PTSD After Pregnancy Loss

I have taken the bones (and admittedly, most of the meat) from the post, PTSD after childbirth, to construct this post. I know personally and from talking to others that women can experience Post-traumatic Stress Disorder (PTSD) and Post-partum Depression (PPD) following birth losses. We enter our pregnancies with the fear of loss in the background – some worry more than others – but ultimately expect to be holding our beautiful babies in a mere 8 months after getting that BFP (big “fat” positive) on the home pregnancy test. I myself have been pregnant 4 times and have one living child. I have a lot to be thankful for. But 3 consecutive losses were almost too much for me.http://www.flickr.com/photos/parapet/

Yes, women can and do experience PTSD and PPD after miscarriage, pre-term birth loss, and still birth. The Florida Psychotherapy blog applies the DSM-IV-TR to childbirth related trauma. Let me apply the criteria outlined in that post to PTSD after loss(es).

According to the DSM-IV-TR, the following criteria must be met to be diagnosed with Post Traumatic Stress Disorder (PTSD):

A. The person has experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others AND the person’s response involved fear, helplessness or horror.

How a prospective mother views early pregnancy can contribute to PTSD. One of my sister-in-laws had an early loss but wasn’t terribly affected by it. I was shattered after my first loss. How did the prospective mother react to her loss? Did she panic? Did she cry a lot? Does she remember the entire experience? Has she withdrawn from her life? These and other reactions can be stress responses to her loss.

B. The traumatic event is persistently re-experienced in at least one of the following ways:

  • Recurrent and intrusive distressing recollections of the event.
  • Recurrent distressing dreams of the event.
  • Acting or feeling as though the event were recurring (including flashbacks when waking or intoxicated).
  • Intense psychological stress at exposure to events that symbolize or resemble an aspect of the event.

Women who have experienced pregnancy losses can have nightmares about her losses. Strong images and flashbacks may occur at random moments, or she may have trouble NOT thinking about her experiences with pregnancy loss. Women who do participate in support groups and especially on-line forums need to be careful here. By continuing to relive and replay the experience, you may slow down your recovery.

C. Persistent avoidance of stimuli associated with the trauma or numbing of general responsiveness (not present before the event) as indicated by at least three of the following:

  • Effort to avoid thoughts or feelings associated with the event.
  • Efforts to avoid activities or situations which arouse recollections of the event.
  • Inability to recall an important aspect of the event (psychogenic amnesia.)
  • Markedly diminished interest in significant activities, such as hobby or leisure time activity.
  • Feeling of detachment or estrangement from others.
  • Restricted range of affect; eg, inability to experience emotions such as feelings of love.
  • Sense of a foreshortened future such as not expecting to have a career, more children or a long life.

Here are some examples of how this many manifest. She may avoid places where she is most likely to encounter other pregnant women – play groups, gynecologist, church, heck . . . even the grocery store. She may have trouble relating to other friends with children and friends who are currently pregnant. She may be unable to watch shows that feature pregnancy and birth, look at milk cartons, hear about abused or murdered children, etc. She may no longer find pleasure in activities she once enjoyed. She may avoid sex and/or intimacy with her partner. She may not remember that she was bleeding all over the bathroom and that her young daughter saw the blood . . .

D. Persistent symptoms of increased arousal (not present before the event) as indicated by at least two of the following:

  • Difficulty in falling or staying asleep.
  • Irritability or outbursts of anger.
  • Difficulty concentrating.
  • Hyper-vigilance.
  • Exaggerated startle response.
  • Physiological reactivity on exposure to events that resemble an aspect of the event, eg breaking into a sweat or palpitations.

Moms may have an anxiety reaction when driving past their birth centers or hospitals. They may get anxious when discussing the birth or when birth stories come up in conversation. They may also feel detached from their baby, partner, family, or friends.

E. B, C, and D must be present for at least one month after the traumatic event.

I certainly experienced many of the above symptoms. I had an outright panic attack shortly after my first loss. After my second and third losses I was taking medicine to keep that from happening. I’ve had an incredibly difficult time concentrating since my losses began. I’m doing better now, but last Spring was agonizing.

F. The traumatic event caused clinically significant distress or dysfunction in the individual’s social, occupational, and family functioning or in other important areas of functioning.

Like postpartum depression, PTSD is highly treatable, meaning the woman can get better, sometimes very quickly. Treatment options include

  • talk therapies such as cognitive-behavioral therapy
  • medications and herbs
  • acupuncture
  • body therapies such as Eye Movement Desensitization and Reprocessing (EMDR), biofeedback, and hypnosis

I wasn’t able to recover quickly or easily and was prone to relapses. My last relapse was in August 2008. I went to a therapist and got tired of being told that “this is normal.” There is nothing normal about considering suicide. That is NOT an acceptable response, in my opinion, to any situation – merely “stressful” or absolutely traumatic. There is nothing normal about excessive drinking. There is nothing normal about not wanting to be around your partner or child (children). There is nothing normal about being nearly incapacitated for months and months. There is nothing normal about going out drinking and accidentally getting so drunk that you throw up in public, have to be driven home, black out, and want to kill yourself all over again. Of course, this last paragraph is MY situation, and I’m sure it may seem a normal response to recurrent pregnancy loss, but that doesn’t make it ok. I share these deep dark secrets with you so that you know if you experience these same or similar things, that you’re not alone. It may be normal, but it’s not ok. Please get help!

Additional resources:

26 responses to “PTSD After Pregnancy Loss

  1. Thank you so much for sharing your story. I kept thinking I was “better” and it has only been in the last two months or so that I have actually felt the shift within myself. I was lost, it was truly midnight in the sun for me…

    I’m not sure if the eating right, exercising, and meditation made me feel better or if I was starting to feel better so that I could do these things, but I know how important they are to me now and I recommend it, along with medication and/or counselling for most women even just for a bit.

    I don’t visit the Pregnancy & Birth loss forums at MDC anymore, choosing to spend my time in the ttc and homebirth sections as I did feel it wasn’t where I needed to be after awhile. I felt guilty that I “only” had one loss, that I didn’t have a stillbirth, etc. in addition to it sparking memories/flashbacks. So, while it was what I needed for awhile I did recognize that I needed to step back from it after awhile.

    This is such a wonderful post, it brings back a lot. I have tears in my eyes, but hope in my heart. Big hugs.

  2. Sending big ((HUGS)) your way.

    While I haven’t gone through the same things as you, I have had these feelings after both of my childrens’ births and unnecesareans. I am finally moving on, and seeing a glimmer of light, now six months after my daughter was born.

    I may not understand completely the loss of a child, but I do understand the darkness of depression. And you’re right, it is NOT normal.

    Thank you for being so transparent with us. It will help many.

  3. Pingback: PTSD after Pregnancy Loss « Woman to Woman Childbirth Education

  4. I saw something on this on our local news channel (Boston) and I knew that this is just what I have been experiencing. It was the first time in a long time, I felt a bit of redemption. My loss is not just “being sad”—I am recovering from a serious trauma–and that is how the medical industry complex should address these circumtances. I have a lot more to learn and research, but wanted to thank you for your post.

  5. Kimberly,

    I’m so sorry for your pain. It’s not fair. I’m also sorry that the therapist was so dismissive of your pain. But I thank you so much for being so open of your experience. Not feeling alone means so much.

    Hugs,

    Christie

  6. Thank you all for posting your comments. It’s important for people to know that these things happen to women all too frequently. Why we’re expected to suffer silently is beyond me . . .

  7. Thank you.
    At times I feel I have got it all together. But when I feel like I don’t and reach out to others to ask for help, their response of “you’re so strong” and “what you’re feeling/doing is to be expected” is not what I need to hear. Its what you said—its not normal. Its not what we want to be feeling. And maybe its understandable but for cryin out loud we’ve already lost so much please help us when we ask because we, at times, feel like we’re losing our mind! Sharing like you have helps you and helps me. And it is true. We are strong.
    Thank you.

  8. Thank you for these stories. i am a clinical social worker in Boston and I almost exclusively treat women (and men) who have suffered a pregnancy loss and are trying to come to terms with it. I am interested in the feelings of those who have gone on to have a healthy child after a loss. Is there any residual PTSD or depression? Thank you and I hope you all find a way to get comfort and heal.

  9. Thank you for sharing your story. It really makes me feel less alone. Perhaps therapy is in order for me again. I too have hade 4 pregnancy losses and 1 living child who I am so grateful for. My first daughter Samantha was stillborn at birth and was 4 lbs. I have been to therapy before but thought I was out but perhaps I am not. I most definitely have PTSD and have had panic attacks on and off. I had a miscarriage recently three months ago that set all of this in motion again. I appreciate you giving me the courage and inspiring me to look for other options through therapy.

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  12. Thank you so much for this post! I had the unique situation of losing one of my twin daughters, Alyssa, to TTTS at 19 weeks, then continuing to carry both of my girls till a very traumatic emergency c-section at 35 weeks where we almost lost my survivor, Harper. I’m now suffering from excessive anxiety and sleeplessness – I’m almost convinced, as strange as it may seem, that something is going to happen to Harper now; that I’m waiting for the other shoe to drop. I can’t sleep when she sleeps because I feel like I need to watch her to make sure she’s still breathing. I’m calling tomorrow to make an appointment to see a doctor about it – I’m hoping that, being a military medical facility, they’ll recognize it for what it is – PTSD. To anyone who is going through this – talk to someone: you shouldn’t have to feel this way.

    Thank you again!

    • My goodness, Sarah! No wonder you’re dealing with some PTSD. And actually, I struggled with it even after my successful vaginal birth 3 months ago. It was transient, thank God. Big hug to you and baby Harper! And a prayer for your angel baby twin.

  13. Pingback: Long Term Healing/Perspectives | stillbirthday

  14. Thank you for this very comprehensive and easy-to-understand description of postpartum PTSD. I also have had 4 pregnancies and have one living child. Our first (our son) was stillborn at 33 weeks. It’s been almost 6 years since he died. Then I had two early miscarriages. Finally our beautiful daughter was born, she’ll be 2 next week. I was diagnosed with PP Depression and Anxiety a few weeks after her birth and have been working on recovering, a long road for me. I knew I also had symptoms of PTSD from my first loss but I never realized how clearly the diagnosis criteria described my experience. I’ve recently started seeing a therapist who has quickly realized that many of my current issues are related more to PTSD than depression and is modifying my treatment plan to address this. I’m hoping this is the turning point I need to help me truly feel better.

  15. Thank you for being brave. I had had to give birth to her at six months on my 20th birthday and I haven’t been the same. I have acted out in numerous ways that have never benefited me including isolating myself from my family ( who didn’t even know I was pregnant) and friends. At the time, I was so scared. I was 19 without a good support system. I tried my best. To this day, I only remember bits and pieces of the day and I can’t remember at all the subsequent ones. I blocked it. Went to work, sometimes 60 hrs/ wk with a full college work load. And was so alone. Then came my 21 st. birthday. I have had a big problem with alcohol. ever since. I now have a fiance and hopes to build a family but am scared, as anyone who goes through this probably is. There are so many nightmares, so many emotions that pop up unexpectedly because you have gone through what you have, what ever YOUR situation. I capitalize that because it is so personal and some have gone through it feeling completely alone. You aren’t. And this is the first thing I have ever written about it. So thank you for the opportunity. . kgjames

  16. Hi, I believe my wife is suffering from some of the symptoms above. As a husband, what can I do to help and support her? I’m more worried than anything and I just want her to feel better. We lost our daughter 9 months ago, and it still hurts like it’s happening now but she’s taking it worst than me. I can’t comprehend the pain she is still going through. We have a 2 year old son and I need her to get better for him as well as me! Any help will be greatly appreciated!

    • Terence, your wife is very lucky to have such a loving husband who is willing to reach out to help her. My husband is the same way. He had his own pain to work through after our baby boy was stillborn at 33 weeks, but his patience and kindness helped get me through. I’m still working on my recovery from that trauma. It’s been 6 years but the first year was the worst. We joined a pregnancy and infant loss support group that we attended together which was very helpful. There are many online groups as well. I read a lot of books about loss and grief. I found a good therapist and saw her often, my husband came with me sometimes and he got some guidance about out how he could best help me. I tried some alternative therapies like EMDR, acupuncture, massage and meditation. I was very resistant to taking antidepressants because I wanted to get pregnant again right away, but looking back it probably would have been a good idea. I’m on them now as a result of postpartum depression and anxiety after the birth of my daughter who is now 2. Don’t give up, it will get better! Encourage and help your wife to take care of herself with good nutrition, sleep, time outside (in nature if possible) and physical activity. Time with sensitive and understanding friends is helpful, as well as any activity that she enjoys (even a little bit). I hope this helps. My heart goes out to your family. Please tell your wife that she is not alone, there are many caring people who have found their way through losing a child who can give her hope and help her on her path to healing.

  17. Pingback: Long Term Healing/Perspectives // Still Birth Day

  18. Thank you for posting this. I am sure I am viewing this late, but I wanted to leave a note stating how helpful this is (I don’t normally post comments on things). I have been suffering in silence for a long time, and it is hard to find people to relate to. It seems as if everyone who knows about your loss tries so much to avoid it because they either don’t know what to say, or are afraid to make you cry. I lost my pregnancy last month, and it seems as if it has exacerbated my PTSD from a previous loss at 16 that I never dealt with properly. It’s hard to navigate your emotions, and I feel like it can consume you. It is even worse when you are rushed to move on just to keep to the pace of everyone else living their lives. it is almost as if there is no time to mourn, especially as I have to work and take care of my 1 year old daughter. My husband is helpful, but does not understand. He is extremely supportive but frustrated. This post gives me hope that with time and effort I can move forward

    Thank you.

  19. Hi, I’m not sure if this site is even monitored for comments still, but wanted to add a thank you for explaining PTSD in context with pregnancy loss. I had an early MC over 2 years ago which knocked me sideways. But after a few months, I was ready to try again. But then tragedy struck the family again and my sister lost her baby to stillbirth. Still trying to deal with my own loss and now trying to be there for my sister has been incredibly hard. I had to go and see her in the hospital as I needed to hug her tight, and I also felt the need to nurse her sleeping baby boy. I realise now that it may not have been the best move as I was still grieving for my own lost baby. This only helped me to visualise what I’d lost. For a long time I’ve bottled up my emotions and withdrawn further and further into isolation. I don’t think anyone really realised that although I might have been physically in the same room, I haven’t really been there mentally or emotionally. I’ve also had a lot of work stress in the last 4 years which has only helped me to bottle my emotions further. I’ve recently taken a couple of weeks off work, asked for blood tests to check hormone levels (as I believe they are off balance due to stress) and asked to be referred for some sort of psychological therapy too. I think I might have relied too heavily on alcohol over the last 2 years as a coping mechanism and now that I’m drinking less, I think my brain has forgotten how to cope with and manage stress. I’ve been experiencing some strange symptoms including hissing in my ears, trembling, dizziness, body zaps when someone else is in control of a vehicle, irritability and moodiness, to name a few. I’ve read up about stress, anxiety and depression, and I believe a lot of my issues boil down to a drip-drip effect of long term stress at work, with the added emotional stress over recent years. But I’m also beginning to wonder even more about the possibility of suffering from PTSD. I don’t have all the symptoms, but some that I do have seem to fit with PTSD. Thank you for sharing your stories ladies and especially to the original poster. Let’s hope we all get some help and don’t have to suffer alone xx

    • Hi Sharon,
      Yes I’m still here and reading comments on these posts. I’m so sorry to read about your struggles these past few years. It can get better, but you really have to dedicate yourself to making it better. I’m not always very good to myself – but we have to believe that we deserve to be happy and work to make changes that support that belief.
      It’s certainly possible that your sister’s tragedy triggered a stress response – everyone handles and processes tragedy differently.
      I hope you get the help you need and find a way to get back on track. I know I had a few very fuzzy years – sucks to lose that time.
      Best,
      Kimberly aka labortrials

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