Ask a Therapist: Can Postpartum Depression Resemble Birth Trauma?

Ask a Therapist: Can Postpartum Depression Resemble Birth Trauma?

By Kendra Doukas, LMFT and Joey Tadie, PhD

     We get a lot of postpartum mothers at the Catalyst Center that come in either with an official postpartum depression diagnosis, or with concerns that they might have this condition. This form of depression is unique from other types of mood problems and often requires different considerations or treatment styles to address. Because postpartum depression has generally become a “catch all term” for any emotional challenge around pregnancy, it is important to highlight the reality that this term doesn't fully capture the nuances that are present for various postpartum conditions. 

     For instance, we know that there are specific postpartum challenges that are more accurately identified as postpartum anxiety and postpartum Obsessive Compulsive Disorder (OCD). These conditions have overlap with, but are distinct from postpartum depression and often require different interventions. Postpartum issues like the ones highlighted above affect a great number of new parents (mothers and non-birthing partners as well), and it is important to know whether these emotional struggles are indeed related to postpartum health or some other unidentified problem. What other problem could relate to and even resemble postpartum struggles? To answer this, we would like to highlight a lesser known but very powerful emotional challenge called “Birth Trauma.” This is a significant condition that also needs specialized treatment much like other forms of postpartum struggle. We will discuss in more detail what this condition looks like and ultimately what can be done to help minimize its negative impact.

What is Birth Trauma?

     Birth is often crazy and unpredictable. For some mothers and families, the experience of giving birth ends up varying greatly from what they planned or hoped for.  A traumatic birth experience can be anything from a scary or life-threatening birth experience or simply a birth that did not go as planned or hoped for. 

The Impact of a Traumatic Birthing Experience: 

     It is very common for a woman to struggle with postpartum issues when she has had a traumatic or intense birth experience.  Thus, these mothers can often look like they suffer from a postpartum issue when really the root issue is trauma. Aside from challenges associated with birth, other clients have an intense or traumatic early postpartum period wrought with nursing or feeding issues such as tongue tie, trouble with weight gain, and/or health concerns for the infant or parent. When our babies our very young, we aren’t doing much to parent them outside of feeding them and keeping them alive. That being said, if nursing or feeding isn’t going well, or the actual birth was traumatic, it often negatively affects our identity as parents. One could feel inadequate, ill-equipped, or even incapable of meeting their or others’ parenting standards, which is understandably quite painful to consider. 

What Can Be Done to Help?

     Surprisingly, over the years we have observed more cases where the core problem is rooted in trauma rather than typical postpartum depression/anxiety/etc. The exciting news is that these issues are very treatable and quickly resolve. Often, when we treat the underlying trauma, the postpartum issues almost always disappear or at the very least significantly diminish. One example involves a client who had planned on a natural childbirth and wanted as little intervention as possible. Due to some complications, the client ended up needing to transfer from a birth center to a hospital and ended up birthing by cesarean. The client’s doctors couldn’t understand why the mother was having emotional struggles, saying things like, “I don’t get it! You have a healthy baby and that’s all that matters.” For this client her experience of the birth was devastating. She felt like she failed the very first “parenting test” she was given. She had been diagnosed with postpartum depression although she reported it did not seem to fit for her. She had no trouble connecting with baby although she did question her abilities as a mother. She loved every minute of being with her newborn (far more than even is typical) but could not seem to stop crying, had trouble sleeping, and experienced recurring thoughts and memories of the birth. 

     When the client came in for therapy it became clear that rather than classic postpartum depression, what was actually happening to her was reflective of Post-Traumatic Stress Disorder (PTSD) stemming from the client’s chaotic experience of giving birth. Although depressive symptoms can overlap with trauma symptoms, the best way to resolve this client’s challenge was to appropriately target the trauma roots rather than just her mood symptoms. In order to address her problems in the most precise way, the client participated in several sessions of Eye Movement Desensitization and Reprocessing (EMDR) therapy. EMDR is a highly efficient and effective intervention, and is the most empirically-validated therapy for trauma. Through the gains from her therapeutic work, the client was able to imagine having a different birthing experience and instantly the client’s trauma and mood symptoms vanished. This mother went on to have a very healthy perspective about her experience of birthing and felt fulfilled and happy as a parent. 

     Trauma from birth and postpartum periods can mimic postpartum depression or other postpartum issues, yet the way we resolve these problems are distinct. Having a clear vision of the core aspect of your emotional challenges related to birth/parenting allows us to support you in the best possible way. When treated correctly Birth Trauma and other postpartum issues can be addressed in fairly short order. Remember that everyone is different as are our perspectives and experiences. But when you are feeling haunted by aspects of your birth experience and can’t grasp why you are struggling, it is worth a conversation with a professional who specializes in this type of care. We want you to be your best self so you can truly be the amazing parent you desire to be. Birth Trauma doesn’t have to burden you forever, as there truly is hope for healing, recovery, and renewal.

Ask a Therapist: What is Psychological Assessment Anyway?

Ask a Therapist: What is Psychological Assessment Anyway?

Giving Birth by Cesarean: Honoring the Experience

Giving Birth by Cesarean: Honoring the Experience