I was so traumatized by my labor and delivery experience that I could not remember simple pieces of information—it was like my memory had been wiped clean. In the most acute period, I could not even remember my home address. I could not name the current vice president (although, in retrospect, perhaps that was a nice little silver lining). I could not remember how to perform my job duties at the company where I had worked prior to having my son. It turns out that memory loss is commonly associated with post-traumatic stress disorder (PTSD)—yet, when I brought this up to several physicians and mental health providers, they seemed unfazed by it. Instead, for months, they all continued to declare that I had postpartum depression.
Immediately after experiencing a labor and delivery that can only be described as a train wreck—rife with poor medical decision-making and questionable interventions—I remember thinking, “That was the most terrifying and traumatic experience of my life, but thank God it’s over.” Little did I know that my horrific postpartum saga had just begun. The next four and a half months of my life were filled with a slew of serious physical complications that could have been avoided with better medical care and which were compounded by the expected yet intense stress of becoming a new parent. As a result, my mental state collapsed, too—and getting a correct diagnosis and treatment for my particular issue was extremely difficult. It didn’t have to be.
When it comes to postpartum PTSD, obstetric providers simply aren’t reckoning with the fact that one-third of new mothers in the United States report feeling traumatized by their birth experience
Obstetricians—and the medical community at large—often view postpartum depression as the catchall for any mental health issues that women experience during the postpartum period. In fact, there are a number of different maternal mental health disorders. Among them are postpartum anxiety, postpartum psychosis, postpartum obsessive-compulsive disorder (OCD), and PTSD, the last of which I developed. There are likely a number of reasons for the intense focus on postpartum depression above all of these other disorders. But when it comes to postpartum PTSD, obstetric providers simply aren’t reckoning with the fact that one-third of new mothers in the United States report feeling traumatized by their birth experience and over 13 percent of new mothers emerge from labor and delivery with clinically diagnosable PTSD—with symptoms akin to rape victims and war veterans.
The urogynecologists who treated my physical complications wrote in my notes that I was suffering from postpartum depression. Several mental health providers that I saw also suggested that I had postpartum depression, as did some family and friends. I knew, though—from the flashbacks and nightmares, from my inability to sleep more than one or two hours within a 24 hour period, from my memory loss, from the constant terror that I felt—that even if I was depressed, this was not my primary mental health issue. And I was right.
Approximately three months after my son was born, my family found a psychiatrist for me to see, who—in addition to having true compassion, as well as anger, for what I had endured— immediately diagnosed me with PTSD and provided me with a treatment plan. In order to diagnose me, she did not work off broad assumptions, as others had, but asked specific questions, like “Are you having constant flashbacks and nightmares about the delivery and subsequent complications?” The answer was, of course, yes. I was having nothing but flashbacks and nightmares. Behind my eyelids played a constant horror movie of physicians and residents standing over me, grabbing at me, examining me. I was a doll, a corpse; I couldn’t scream. I thought my heart would burst out of my chest during these nightmares and flashbacks. I could barely distinguish them from reality.
“Are you having constant flashbacks and nightmares about the delivery and subsequent complications?” The answer was, of course, yes. I was having nothing but flashbacks and nightmares.
Although there is some overlap between the treatments of postpartum PTSD and postpartum depression—particularly in terms of medications prescribed—there are also significant differences. Women with postpartum PTSD need the space and support to constantly process the trauma that they experienced—often the birth itself, but, in some cases, trauma that they experienced before or after the birth. All of the physicians and mental health providers whom I saw at first seemed to want me to get past the birth and the complications that I experienced, overlooking and downplaying how poorly I was treated. But the psychiatrist who correctly diagnosed me understood that I needed to continually discuss and process these traumatic experiences. Nineteen months later—even though my memory is back, and the nightmares and flashbacks are mostly behind me—the trauma surrounding my son’s birth is still something I work through every day.
Our maternity care system is profoundly broken. The United States has the highest maternal mortality rate of any country in the developed world. American women giving birth today have a 50 percent greater chance of dying in childbirth than their mothers did. Women of color have a significantly increased risk of dying during pregnancy and in childbirth; black women are three to four times more likely to die from maternal health complications than white women are. And none of these statistics even consider our severe maternal morbidity crisis: the more than 50,000 new mothers who almost die of largely preventable maternal health complications each year, but don’t. And this rate has been increasing: From 1993 to 2014, the severe maternal morbidity rate in the United States increased nearly 200 percent.
Nineteen months later—even though my memory is back, and the nightmares and flashbacks are mostly behind me—the trauma surrounding my son’s birth is still something I work through every day.
It will likely take decades to reverse these disturbing trends—if they will be reversed at all. In the meantime, the very least that obstetric providers, mental health providers, and the medical community at large can do is recognize that feeling traumatized, or developing PTSD, is a logical response or outcome for many new mothers after giving birth within this broken system. Postpartum mental health issues—much like postpartum physical health issues—are not one-size-fits-all. Let’s stop treating them like they are.
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