Over the past few months, I have started on my journey to recover from my traumatic birth experience.  During this process I have often struggled on whether to categorize my journey as one of grieving the loss of my birth experience, or as a trauma recovery.  I grieve that I did not birth my son, hold him skin to skin, breathe in his scent, and nourish him in the precious moments after he entered the world. Those are moments that I will never have with him, and that makes me feel heartbroken.  But I also feel a nearly indescribable  and paralyzing array of negative emotions when I think of his cesarean birth, the loneliness of being on the operating table, the crushing intensity of my anxiety as I couldn’t feel my body, and the indifferent conversation of the surgeons as they dissected my body.  The overwhelming physical and emotional reaction to my memory of the cesarean leads me to focus trauma recovery rather than grieving.

Trauma recovery is a hot topic in the military.  Many soldiers experience trauma while in performance of their duties overseas, and are then prone to Post Traumatic Stress Disorder.  According to the United States Department of Veterans Affairs, Post Traumatic Stress Disorder, or PTSD, occurs after experiencing a traumatic event such as combat exposure, physical abuse, physical attack or serious accidents like a car wreck.  During the traumatic event you believe that your life or others’ lives are in danger, that you have no control over the situation.  Most people experience stress after a traumatic event, but if your reactions don’t go away over time and they disrupt your life, you may have PTSD.

It is not clear why some people develop PTSD and others do not.  Many factors contribute to the possibility including whether or not you were injured, how close you were to the event, how much control you had over the event, how strong your reaction was, how much help and support you received after the event,  and how intense or long the event lasted for.  Some key markers that can indicate PTSD include reliving the event, avoiding situations that remind you of the event, negative changes in beliefs and feelings, and feeling “keyed up” in scenarios that remind you of the event itself.

There are very few resources regarding the recovery of the woman after a traumatic birth experience.  According to research done by  Kalina Christoff, Ph.D., Professor of Psychology at the University of British Columbia, Vancouver, around 30% of women are traumatized during the birth of their child and between 2% and 6% go on to develop Post-Traumatic Stress Disorder (PTSD) as a consequence. To put this in perspective, according to the same article, the rate of PTSD in the regular Canadian Forces is estimated to be 2.8% overall and 4.7% in soldiers with 3 or more deployments (Christoff).

A birth is defined as traumatic if the woman was or believed she or her baby was in danger of injury or death, and she felt helpless, out of control, or alone, and can occur at any point in labor and birth.  It is important to recognize that it is the woman’s perception that determines the diagnosis, whether or not clinical staff or caregivers agree.  Even though physical injury to mother or baby often occurs during a traumatic birth, a birth can still be traumatic without such physical injury. Unfortunately, clinical symptoms of full diagnosis of Posttraumatic Stress Disorder (PTSD) can occur for mothers andpartners following a traumatic birth, the effects of which impact attachment, parenting, and family wellness (Karraa).

Treatment options for birth trauma include trauma focused psychotherapy (counseling) and medication.  The two most effective forms of trauma focused psychotherapy are Cognitive-Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR).  CBT includes cognitive therapy, exposure therapy and stress-inoculation therapy.  Ideally, this therapy allows the patient to confront your traumatic past without triggering PTSD symptoms.  EMDR is highly effective and considered a frontline treatment for PTSD.  In EMDR, you are told to think about your traumatic experience while moving your eyes back and forth following the therapist’s fingers as they briefly move across your field of vision (Kendall-Tackett).

There are also several medications that can be used during recovery from traumatic birth including antidepressants and antipsychotics.  These should be discussed with a medical provider to see if they are right for you.  Antidepressants have been viewed as a key part of treatment for PTSD and can compliment counseling treatment as well.

After gleaning all of this information, it is even more obvious to me that recovery is not just going to happen and that as a patient I must take an active role in my recovery.  If I do not confront my trauma, it could cause further problems with future birth experiences.

Have you pursued counseling or medication in your recovery from traumatic birth?  How has either helped you in your journey?

Sources:

“What is PTSD?” United States Department of Veterans Affairs, National Center for PTSD.   12 August 2013 <http://www.ptsd.va.gov/public/pages/what-is-ptsd.asp&gt;

Christoff, Kalina, Ph.D.,  “Vancouver Birth Trauma: connecting women who were traumatized during childbirth.” University of British Columbia, Vancouver.  12 August 2013 <http://www.vancouverbirthtrauma.ca/home.html&gt;

Karraa, Walker, MFA, MA, CD(DONA). “Traumatic Birth Prevention and Resource Guide,” 12 August 2013 <http://givingbirthwithconfidence.org/2-2/traumatic-birth-prevention-resource-guide/&gt;

Kendall-Tackett, Kathleen, Ph.D., IBCLC, FAPA. “Treatment Options for Trauma Survivors with PTSD,” 12 August 2013 <http://givingbirthwithconfidence.org/2-2/traumatic-birth-prevention-resource-guide/treatment-options-for-trauma-survivors-with-ptsd/&gt;