Labor and delivery can be a beautiful, moving and transcending experience for a woman and for those who witness it. Unfortunately, it can also be wrought with complications that can render the experience traumatic. Many labor and delivery complications are unexpected and can quickly become life-threatening for the mother and/or for the child(ren). When labor and delivery lead to a threat of loss of life or serious threat of physical injury, it is traumatic.
How is a Traumatic Labor Defined?
The Diagnostic and Statistical Manual for Mental Health Disorders- Version 5 (DSM-5) defines traumatic events, or Criterion A traumas, as the following:
Exposure to death, threatened death, actual or threat of a serious injury, or actual or threatened sexual violence. Traumas can be experienced in 4 different ways:
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directly experiencing the traumatic event
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witnessing (in person) the event occur to someone else
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learning that a traumatic event occurred to a close friend or family member that was violent or accidental
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experiencing first-hand repeated or extreme exposure to aversive details of trauma (not via media, unless work-related)
Natural Reactions after a Traumatic Labor
In the immediate aftermath of a traumatic event, it is completely normative to experience posttrauma reactions. These experiences may include:
-intrusive memories of the event, during daytime or nighttime
-distress when faced with trauma reminders
-avoiding thinking about the event
-social withdrawal
-feeling more irritable or on-edge
-feeling anxious
Typically these reactions dissipate naturally over time as one makes sense of the experience and reconnects with their life and their social supports. This process is called natural recovery.
It is important to keep in mind that in addition to the mother, the partner, labor support staff, or anyone else in the labor and delivery room may experience these posttrauma reactions.
Tips on How to Support Natural Recovery after a Traumatic Labor
According to trauma therapist Dr. Stephanie Sacks, there are a number of things that people can do to facilitate natural psychological recovery following a traumatic labor. Utilizing social support has been found to be a protective factor following traumas. Perceiving that one has a solid and positive support network is a factor that can promote natural recovery and help one resume functioning. In addition, it can be helpful to go on about life’s normal activities as much as possible so as to reduce the chance of utilizing avoidance as a coping strategy. Further, it can be helpful to intentionally allow oneself to remember memories of the traumatic labor while giving space for natural emotions that may arise.
For some people, these posttrauma reactions may linger and can cause emotional distress and/or may impair one’s ability to function.
When Help May be Needed
If someone continues to experience significant distress or impairment in their functioning, along with any of the symptoms noted below, it may be time to seek some additional support in the form of a qualified trauma therapist. These symptoms may indicate the development of Posttraumatic Stress Disorder (PTSD), though they should be formally assessed by a mental health professional.
-intrusive imagery of the trauma
-nightmares about the trauma
-emotional upset or physiological arousal (i.e., heart racing, trouble breathing, hands shaking) when faced with cues of the trauma
-urge to avoid thinking about or talking about the trauma
-avoiding internal or external triggers of the trauma (people, places, things, activities)
-blaming oneself or others for the traumatic labor
-changes in thinking following the trauma, such as increased concerns about safety, trust, power/control, esteem or intimacy
-trouble with sleep or concentration
-Feeling keyed up, on edge or having an exaggerated startle reaction
If these posttrauma symptoms last for more than a month, it may be necessary to seek mental health support in the form of therapy in order to help jump-start the recovery process. There are excellent therapies to address these symptoms that are time-limited and solution-oriented, but they do need to be delivered by well-trained trauma therapists.
How to Find a Well-Trained PTSD Therapist
Therapists who are well-trained in trauma therapy can be hard to find. When you go looking for a therapist, inquire about the experience and the type of training they have had in working with clients who have experienced traumas, such as traumatic births. There are several excellent find-a-therapist search engines to help narrow down your search.
International Institute for Traumatic Stress Studies (ISTSS) Find-A-Therapist
https://istss.org/public-resources/find-a-clinician
Association for Behavioral and Cognitive Therapies (ABCT) Therapist Finder
https://services.abct.org/i4a/memberDirectory/index.cfm?directory_id=3&pageID=3282
There are many reasons to have hope! Evidence-based PTSD treatments- specifically Cognitive Processing Therapy, Prolonged Exposure Therapy and EMDR- are extremely effective for treating PTSD resulting from traumatic labor.
