Mental Health After C-section - What to Look Out for and How to Get Help

Any experience of birth involves a mental processing and reflection on the event afterward. For those who experience trauma during birth, usually due to unexpected events, extreme emotions, or unresolved past experiences, it is important to formally process the experience in order to heal from the trauma. Not all c-sections are traumatic, just as not all vaginal births are joyful. But for those who experience a cesarean and have emotional distress because of it, professional postpartum support and counseling or therapy is critical.

In an article on VBAC.com, author Nicette Jukelevics, MC, ICCE, writes:

"Women who have a surgical birth are more likely to experience feelings of loss, grief, personal failure and lower self-esteem. ... Some women who experience a cesarean especially if was not a anticipated can suffer from post traumatic stress. Current evidence suggests that the incidence of post-traumatic stress disorder after childbirth ranges from 1.5% to 6%."

Signs & Symptoms

If you're experiencing depression or other ongoing emotional or mental issues anytime in few weeks, months or even years after your cesarean, you may already be aware of it and ready to seek help. If you're unsure of what to look for, here are some signs:

PTSD symptoms, according to the National Center for PTSD (amended for cesarean-specific information):

Reliving the event (also called re-experiencing symptoms)

For example:

1. 1. • You may have nightmares.
      • You may feel like you are going through the event again. This is called a flashback.
      • You may see, hear, or smell something that causes you to relive the event. This is called a trigger. Reading articles of seeing pictures of birth or c-sections, driving past the hospital where you gave birth, or hearing noises that remind you of surgical instruments are examples of triggers.

Avoiding situations that remind you of the event

For example:

1. 1. • You may avoid hospitals, because they feel dangerous.
      • You may avoid talking about your birth or sharing pictures.
      • You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.

Negative changes in beliefs and feelings

For example:

1. 1. • You may not have positive or loving feelings toward other people and may stay away from relationships.
      • You may forget about parts of the traumatic event or not be able to talk about them.
      • You may think the world is completely dangerous, and no one can be trusted

Feeling keyed up or "hyperarousal"

For example:

1. • You may have a hard time sleeping.
   • You may have trouble concentrating.
   • You may be startled by a loud noise or surprise.
   • You might want to have your back to a wall in a restaurant or waiting room.

For those who are experiencing symptoms of mood disorders like depression, anxiety, or OCD, be on the lookout for the following signs (adopted from Postpartum Support International):

• Feeling sad or depressed
• Feeling more irritable or angry with other people around you
• Difficulty bonding with your baby
• Feeling anxious or panicky
• Difficulty eating or sleeping
• Having upsetting thoughts that you can't stop
• Feeling as if you are 'out of control' or 'going crazy'
• Feeling like you never should have become a mother
• Worried that you might hurt your baby or yourself

Support Groups

If any of the above sounds like something you're experiencing, it's critical to find support to improve your mental health. A support group is a good place to start. You can find relevant support through the following organizations:

Postpartum Support International

Solace For Mothers

ICAN

Postpartum support groups listed by state (from Postpartum Progress)

Professional Support

A support group is a great place to start, but often, more specific, professional care is necessary. A therapist, counselor, or psychiatrist will be able to provide you with targeted, ongoing mental health support. To find support, find out first what kinds of resources are offered from your insurance -- many times, there are free mental health support services available. You can also seek referrals for providers from your support group, if is local. Postpartum Support International (PSI) offers a "warm line" to call, as well as free live weekly phone sessions. They also have on their website a resource guide map for a support coordinator near you. PSI Coordinators are volunteers who offer caring and informed support and resources to moms and their families. They also provide information and resources for area providers who are caring for pregnant and postpartum families.