May 6, 2024 – Megan Tavares was at the grocery store when her doctor called to tell her to get to the hospital immediately. Blood tests had shown that Tavares, who was 39 weeks pregnant, had a rare condition linked to preeclampsia. Her baby needed to be delivered right away.
Nine hours later, Tavares, a social worker from Somerset, MA, delivered a healthy baby boy. But the ordeal proved traumatic for the new mother. In the weeks following the birth, she began experiencing depression, obsessive behaviors, and other troubling symptoms.
“I felt like a ticking time bomb,” she said.
Tavares’ struggles continued for six months until her primary care doctor diagnosed her with postpartum posttraumatic stress disorder (PTSD), as well as postpartum depression and anxiety.
Postpartum PTSD affects about 8 million women worldwide annually, according to the National Institutes of Health. Symptoms typically appear within a month after a traumatic birth experience, such as an unplanned cesarean section, neonatal intensive care unit (NICU) admission, forceps birth, vacuum extraction, other medical complications, or lack of support from healthcare professionals during birth. Although early treatment is crucial, postpartum PTSD often goes undiagnosed.
A new study by Massachusetts General Hospital and Bar-Ilan University aims to change this. The research team used a low-cost artificial intelligence (AI) tool that any OB/GYN could theoretically use to improve diagnostics.
For the study, nearly 1,300 women wrote 30 words about their birth experience, focusing on the most traumatic parts. Lead author Sharon Dekel, PhD, an assistant professor of psychology at Harvard Medical School and director of Massachusetts General Hospital’s Postpartum Traumatic Stress Disorders Research Program, explained that an AI model analyzed the pattern of words and speech used by the women to identify mental illness through the nuances of their language. The AI model achieved a 75% to 85% accuracy rate in diagnosing postpartum PTSD.
The researchers believe this technology could easily be integrated into routine OB/GYN care, allowing for quicker intervention for at-risk women.
Importance of Early Diagnosis
Speed of diagnosis is vital, according to Dekel. “If a woman develops a mental illness following a traumatic childbirth experience, it can potentially impair the health of both mother and infant,” she said.
Understanding Postpartum PTSD
PTSD can occur after a terrifying event, causing flashbacks, nightmares, anxiety, and persistent thoughts about the event. Recent research from Lomonosov Moscow State University in Russia shows that postpartum PTSD can result from frightening childbirth circumstances or previous trauma reactivated during delivery. Women with a history of sexual assault or childhood sexual abuse are more likely to develop postpartum PTSD. Additionally, racial discrimination during care increases the risk, with Latina and Black women three times more likely to have a traumatic reaction to childbirth.
Serious medical complications, poor treatment from hospital staff, or a lack of control over the birth experience can also contribute to the condition.
“A woman may feel like she has failed for not having a vaginal delivery,” Dekel said. “In some cases, postpartum PTSD can disincentivize future pregnancies, leading to avoidance where women say, ‘I’m never going to do this again.’”
Symptoms of Postpartum PTSD
Key symptoms include unusual tension, high levels of stress in the postpartum period, re-experiencing or avoiding the traumatic event, and negative changes in mood or thinking. According to Sarah Horvath, MD, MSHP, an assistant professor of obstetrics and gynecology at Penn State Hershey Medical Center, you may also experience:
Can Postpartum PTSD Be Prevented?
In some cases, yes.
“Being prepared for potential PTSD can be really helpful,” said Horvath. “Thinking through both ideal and less-than-ideal birth experiences can help you accept uncertainty and cope better if the unexpected happens.”
Your OB/GYN can also assist. “Discuss your fears and need for support with your obstetrician in advance. Additionally, if you have a trusted family medicine doctor, psychiatrist, or psychologist, work with them ahead of time to plan for support and resilience,” Horvath advised.
Treating Postpartum PTSD
Treatment typically involves medication and/or therapy. In Tavares’s case, she was prescribed Zoloft and began counseling a few months later.
“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 feel validated.”
Don’t hesitate to seek the help you need, Dekel emphasized. “There is no need to be ashamed. If you experience symptoms within the first few days after birth, 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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