Inside the Survivor’s Guide

Birth Trauma, Perinatal Mood and Anxiety Disorders from AFE

Survivors, spouses, and family report trauma or mental health challenges and PMADs as a result of AFE. PMADS are perinatal mood and anxiety disorders.

Below we explain the impact of birth trauma. We offer resources and assessments to discover if you have a perinatal mood and anxiety disorder. Be sure to check out our Let’s Talk Therapy section on how and where to seek help.


Birth Trauma

Birth Trauma is experienced by a majority of women who survive an AFE. Trauma is an emotional response to a life-threatening or frightening event. Birth trauma is distress experienced by a mother during or after childbirth. It may be caused when the mother or baby’s life is threatened. It may also be caused by an extreme sense of powerlessness, isolation, lack of care, fear, or anxiety. Birth trauma is complex because birth is often expected to be a happy event. Click here to learn more about birth trauma.

The postpartum period following an AFE may be accompanied by confusion and failure. Your birthing expectations were shattered, and you’ve been left to make sense of it all. Your emotional and physical recovery from an AFE may be complicated by PMADs. PMADs are perinatal mood and anxiety disorders.

COVID19 and Birth Trauma

COVID-19 has added to the trauma of surviving an AFE. It increased feelings of isolation. It limited access to support which may lead to increased risk of PPD and PTSD. If you have delivered during the COVID-19 pandemic, be mindful of your mental health. Prioritize your healthcare needs.

Perinatal Mood and Anxiety Disorders or PMADs

Is the term used to describe a group of mental health disorders that occur during pregnancy and after delivery. These disorders include postpartum depression, postpartum anxiety, obsessive-compulsive disorder, postpartum psychosis, and post-traumatic stress disorder.

Postpartum Depression

Postpartum depression (PPD) occurs after childbirth. It is comparable to depression unrelated to child bearing. The main difference is that PPD disrupts your postpartum experience, just as your AFE disrupted your birthing experience. It can devastate your expectations of parenthood and leave you feeling like you weren’t meant to do this. But, here’s the good news, it’s treatable.

Learn more about postpartum depression:

Baby Blues or Postpartum Depression?

Sometimes it can be difficult to discern postpartum depression from the “baby blues”. The baby blues occur shortly after birth due to the fluctuation in hormone levels.

Below is a quick side by side to help you identify what you may be feeling and if it might be PPD.*


Baby BluesPostpartum Depression
Very common1in 7 women will develop PPD
Onset typically begins 3-5 days after delivery due to hormone fluctuation and other physiologic changes that accompany birth.Feelings persist beyond 3 weeks after birth and can last many months if not treated
Usually resolves within 3-4 weeks as hormones stabilizeRequires treatment, most commonly with therapy and/or medications
Excessive crying
Mood swings
Feeling withdrawn from family and friends
AnxietyLack of interest in regular activities
Feeling overwhelmedFeeling worthless or not being a good parent
ExhaustionSleep disturbances such as insomnia or sleeping too much
Having a hard time concentratingFeeling worthless or not being a good parent
Inability to bond with your baby
Thoughts of harming your baby or yourself*

Take the Postpartum Depression Risk Assessment

The risk assessment below can help you understand if you might be experiencing symptoms of PPD. This is not a diagnostic tool, but may be helpful in assessing your symptoms. If you believe you are suffering from symptoms of PPD, it’s important to seek professional support.

PPD Risk Assessment

Women of Color and Postpartum Depression / PMADs

We celebrate that our community is diverse in experiences, cultures, and geographic locations. Our priority is to ensure that every member of our community gets the support they need to thrive.

It is concerning to us that AFE survivors of color have an increased risk for postpartum depression. The National Alliance on Mental Illness shares that although PPD can affect all mothers. However, much of the research conducted and screening tools developed have focused on white women. Doctors may miss somatic symptoms that tend to present in nonwhite women. These symptoms include high blood pressure or unexplained body aches, pain, and nausea women of color at increased risk at risk for PPD.

Nurse Ashley Kilgoe shares her personal lived experience and the research she has conducted. “Many Black women experiencing PPD are silenced by shame and stigma. In the Black community, seeking help is often viewed as a sign of weakness. When someone makes the decision to seek guidance, they are likely to turn to family, friends or religious leaders rather than trained personnel. In the U.S., when it comes to mental illness, Black individuals are less likely to receive treatment than nearly all other racial and ethnic groups. Reasons many do not seek professional help can include”:

  • Stigma and perceptions of mental illness in the Black community
  • Experience with inaccurate diagnoses
  • Lack of representation or diversity in healthcare
  • Distrust of the healthcare system
  • Racial discrimination

Here are the resources used throughout this guide.

Our colleagues at the Shades of Blue Project, a group dedicated to helping minority women with PPD, offer several online support groups. They offer community-based programs to meet the unique needs of Women of Color suffering from PPD. “If all women receive the same quality of care, then there would be no need to have specific care for black women in the future,” says Kay Matthews, the founder of the Shades of Blue Project. “Acknowledgment, respect, and support are the three things that must be present in our care treatment because without it we continue to experience racism and lack of care every time we go into clinics and hospitals seeking treatment.”

If you need any assistance in finding the right support, please don’t hesitate to contact us.

Post-traumatic Stress Disorder

AFE survivors and their partners may develop post-traumatic stress disorder or PTSD. PTSD is a condition that can occur after a person has experienced or witnessed a traumatic event. At this event there was serious physical harm or threat of physical harm or death. A diagnosis made by a mental health professional and requires treatment. Read more about the link between traumatic birth and PTSD.

Take the Post-traumatic Stress Disorder Risk Assessment

The risk assessment below can help you understand if you might be experiencing symptoms of PTSD. This is not a diagnostic tool, but may be helpful in assessing your symptoms. If you believe you are suffering from symptoms of PTSD, it’s important to seek professional support.

PTSD Risk Assessment

Postpartum Anxiety

Postpartum Anxiety (PPA) affects up to 10% of postpartum women. Symptoms may include constant worry, hypervigilance, racing thoughts, sleep disturbance, and appetite changes. Symptoms can also be a feeling that something bad is going to happen. PPA can include obsessive thoughts or be related to postpartum obsessive-compulsive disorder. Learn more about PPA.

Postpartum Obsessive Compulsive Disorder

Postpartum obsessive-compulsive disorder affects between 3-5% of postpartum women. It typically includes obsessions and/or compulsions.

Obsessions are often centered around the newborn. These are persistent, repetitive thoughts. Compulsions occur as a way for the mother to reduce fears or obsessions. These compulsions may be checking, counting, cleaning, or thought-based.

Mothers with Postpartum OCD understand that their thoughts are strange. They are unlikely to act on them.

Without treatment, Postpartum OCD is likely to worsen over time. Treatments such as Cognitive Behavior Therapy and Exposure Response Prevention, along with medication, have been successful in treating Postpartum OCD. Get more information on Postpartum OCD.

Postpartum Psychosis

Postpartum psychosis is rare, occurring in just .1-.2% of postpartum women. It typically occurs within the first 2 weeks postpartum. Postpartum psychosis is a break from reality. It can include delusions that the mother believes. Postpartum psychosis is treatable with professional help. It is important to get treatment rapidly. Symptoms may include:
Hallucinations, irrational thinking, rapid mood swings, difficulty communicating at times, and paranoia.

Postpartum Psychosis is an emergency. The mother needs treatment quickly. Call your doctor or take your loved one to the ER promptly.

Perinatal Mood and Anxiety Disorders are:

  • Not your fault
  • Not who you are as a mom
  • Temporary medical conditions
  • Treatable

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