The following symptoms may occur shortly after the birth and are highly suggestive of maternal psychological trauma:

Inability to sleep.  This is one of the first signs that the mother may be traumatized.  Despite her extreme exhaustion from giving birth, the mother may have difficulty falling asleep or may feel that she doesn't need to sleep -- something which may seem puzzling to those around her and even to herself.  This inability to sleep is partly due to extremely elevated adrenaline levels following trauma (the body's "fight or flight" response which is activated in the face of danger persists even after the danger is no longer present).  Even if the mother manages to fall asleep, she may soon awake, unable to stay asleep due to violent nightmares related to the birth or dreams of her own or her baby's impending death.

Delayed and/or reduced milk production.  Elevated adrenaline can suppress the body's natural production of oxytocin and this can lead to delays in breast milk production or reduced milk supply.  The 'letdown' relfex, which causes the milk to be released from the breast, is also oxytocin dependent and may be affected adversely by trauma and heightened adrenaline.

Agitation and hyperarousal.  While trying to cope with her trauma in its immediate aftermath, a mother may act in an agitated and hectic manner.  Well-meaning friends and relatives may tell her that she is "trying to do too much" and she should "just slow down and relax".  This advice is often impossible to follow because the hectic activity and sense of agitation are simply an expression of the elevated adrenaline levels.  The hyperarousal may also take the form of physcial symptoms such as increased heart rate, sweating, difficulty breathing (rapid, shallow, panting, etc), cold sweats, tingling and muscular tension.  It can also manifest as a mental process in the form of increased repetition of thougths, racing mind, and worry.

Emotional numbing and dissociation. This occurs during the trauma as a way of coping with the traumatic, potentially life-threatening events.  For example, during an emergency C-section a mother may dissociate and start to feel that the events around her are "unreal" and "are not really happening", or she may mentally remove herself from the situation and feel like she is just observing it from a distance, with a sense of cool detachment.  She may also experience part of her body as being disconnected or almost absent.  During and after birth trauma, women often feel numb and shut down.  They may feel emotionally disconnected not only from themselves but from their baby too.

Intrusive, upsetting flashbacks of the birth. Flashbacks are sudden, vivid images of the traumatic event (imagined or remembered) accompanied by strong, ovewhelming emotions such as extreme anxiety and fear.  In the case of birth trauma,  the mother may experience flashback images of the delivery room, of being cut open during a C-section or of her tissues being torn by forceps extraction.  A flashback literally brings the mother back to the original traumatic birth events and causes her to re-experience them all over again, both mentally and physiologically.  

Avoidance of all reminders of the birth.  This includes inability or refusal to talk about the birth (denial).  The mother may avoid anything that reminds her of the birth, including TV shows about childbirth, medical professionals, and even necessary medical care.

Feeling sad, angry, or helpless about the birth.  The helplessness that is experienced during and after trauma is not the ordinary sense of helplessness that can affect anyone from time to time.  It is a sense of being collapsed, immobilized, and utterly helpless.  This pervasive sense of helplessness may alternate with or be accompanied by an overwhleming sense of anger about what happened during the birth.  Words like "violation", "assault", "invasion", "torture" and "rape" may come to the mother's mind while thinking about her child's birth, whether or not she chooses to speak these words out loud.

"Evangeline" Copyright © 2007 Amanda Greavette