Complex trauma during the perinatal period

What is CPTSD?

Complex post-traumatic stress disorder (CPTSD) can develop as a response to trauma that is intense and/or ongoing. These events can take place due to the occurrence of trauma at any time across the lifespan. However, not all people who experience trauma develop symptoms. There are variable responses, and everyone is different in how their perceive and experience the same situation. Some become more resilient, but this can be hard when becoming a parent as your emotional and general energy reserves are lower and finding time to regulate can be more difficult.

In the perinatal period, CPTSD can occur due to: birth trauma, routine antenatal checks triggering abuse memories, intrusive medical procedures, activated sexual assault memories, threats of death or unexpected birth experiences, poor social support, intergenerational trauma, impactful family adversity or other sorts of abuse such as intimate partner violence or emerging memories of childhood abuse.

There is strong evidence that mothers who have experienced potentially traumatic events during their lifetime are at greater risk of developing other mental health conditions in the perinatal period. This can then impact her relationships with the infant/partner and those around the new mother, leaving her feeling even more distressed.

Becoming a parent is already a time of great change and transition, so adding in trauma and finding ways to be a different parent or managing the intensity of unresolved emotions can be hard.

When someone has experienced trauma, the risk of experiencing further trauma is higher, so there is a greater need to help identify those at risk and devise a care plan to support them at this most vulnerable time.

Recognising CPTSD

Recognising complex trauma, also known as Complex post-traumatic stress disorder (CPTSD) during the perinatal period is a really important step in the journey to understanding, seeking the right help at this time (trauma informed therapy), and ultimately taking the leap into a healing therapeutic journey.

“There is growing evidence about what can be done to help women and their families during this important life transition. The perinatal period provides an opportune time to provide help in order to disrupt the potential transmission of difficulties for the next generation…research has revealed that childhood maltreatment, lifetime traumatic experiences, pregnancy stressors, re-traumatising labour experiences, postpartum events and poor social support …contribute to the development of significant mental health problems in mothers”. (Australian Child and Adolescent Trauma, Grief and Lossearlytraumagrief.anu.edu.au)

If you’re experiencing CPTSD (complex trauma) you may have the following symptoms:

·      Flashbacks and nightmares

·      Lapses in memory

·      Unstable or unintegrated sense of self (recognise many aspects of self but feel they don’t make sense as a whole)

·      Finding it difficult to manage emotions

·      Heightened arousal (heightened anxiety, unable to relax regardless of the context)

·      Unsettled stomach and other physical complaints

·      Sleep disturbances (notwithstanding the disturbances that come with a newborn)

·      Conflict in relationships

·      Avoidance of infant, certain people, places or circumstances

·      Substance abuse

·      Disordered eating

·      Low self esteem

·      Chronic health conditions

·      Autoimmune conditions

This list is by no means exhaustive but does cover many of the symptoms sufferers of complex trauma experience during the perinatal period.

What to do:

If you identify with any of the symptoms, it’s a good time to reach out to a perinatal mental health clinician who can provide the support you need to navigate the perinatal period. Start with someone you trust and find a trauma informed Clinician. Early identification and intervention are so important.

Other resources

The following have specialist information that may be useful:

Australian Child and Adolescent Trauma, Loss and Grief Network

https://earlytraumagrief.anu.edu.au/

Blue Knot Foundation www.blueknot.org.au

Complex Post-Traumatic Stress Disorder in the Perinatal Period. CurrentPsychiatry 2022 November 21(11) 20-26,46 Idoi: 10
https://cdn.mdedge.com/files/s3fs-public/CP02111020.pdf

Birchtree Centre www.birchtreecentre.com.au