What physical changes during pregnancy can trigger post-traumatic stress disorder (PTSD) symptoms?

From the Guidelines

Pregnancy can retrigger trauma through various physical changes, including weight gain, breast tenderness, pelvic exams, morning sickness, and hormonal fluctuations, which can remind individuals of past traumatic experiences and exacerbate feelings of loss of control, vulnerability, and anxiety 1.

Key Body Changes that Retrigger Trauma

• Weight gain and body shape changes, causing feelings of loss of control similar to those experienced during trauma
• Breast tenderness and enlargement, potentially triggering memories of sexual trauma
• Pelvic exams and vaginal procedures, which can be particularly difficult for survivors of sexual assault
• Morning sickness and nausea, creating feelings of physical vulnerability
• Hormonal fluctuations, intensifying emotional responses and lowering psychological defenses against traumatic memories
• The sensation of a baby moving inside the body, which can feel invasive to some trauma survivors
• Labor and delivery, involving pain, vulnerability, and loss of bodily autonomy that directly mirror traumatic experiences

Importance of Therapeutic Support

For individuals experiencing pregnancy-related trauma triggers, therapeutic support from trauma-informed healthcare providers is essential 1. Techniques such as grounding exercises, mindfulness practices, and clear communication with medical providers about triggers can help manage these responses. Many hospitals now offer trauma-informed birth planning to help create a sense of safety and control during the birthing process. Understanding that these reactions are normal responses to past trauma rather than signs of being an inadequate parent is crucial for psychological well-being during pregnancy. Coping skills and psychological adjustment during pregnancy are critical in preventing adverse mental health outcomes, including post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms 1.

From the Research

Body Changes in Pregnancy that Retrigger Trauma

• Hormonal changes during pregnancy can exacerbate symptoms of depression and anxiety, which may be triggered by past traumatic experiences 2, 3
• Physical changes, such as weight gain and body shape alterations, can also affect a woman's self-esteem and body image, potentially retriggering trauma-related emotions 4
• The emotional and psychological changes that occur during pregnancy, including increased stress and anxiety, can also contribute to the retriggering of trauma 5, 4

Trauma and Pregnancy-Related Complications

• Women with a history of trauma may be at a higher risk of developing pregnancy-related complications, such as preterm birth and low birth weight 2, 3
• The use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy has been associated with an increased risk of preterm birth and other complications, which may be particularly concerning for women with a history of trauma 2, 3

Barriers to Treatment and Support

• Women with complex trauma histories may face barriers to seeking treatment and support during pregnancy, including systemic issues, dissatisfaction with treatment, and intrapersonal barriers such as fear of the healthcare system 4
• Access to affordable, trauma-informed care and supportive healthcare workers can facilitate engagement and access to treatment for women with complex trauma histories 4