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In this section:
  • Post Traumatic Stress Disorder after birth and loss 

  • Surviving Post Partum
    - The early days and late nights.

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Conversations with Carla

Grab a cup of coffee and join Carla as she discusses important topics from her personal perspective as a women's healthcare provider.

Post Traumatic Stress Disorder (PTSD) after birth and loss


I get so frustrated with  "providers" who don't listen to women. One of my patients had a very traumatic birth with her first child. This was her lived experience. She came to me with her second pregnancy and was having nightmares and flashbacks from her first experience.


She explained that her birth plan was in place, she was well educated and prepared for the birth of her first child. None of it went the way she had hoped and dreamed. She ended up stuck in a bed, and felt forced to get an epidural. A vacuum was used to help deliver her baby and the physician gave her an episiotomy which was very painful.


Her doctor did not follow her birth plan and said things like, "Your baby is too big, it might get stuck" (she was 7 pounds 8 ounces.) "You have not changed your dilation, so you have to have pitocin." and  "If you could just relax - that's why you need an epidural."


When she went back for her 6 weeks post partum visit, she spoke with the physician about her experience and was told - "Well you got a healthy baby right? And you are doing fine right?"


She was unsupported during her birth, and also on her post partum visit when she tried do discuss her feelings with her physician. In order to heal, she needed to be acknowledged. Instead, she felt even sadder and "silly" that she had even brought it up. She felt guilty that she gave in and had the epidural. She felt bullied by the physician, and felt a deep emotional pain from having to relinquish her deepest beliefs about birth. And yes, she felt violated. She is NOT alone, I have heard this story way too many times.

This brings me to the importance of storytelling.

Women who gather with other woman and share their stories report feeling supported,loved and validated. It helps one to feel that they are not alone, that her feelings are real and that other woman have gone through the same experience.

Two women talking

This patient's second birth experience was very different.

She was a partner with her midwife (me) and she was included in all of the decision making surrounding the birth of her child. She even reached down and helped to deliver him... and he was 8 1/2 pounds! (So much for being too big.) This was a very healing experience for her, but she also reported that it made her sad because she had missed out on the joy of birth the first time.  Birth and mothering is one of the most important things we do, and we don't get to do it very often. Here are some ways to make the most of your experience:

  • Be careful with your choice of providers

  • Always ask questions

  • Don't be bullied! Speak out and be heard

  • Know that you have the right to participate in your healthcare decisions

Birth, death, and pregnancy are all mysterious things.  
There are not always black and white answers. An aspect of women's healthcare that is grossly over looked and unacknowledged, is the loss of a pregnancy. There are many kinds of pregnancy loss. There are miscarriages, stillbirths, "chemical pregnancy," ectopic pregnancies, blited ovuum, and infant death from medical complications. What ever the situation or medical term for it, we must realize: This is a significant loss in a family's life! These are their hopes and dreams for their future. The pain from this loss is not something that can be easily brushed away with idle conversations and statements like - "You can always get pregnant again," or "It just wasn't meant to be."


Women usually blame themselves

There are so many questions that surround a loss, and most women ask "What could I have done differently?  And these families - yes whole families - moms, dads, grandparents, children - they ALL need time to grieve. They need love and support. They need to be able to cry and express feelings. They need to be cared for and validated. What is done in healthcare now is basically ignore the very real pain these individuals are experiencing.  It drives me mad. They need time to heal. Instead they are ignored, hurried along and expected to carry on as if nothing happened.


These stories are true, and the post traumatic stress that these women feel needs to be acknowledged and supported. Listen to women, hear their stories, share your stories, learn from each other, support and love each other.

Additional Resources:

The Compassionate Friends Website

The Compassionate Friends Newsletter

Post Partum
Post Partum - The Early Days and The Late Nights


Remember at the end of your pregnancy around 38 -39 weeks how much trouble you have sleeping?  This is nature's way of getting you ready for those late nights and early days. The first few weeks with a newborn can be overwhelming. With hormone changes, no sleep and a crying baby -  who wouldn't be depressed?


If it is your first baby, it is no doubt you are overwhelmed and wondering if you doing everything right.  Let me assure you, you are!  If it is your second or third baby, now you have your other children and your baby to care for, along with the demands of running a home and keeping a satisfying relationship with your husband.


One issue during the post partum period is the hormone changes.  Most women are not aware of the big progesterone drop that happens in the first month post partum. Progesterone is the hormone of pregnancy, and the blood levels of progesterone go up significantly.  Women who are progesterone driven love being pregnant - you know them, they have that glow.  It's great! However in the post partum period when progesterone levels drop greatly they begin to feel "not like myself".  Some women will experience "baby blues" some will have depression and some even go into psychosis.


It is VERY important to talk to your provider about these feelings. And the sooner the better. Even during your pregnancy, if you have already had a child and experienced these feelings, make sure you let your provider know. We can treat some of the hormone imbalance and progesterone deficiency with progesterone supplements.  Not everyone needs an anti-depressant. I am not against anti-depressants, I just prefer to look at all of the underlying hormones that could be contributing to the way you feel.


Please click here to read more about hormones and balance.

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