Traumatic Experiences and PTSD
Approximately 70% of people will be exposed to at least one traumatic event during the course of their life and from that 8% will develop Post Traumatic Stress Disorder (PTSD). PTSD is marked by unwanted, intrusive memories of a traumatic event(s), increased emotional or physical distress and reactivity, feelings of being on high alert, difficulty sleeping and concentrating, as well as avoidance of reminders of the event(s). While most people who experience traumatic events don’t develop PTSD, women are two times more likely than men to experience a traumatic stress response, and approximately 1 in 10 women will be diagnosed with PTSD in their lifetime.
Trauma and PMADs
One quarter of women will experience physical or sexual abuse or neglect over the course of their life. A history of trauma or a traumatic childbirth increases the risk that a woman will develop complications during pregnancy or postpartum, including developing a Perinatal Mood or Anxiety Disorder. Three percent of pregnant women and 4% of postpartum women are diagnosed with PTSD, though many more experience the emotional, psychological, and behavioral impact of traumatic events. The effects of trauma can “flare” at times of transition and change, and the perinatal period is a time of profound emotional, physical, social and interpersonal transformation for a woman. While it is difficult to differentiate whether previous experiences or a traumatic birth contributes to the development of PTSD in the postpartum period, it nevertheless requires attention because of the vulnerability of mom and baby during this time.
Trauma Informed Care in the Perinatal Period
Trauma Informed Care (TIC) is a framework and set a of practices and principles that address the ways in which traumatic events shape, color and influence a person’s experience in the world and over the course of their life. TIC care shifts the question from “What is wrong with you?” to “What happened to you?” as a way to remove stigma and blame from survivors of trauma.
As both an individual practice and organizational model, Trauma Informed Care (TIC) addresses the following:
Acknowledges that traumatic events have the potential to create a ripple effect across social/relational, emotional, behavioral, and physical domains.
Provides screening for trauma as standard clinical practice.
Educates survivors and all providers (even non-clinical staff) about the ways in which trauma negatively impacts individuals, families, and systems.
Seeks to minimize power dynamics and the potential for re-traumatization by providers and systems by promoting trust, safety, collaboration, and choice helps individuals cultivate a sense of resilience, empowerment, and control uses evidence-based treatment interventions to address the impact of trauma.
Engages other providers and organizations to holistically approach each individual.
In addition to the above, Trauma Informed Care in the perinatal period draws specific attention to the potential intersection of previous adverse life experiences and the transition into motherhood - physically, emotionally, psychologically, and interpersonally. The TIC model is at best vital and worst helpful - not just in the field of maternal mental health, but perhaps even more so for providers attending to the physical health of pregnant and new mothers, and their children.
For all mothers, pregnancy and the postpartum period can be a destabilizing, emotional time that involves the feeling of loss of control and a sense of being more “tuned in” to threats of danger, while feeling unskilled in attending to the developmental needs of their baby. In the perinatal period these feelings can be amplified by experiences of trauma, which can impact the ongoing experience of both mother and baby. Being a survivor of trauma is not a determinate and with the elements of TIC, moms can access new experiences that help shift unhelpful narratives they have around themselves, their relationships, and the transition to motherhood, so that they make more conscious choices in coping and healing.