A recent article published by Mass General Hospital tells the story of Anna, a woman who experienced complications after the birth of her second child. Although her labor went smoothly at first, she ultimately had to have an emergency cesarean section that was complicated by postpartum hemorrhage. Both Anna and her baby did well physically after the experience; however, what are the emotional consequences of such a terrifying experience?
While we are increasingly attentive to screening for depressive symptoms during pregnancy and the postpartum period, less often do we inquire about symptoms of post-traumatic stress disorder or PTSD. Childbirth-related PTSD (CB-PTSD) may be precipitated by a stressful or traumatic childbirth experience. Of note, childbirth-related PTSD is not dependent on the severity of the trauma. CB-PTSD may certainly occur after stillbirth or deliveries associated with infant medical complications, CB-PTSD may be triggered by less severe complications, or even unexpected events. Current research indicates that as many as 25% of women experience CB-PTSD symptoms after giving birth to a healthy full-term baby (Dekel et al, 2017).
Sharon Dekel, PhD, MS, MPhil and members of her lab are leaders in this relatively new area of research, conducting large-scale clinical and translational studies focused on characterizing childbirth-related PTSD. Dr. Dekel’s research team is developing novel tools for the early detection of parents at risk for CB-PTSD and testing preventive treatments that are effective and safe.
Findings from Dr. Dekel’s research show that objective stressors in birth such as mode of delivery and obstetrical complications, like the ones Anna experienced, can predict the development of subsequent CB-PTSD. In fact, her research finds that patients who have an unscheduled c-section are three times more likely to suffer from CB-PTSD.
“The experience of childbirth and subsequent negative and positive psychological responses vary greatly person-to-person,” Dr. Dekel explains. “My research aims to better capture the various postpartum mental health trajectories. Unfortunately, a significant portion of women will experience clinically significant distress and develop a mental illness in the form of depression, anxiety, or CB-PTSD. We want to understand what puts a person at risk to experience birth trauma as well as what helps people recover psychologically following traumatic childbirth and even experience posttraumatic psychological growth (PTG). This will ultimately help clinicians more fully understand postpartum mental health conditions which will translate to better, more comprehensive mental health care for mothers and their children.”
Source: Anna’s Story: Healing After a Traumatic Birth (MGH News)
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Chan SJ, Thiel F, Kaimal AJ, Pitman RK, Orr SP, Dekel S. Validation of childbirth-related posttraumatic stress disorder using psychophysiological assessment. Am J Obstet Gynecol. 2022 Oct; 227(4):656-659.
Dekel S, Ein-Dor T, Berman Z, Barsoumian IS, Agarwal S, Pitman RK. Delivery mode is associated with maternal mental health following childbirth. Arch Womens Ment Health. 2019 Dec;22(6):817-824.
Dekel S, Stuebe C, Dishy G. Childbirth Induced Posttraumatic Stress Syndrome: A Systematic Review of Prevalence and Risk Factors. Front Psychol. 2017 Apr 11;8:560.
Thiel F, Berman Z, Dishy GA, Chan SJ, Seth H, Tokala M, Pitman RK, Dekel S. Traumatic memories of childbirth relate to maternal postpartum posttraumatic stress disorder. J Anxiety Disord. 2021 Jan;77:102342. 222.
Sharon Dekel, PhD, MS, MPhil is the Director of the Dekel Laboratory at Massachusetts General Hospital and an Assistant Professor of Psychology in the Department of Psychiatry Harvard Medical School. Her research focuses on women’s mental health following the birth of a child, specifically focusing on traumatic childbirth and the mechanisms responsible for postpartum adjustment.
