1 out of 5 moms experience postpartum depression and/or anxiety.
Just by giving birth, you are at a high risk of mental health issues. By also going through birth trauma, you are at an even higher risk.
What is “mental health?”
MentalHealth.gov describes mental health as a person’s “emotional, psychological, and social well-being.” It influences and affects how a person thinks, feels, acts, handles stress, and relates to others.
The majority of new mothers will experience a difference in their mental health during the first few postpartum weeks. Mood swings, lack of concentration, tearfulness, irritability, and anxiety are all common. These feelings are caused by a major lifestyle change and by changes in hormone levels. A normal adjustment period is around three weeks, when the symptoms tend to get better or go away.
If these symptoms do not resolve by themselves or if they worsen, a mother may be experiencing postpartum depression or anxiety. Twenty percent (1 out of 5) moms experience this. Mental health issues are the number one complication of childbirth.
What is “birth trauma?”
According to Pregnancy, Birth, & Baby, “‘Birth trauma’ is distress experienced by a mother during or after childbirth. While trauma can be physical, it is often emotional and psychological.” It is important to note that birth trauma is not only about what happened during the labor and birth itself, but also about how a mother is left feeling afterwards.
Mental health, birth trauma, and maternal nerve injury
After childbirth, those suffering from nerve damage from childbirth are experiencing physical trauma and, for the vast majority, emotional trauma, as well. This strongly affects the mother’s mental health and wellbeing. While the topic of postpartum health has become more prominent over the last few years, many mothers with lower extremity nerve damage feel completely unheard by the medical community. Even though approximately 1 million women have some form of nerve damage from childbirth yearly, the majority of doctors and nurses are completely unfamiliar with it, particularly damage to the legs and feet. Sadly, instead of taking the opportunity to educate themselves (even just reading this website!), the medical community often ignores these women. The women are sent home, unable to walk and without a plan of action or recovery. They are bounced from doctor to doctor, appointment to appointment, without anyone taking the responsibility for care. They often have no idea when, or even if, they will recover. The unknown, feeling unheard, and being ignored by those that are supposed to try to help takes a toll on mental health.
As far as the day-to-day aspect of this injury, many even basic logistics have to be figured out. Women ask: “How do I walk without falling?” “How do I sit down on the toilet?” “How do I get into the shower?” “Can I drive safely?” “How do I keep up with any of my pre-baby/injury responsibilities?” Many of the answers to these questions result in having to rely heavily on another person. Asking for help can be hard; having someone able to help can be even harder. Family can live far away; spouses and partners can need to go to work. Not to mention, the lack of freedom and the reliance on another can have its own psychological toll.
Not only is the new mother trying to cope with her own injury, which is generally debilitating and often painful, but she is also trying to figure out how to care for a new baby: “How do I safely change her diaper?” “What do I do when he just needs to be bounced?” “How do I get the baby from one room to the next?” “How do I bathe her if I can’t stand or kneel safely?” “Are any treatments or medicines I need not compatible with breastfeeding?” Nerve injury mothers are often left feeling guilty or like a failure, not being able to care for their newborn. They can feel like they are missing out on their own child’s life, sitting on the sidelines rather than being a primary caregiver.
These immense feelings of guilt, inadequacy, failure, being a burden, and missing out have a strong impact on a mother’s mental health. The trauma, not only from the injury itself, but also from the psychological journey, can haunt them long after they have physically recovered. Memories of those first few weeks and months can be laced with disappointment, anger, frustration, and sadness. Other women’s birth stories can be triggering: “I am so happy for my friend, but why couldn’t my birth have gone differently?” Subsequent births become a huge question: “Will I get injured again? I always wanted another baby, but is it worth the risk?” Working out can even be fraught with concern: “My foot/leg feels weak, did I push too far? Will it return to normal?” All these difficult and negative feelings during the baby’s birth and the baby’s first months, or even years, can readily cause mental health issues in new moms.
What can be done?
While nerve damage from childbirth is rare, postpartum anxiety and depression are not, coming in as the number one complication of pregnancy and childbirth. Nerve damage from childbirth creates a perfect confluence of events to cause depression and/or anxiety. So how do you know if you have it or need to seek help?
If symptoms of mood swings, lack of concentration, tearfulness, irritability, and anxiety last longer than two weeks it is important to speak to a doctor. This injury is often ignored or downplayed, so be sure to advocate for yourself and find your own mental health professional if needed through the resources below.
Further, with nerve damage caused by labor and delivery, issues of anxiety, depression, anger, hopelessness, and other facets of trauma can pop up long after the original injury. Post traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced a traumatic event. People with PTSD have intense, unsettling thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks, nightmares or triggering events (in this case, a friend having a baby, a loved one getting sick, or even just driving past the hospital they delivered in). They may feel sadness, fear, or anger. So it is important to be open to getting help even if it is years later.
It is essential to advocate for help, not just physically, but also mentally. For some, admitting that they need mental and emotional support can be very difficult. Know you are not alone and that getting help will not only help you, but it will help your baby and your loved ones. This injury is a mental and emotional journey as much as it is a physical one. The mental aspect is often more difficult and longer lasting.
If you have a nerve injury after giving birth, ask for help. Get support from fellow injured moms. Reach out to a therapist. Find your support group. Below are resources to help you along your journey.
Resources:
Postpartum Support International – 1-800-944-4773
PSI helps new and expectant mothers and their families overcome anxiety and depressing by providing free telephone, email, and group support resources, references and referrals, outreach, and education. They even have a hotline that moms can text (do it while the baby sleeps!).
Make Birth Better
Make Birth Better is an organization focused on birth trauma and the resultant psychological impact. It provides information about birth trauma, for both the birther and any partners, and provides resources on how to get help.
Prevention and Treatment of Traumatic Birth
PATTCh is a collective of birth and mental health experts dedicated to the prevention and treatment of traumatic childbirth.
Solace for Mothers
Solace for Mothers provides information and support for mothers who experienced childbirth trauma.
The Birth Trauma Association
This is a United Kingdom-based organization providing help to women traumatized by childbirth.
World Maternal Mental Health Day
World Maternal Mental Health Day draws attention to essential mental health concerns for mothers and families.
Moms With Femoral/Peroneal/Sciatic Nerve Damage from Labor/Delivery
A support group on Facebook for moms with lower extremity nerve damage
You are not alone
Did you sustain a nerve injury after childbirth and are now struggling, not only physically, but mentally? You are NOT alone. Below are real words and clips from women who have been similarly injured.
“Some words that come to mind…
Alone, scared, anxious, numb, depressed, heartbroken, angry, helpless, robbed, abandoned”
“Postpartum anxiety triggers my ongoing anxiety”
“Unknown. Feeling alone. Mourning what it was supposed to be like. Trapped on the couch. Unable to care for myself. Navigating so many new things…too many new things. Resilience. Healing. Gaining strength. Hope. Gods strength holding me up. Support. Love from family and friends. Wanting it to just end and be normal again. Feeling like I missed months of my daughters first year mentally. Horror and joy mixed.”
“So alone and confused. Desperate to make sense of this. Searching for answers anywhere. Mourning the loss of what should have been. So so many regrets. Not wanting to exist anymore. So much guilt as my husband took on primary caregiver for my baby and me. The unbearable feeling that I was forever broken.”
“I remember having feelings of wanting to just leave and go somewhere. I didn’t know where I wanted to go but I just wanted to get in a car and have someone drive me far away. I wanted to escape everything.”
“I constantly told myself “mama’s gotta walk” during those 1st few months. Now that I’m more mobile I tell myself “mama’s gotta heal”. I grieve so much of the newborn phase: pumping & dumping for a month because of high dose steroids, to having to give up breastfeeding goals after getting a blood clot from my immobility & being put on blood thinners. Anxious & excited as her first birthday approaches…”
“My mental health now is so different from my mental health right after my injury. It took me about 2 years to work through the grieving process to finally arrive at acceptance. I was very angry for a long time. When I look back now, I am able to process what happened and realize all the lessons it has taught me and how it’s shaped my life for the better!”
“I’ll be two years out in July. The first year was easier, probably due to the mix of emotions of finally having my newborn. Perseverance and having goals pushed me through. Now I’m anxious often due to needing to heal the mental process as the physical process is mostly healed. Is this my new normal?”
“The whole first year is so much about physical healing and then you’re left with the mental. I have always had anxiety but that second year was anxiety on another level. Sometimes panic attacks that were just random. I ended up having to seek help and take some medication. It does get better! Time really does help to heal.”
“I have a very hard time with doctors even now. I felt so neglected and dismissed by the medical community.”
“It’s way more than just anxiety and depression. I was never told that I had birth trauma. I figured that out on my own after it had already been a year. My doctors never even offered me help for my depression and trauma symptoms. I literally felt like I was just a problem to them and they wanted me to disappear because I was making them look bad.”
“Still triggered when I go past the hospital I gave birth in.”
“Frustration, sad, angry, heartbroken, nervous
… then (and the timing is different for everyone)
Hopeful, resilient, whole (even if not physically), reconnected”
“Let others help! Find your outlet and keep asking questions. When you need to talk, cry, scream, etc. do it and don’t be ashamed of it. But push yourself. God chose you for the baby you brought into the world (which is perfect) and I wanted to be whole for him and my family. It took me years and I still have emotional scars.”
“Scared. Alone. UNHEARD. Fear. Depressed. Anxious. Guilt
But also
Motivated, determined, hopeful, dedicated, grateful.”
“Having a birth injury is a huge juxtaposition of emotions.”
“The most frustrating part was being in the hospital and not being taken seriously. I remember crying to the nurse “but what about my foot? I can’t walk. I have a toddler at home. No one has come to speak to me, no one is giving me direction” etc… And she brought me PPA/PPD paperwork and had someone come and talk to me about depression. Which is real and I did have PPD/PPA bad with my first, but this wasn’t the same. This wasn’t the baby blues. I have no feeling in my leg and I’m scared.”
“I remember being envious of all my friends having babies and being able to do all the things I could not.”
“Angry…no answers for a long time..self advocate…pushed around from doctor to doctor. Then when I found out it was nerve damage…anger again…hopelessness…alone.”
“I’m almost 2 years pp and it still hurts to think about the first year and especially the first 6 months. I went to a therapist a few months ago and she diagnosed me with PTSD and Major Depressive Disorder from my injury experience.”
“I constantly felt torn between wanting to fall apart and just cry in a corner by myself or trying to convince myself to be strong because that’s what people should do in these moments that challenge them. There were no answers, I was in pain, paralyzed and I couldn’t even walk or rock my daughter when she needed that comfort that a mother should give her. I couldn’t breastfeed no matter how many hours or supplements I tried because according to my doctors the injury created too much stress for my body to produce milk. I felt like a burden to my husband who worked tirelessly to care for us both.”
“I kept telling myself I needed to give everything I had in my soul to walk again for my daughter. There were so many days I had nothing left to give and that was the only thought I had left to drive me to keep trying. PT 3 times a week for over a year and it was always difficult and frustrating and embarrassing. Progress was always followed by a setback and the doctors could never tell me how much to push myself because if I did too much then I would hurt myself and I couldn’t do anything for weeks afterwards or if I didn’t push myself enough then the possibility of a full recovery was waning because I only had less than 18 months until the nerve wouldn’t regenerate anymore. It was a constant challenge of never having any answers but having to stay positive no matter what happened.”
“Having friends and family support was important but during COVID and with an “invisible injury” after 3 months, it was another challenge.”
“I still have triggers and I’m still trying to navigate what life looks like moving forward. I make the most of everything today but there are many times we mourn what we lost… It’s important to grieve and release. It makes each day easier. My doctor says my pain and nerve damage is permanent and has set limits to what I can do but it’s unsettling to live with someone telling you that you can’t do something. We keep training to stay strong and hopefully change the narrative. We ran a 5k together in December and it was so empowering. The struggle with my mental health was the hardest aspect of my injury and continues to be today.’
“After multiple normal test results, I have been questioning whether this is all in my head. It’s a lonely and scary place when no one understands why this has happened. Or even believes you. At a repeat EMG last week the neurologist told me the findings were abnormal and I cried from relief. Hearing that was GOOD news to me because I finally felt validated and heard.”
‘I felt scared, angry, trapped, grief, anxiety, guilt, regret I also felt thankful for friends and family, I started to appreciate little things more.”
“At first I didn’t feel anything, the postpartum depression was strong. I felt confusion, sadness, grief and worried if I would ever walk again. Scared and alone. I felt hope and strength when I found [the Facebook support] group.”
“Driving by the hospital I have to almost look away.”
“Resilience in an impossible situation.”
References:
CDC Depression among Women, https://www.cdc.gov/reproductivehealth/depression/index.htm. Accessed April 9, 2022.
What is mental health?MentalHealth,gov. https://www.mentalhealth.gov/basics/what-is-mental-health. Accessed April 9, 2022.
Rhona Lewis. What Causes Postpartum Depression? healthline.com https://www.healthline.com/health/postpartum-depression/postpartum-depression-causes. Accessed April 9, 2022.
Birth Trauma. Pregnancy, Birth, & Baby. https://www.pregnancybirthbaby.org.au/birth-trauma-emotional. Accessed April 9, 2022.
What is Post Traumatic Stress Disorder? American Psychiatric Association. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd. Accessed April 10, 2022.
Nerve Damage from Childbirth 