman feel like her life or her baby’s life are in jeopardy. She experiences helplessness, fear, horror. That’s enough for an experience to be traumatic,’ said Deborah Da Costa, a McGill psychologist who co-authored the study.
The rates of birth-PTSD are about the same as those of postpartum depression (PPD), yet this disorder is not as well known. The study also showed that women who have been sexually abused have a particular risk for PTSD following childbirth.
In the study, researchers surveyed and interviewed 308 women before and after giving birth. Using a standard scale that relies on self-reporting, they found that 8% of these moms had PTSD one month after the birth, this number went down to 5% after six months.
When researchers used a different diagnostic tool that relies on interviews with patients as well as the researchers’ clinical judgments, the results were considerably different: only 1.1% of the mothers had full-blown PTSD. The researchers wonder if this analysis was swayed by mothers holding back some (presumably negative) information when talking to health workers.
Of key importance: women who had strong social support were less likely than women without strong social support to experience PTSD.
There’s so much to say about this but here are just a few thoughts:
- Women who have particularly scary births, where there is perceived life-threatening danger– there is very rarely this kind of danger, though sometimes it can seem that way–are understandably traumatized. This is NOT within the realm of normal, it’s not what you “should expect when you’re expecting.” The research here does not indicate that, yes, childbirth is inherently horrifying, it shows that when a normal physiological process becomes pathological it can be terrifying in a way that lingers.
- Other surveys and interviews suggest that trauma from birth is related not just to a difficult birth but to how the mom was treated throughout. Women who are not treated with respect at a time of intense vulnerability are more likely to have lingering feelings about it. New mothers tend to complain less about pain in childbirth and much more about things like, “suddenly, they were doing an episiotomy, they didn’t ask me or tell me about it.” Care-providers must explain what is happening in a clear, respectful, realistic but non-alarmist way. (Unfortunately, the basic language and culture of childbirth these days seems almost designed to instill fear in women.)
- Women who have been sexually abused should get lots of support during and around the time of childbirth–this can be a healing time for some women with a history of abuse, but it can also be extremely difficult. Birth involves the same body parts and also a sense of powerlessness. Women who have been abused can also have an intense fear of needles and may need help throughout birth to avoid the use of IV and epidural. Luckily, with the right support, there can be excellent outcomes in terms of both physical and psychological health for baby and mother.
- There are ways to address and treat birth PTSD. Read this article in SALON for starters, it’s great and it’s all about overcoming birth-related PTSD. There’s talk therapy, medication, group therapy and other kinds of specialized therapy for overcoming intrusive thoughts.
- If you’ve never given birth and you’re reading this and it’s scaring you, realize trauma from birth is not universal. Put some thought into where and with whom you will give birth. There are care-providers who understand that birth is not just about a “healthy baby” (of course it’s about that!) but about a physically and emotionally healthy mother, a life-transition, and an experience of intense vulnerability. Women (and men for that matter) can get through massive challenges if they are supported in the right way. And if something happens that falls outside the realm of your expectations or a normal (if hard) experience then trust that with support and time you can process this.
photo: Mrs Dewees/Flickr