This article is part of the Traumatic Birth Prevention & Resource Guide by PATTCh. Access the complete guide to learn more about traumatic birth and find resources for women and families.
By Walker Karraa, MFA, MA, CD(DONA), President PATTCh
This is an interview I did with my husband, Tony. His perspective on the events of my traumatic birth and subsequent PTSD speak to the impact of these issues on partners, but is not a statement of suggested treatment. It is an honest snapshot of a partner's experience of birth trauma and his partner's PTSD, hopefully shedding light on recovery from traumatic birth and reclaiming life post trauma.
Were you aware of the PTSD in my birth?
I think that my first clue that something was beginning to happen was during labor. It was specifically during transition that I noticed a slow but clear change in your presence. It appeared as though you began to dissociate from not only me but the world, as if your body had been left behind to experience the rest of the experience without you. It changed after we were home with the baby but for me, that was the moment it began.
When did you realize something was wrong?
I knew something was wrong right away. But I didn't realize the extent of the problem. I kept thinking it would get better. But instead it got worse. I didn't know where mild baby blues ended and where postpartum depression began. Nor did I have any information on how to get help.
What was that experience like for you?
Extraordinarily frightening. I didn't know what was happening during labor. We were so connected as a couple and it began to shift in a way that was very scary. Once the full force of the PPD began to level itself in our lives in the first few weeks of being home with the baby, I felt confused and helpless and I was experiencing extreme anxiety. When you passed out from lack of sleep and fell to the floor behind me as I was holding the baby, my anxiety changed to terror.
What would you do differently now that you know about postpartum depression?
I would have reached out immediately to health care professionals for help. I would have encouraged formula feeding and weaning of breastfeeding right away to facilitate more ease of movement for you to be away from the baby for treatment or even just a break. I would have encouraged proper prescribed medication under the guidance of a psychiatrist to begin to ease the terrible burdens of the disease. It is so difficult to remember how helpless I felt and how under the influence I was of all the media hype about breastfeeding and bonding. That really affected my ability to act
What surprised you about my PTSD and postpartum depression?
The insomnia. I was used to seeing depression and how it affected your daily life due to your chronic condition, but the affects of the insomnia were devastating.
What scared you the most?
The scariest thing was the constant fear that you may try to hurt yourself.
What advice would you give a partner?
To act quickly. To know that no matter what the level of depression, anxiety or insomnia your partner is experiencing, they should be seen by a health care professional and there are lots of options.
What do you think women need most if they have PTSD following birth?
They need people in their lives who are willing to acknowledge it for what it is and are willing to be there with them no matter how scary it is. They also need good professional medical care as quickly as possible. Whether it is therapy or medication, they need to be under the care of a professional. They also need to know that they are not permanently damaging their baby and that they can take time away during the day or night, whenever possible, for a break.
How did you see the interaction with our son?
I was worried about him a lot at first. Not just because of your depression but also because of my own stress and anxiety. I was very afraid that it would affect him adversely. But having watched him grow and mature over the last ten years, I am completely convinced that having the treatment that you finally did receive, starting around his third month of life was an invaluable change in the dynamic between the three of us. It was not all smooth sailing after that but it continued to improve because of it. I shudder to think of what might of happen, had you not found and accepted the treatments of the wonderful therapist and psychiatrists that first saw you.
How did you see the interaction with our son?
I was worried about him a lot at first. Not just because of your depression but also because of my own stress and anxiety. I was very afraid that it would affect him adversely. But having watched him grow and mature over the last ten years, I am completely convinced that having the treatment that you finally did receive, starting around his third month of life, was an invaluable change in the dynamic between the three of us. It was not all smooth sailing after that but it continued to improve because of it. I shudder to think of what might have happened, had you not found and accepted the treatments of the wonderful therapist and psychiatrists that first saw you.
How did the next pregnancy and birth of our daughter differ?
Everything was different, but for me, the most notable difference was choosing to be open to bottle feed with formula from the start. That gave you a much greater sense of freedom. You were able to be away without the constant fear that the baby would starve without you. I can't recommend that enough to other parents. I know it goes against the conventional wisdom of the day regarding breastfeeding. But in my humble opinion (which is grounded in personal experience) they are flat out wrong. Our daughter is attached, loving, kind, deeply in touch with emotions and easily able to connect to others. Not to mention she is flipping brilliant (state test score fact¬ merely a parental opinion) and she was bottle fed from infancy. And once you were diagnosed with breast cancer when she was only 7 months old, we were able to transition her so easily. You just never know what is going to happen and having that option saved our lives.
Trauma impacts everyone, and the experience of trauma subjective -- in the eye of the beholder, the person experiencing an event as traumatic. This is true for partners and care providers as well. The perception of sudden, life-threatening circumstances by partners in the birth room merit deeper understanding. Neurological dynamics, and biological responses to trauma perception are on the forefront of much of the trauma research today. And champions in the field are asking the important questions about the effect of birth trauma on partners. And PATTCh will continue to promote ongoing discussions, symposia, and opportunities to share this research. We have a lot to learn.
Preventing the occurence of traumatic birth experiences, through consideration of risk factors for both parents is key. Partners in the military, law enforcement, with a history of trauma or interpersonal violence deserve to be considered with respect in the birth room, and birth process. Support in both information from qualified professional, and instrumental support during birth and at home during postpartum period are necessary for partners to understand the normal range of emotions and what to do if they or their partner experience symptoms of distress beyond that range.
More information on PTSD can be found on the PATTCh Resource Support page.
Disclaimer: Tony's experience, and feelings regarding treatment, and bottle/formula feeding are his, and should not be misunderstood to be those of the Board of PATTCh.
Walker Karraa is a doctoral student at the Institute of Transpersonal Psychology. She is a birth doula, maternal mental health advocate, and researcher. She currently writes for the Lamaze research blog, Science and Sensibility. She presents at conferences, trainings, and organizational retreats pertaining to perinatal psychology, postpartum mood disorders, childbirth education, and labor support. Walker also is the President of PATTCh, a not-for-profit dedicated to the prevention and treatment of traumatic childbirth.
PATTCh is a not-for-profit, multidisciplinary organization dedicated to the prevention and treatment of traumatic childbirth. Our mission is to develop cross-disciplinary relationships, research, and programs that:
- prevent PTSD following childbirth through education, interdisciplinary collaboration, and multidisciplinary research;
- educate perinatal care providers and paraprofessionals in the prevention and treatment of birth and reproduction related trauma;
- encourage the development of culturally appropriate therapeutic approaches to post-traumatic stress symptoms following childbirth;
- promote healthy birth practices for all women and families;
- promote evidence-based research regarding PTSD secondary to childbirth;
- increase global awareness of the prevalence, risk factors, and effects of PTSD secondary to childbirth; and
- support collaboration and understanding among all stake-holders, including: researchers, policy makers, medical and mental health care providers, educators, community members, volunteers, women, and families.