Postpartum PTSD: Right Diagnosis Can Help Mothers and Babies

May 6, 2024 – Megan Tavares was 39 weeks pregnant and at the grocery store when her phone rang. Her doctor was calling to tell her to get to the hospital as soon as possible. Bloodwork from that morning showed the now 41-year-old had HELLP syndrome, which is linked to preeclampsia, and the baby needed to be delivered right away. Nine hours later, her son was born. 

Thankfully, Tavares, a licensed independent social worker from Somerset, MA, and her baby both survived the experience, but it was nothing short of traumatic; up to 24% of pregnant women and up to 34% of babies die from HELLP, according to estimates from Yale Medicine.

It was after Tavares got from from the hospital with her newborn son that she noticed symptoms of postpartum posttraumatic stress disorder, or PTSD. 

“I became afraid to sleep because I was convinced I might die. I didn’t trust my body and became hypervigilant about anything related to my health – I felt like a ticking time bomb,” she recalled. 

Tavares told her OB/GYN about how she felt.

“She said that it was completely normal given what I had experienced, and that I was brave throughout my labor and delivery,” Tavares said. Still, she continued to struggle for 6 months. “My PCP then diagnosed me with postpartum posttraumatic stress disorder, as well as postpartum depression and postpartum anxiety.” 

Many new mothers aren’t aware that postpartum PTSD even exists, but it’s far from rare. Postpartum PTSD affects about 8 million women worldwide annually, according to data from the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. What’s more, a study from Spain found that 50% of women can have postpartum PTSD after they give birth. 

Signs appear within a month after a birth that is traumatic to a new mom or baby in some significant way, often due to things like an unplanned cesarean section, the baby being taken to the neonatal intensive care unit, a forceps birth or vacuum extraction, other medical complications, or lack of support from health care professionals during birth. While it’s important that new mothers who have symptoms of postpartum PSTD to get treatment, the condition often goes undiagnosed.

A new study Massachusetts General Hospital and Bar-Ilan University is attempting to remedy this. The research team used a low-cost form of artificial intelligence that any OB/GYN could theoretically use to improve diagnostics. 

For the study, nearly 1,300 women were asked to write 30 words about their birth experience, focusing on the most traumatic parts, explained lead study author Sharon Dekel, PhD, an assistant professor of psychology in the Department of Psychiatry at Harvard Medical School and director of Massachusetts General Hospital’s Postpartum Traumatic Stress Disorders Research Program

“An AI model made to understand human language then analyzed the pattern of words and speech the women used, identifying mental illness through the nuance of their language and the context of their sentences. We would input, and the model would tell us if the data was representative of PTSD or not,” she said. 

The OpenAI model scored a 75% to 85% specificity/accuracy rate in diagnosing the women among this population with postpartum PTSD. The researchers believe this technology could easily fit into routine OB/GYN care with the hopes that quick intervention could help at-risk women. 

Speed of diagnosis is vital, according to Dekel. “If a woman develops a mental illness following a traumatic childbirth experience, this can potentially impair the health of both mother and infant,” she said. 

More on Postpartum PTSD 

In general, PTSD can happen after an event that’s terrifying. In dealing with the shock of such an event, you can have flashbacks, nightmares, become very anxious, and often can’t stop thinking about what happened. 

And recent research from Lomonosov Moscow State University in Russia shows that postpartum PTSD can either happen for the first time due to frightening circumstances in childbirth or can be caused by previous trauma being reactivated during a stressful delivery. For instance, the researchers found that women who have experienced sexual assault or childhood sexual abuse were more likely to develop postpartum PTSD. What’s more, “racial discrimination during care may also raise a woman’s risk,” Dekel said. “Latina and Black women are three times more likely to have a traumatic reaction to childbirth.”

In addition to serious medical complications or poor treatment from hospital staff, the condition can also be caused if a woman has a lack of control over her birth experience. 

“A woman may feel like she has failed for not being able to have a vaginal delivery,” Dekel said. “In some cases, postpartum PTSD can also become a disincentive for future pregnancy. It leads to avoidance, where women say, ‘I’m never going to do this again.’”

Symptoms of postpartum PTSD 

Feeling unusual tension is one important trait. “You should be looking out for a general level of stress that is higher than expected in the postpartum period, with re-experiencing or avoiding the event that causes negative changes to your mood or thinking,” said Sarah Horvath, MD, MSHP, an assistant professor of obstetrics and gynecology at Penn State Hershey Medical Center in Hershey, PA. 

You may also:

  • Have trouble sleeping
  • Feel “on alert” all the time
  • Have panic attacks
  • Feel increasingly depressed 

Can Postpartum PTSD Be Prevented? 

In some cases, yes. 

“Being prepared for potential PTSD can be really helpful,” said Horvath. “Take time to think through the ideal birth experience, but also think about potential experiences that may be less than ideal.” This can help you accept uncertainty, so you cope better if the unexpected happens.

Your OB/GYN can also help. 

“Patients should talk with their obstetricians in advance to set realistic expectations and express any potential fears or need for additional support,” Horvath said. “Also, if a patient has a trusted family medicine doctor, psychiatrist, or psychologist, work with them ahead of time to think about support and resiliency.”

How to Treat Postpartum PTSD 

Medication and/or therapy is key. In Tavares’s case, she was prescribed Zoloft at the time of her diagnosis and a few months later began counseling.

“I’m doing well,” she said. “Working with a counselor, especially one who specializes in perinatal mental health, is a wonderful healing experience. It’s a safe space to share what you’ve been through, and be validated.”

Overall, don’t hesitate to seek the help you need and deserve, Dekel stressed. 

“There is no need to be ashamed. If you experience symptoms within the first few days after birth, we can treat you, and early treatment can make a huge difference. Open up and share how you feel – it’s an important way to take care of yourself and your baby.” 

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