For about half the women in Israel, giving birth for the first time and the transition into motherhood is associated with moderate to severe crisis, according to a new study conducted at the University of Haifa that examined for the first time how deep the experience of crisis after giving birth is. “The birth of a child is considered to be a positive event, however many women respond to the birth of their first child and the transition into motherhood with difficult feelings of general distress that can lead to severe emotional symptoms,” said Dr. Yeela Tomsis, who conducted the study.

Symptoms of PTSD that may occur after giving birth are well-known, and they have been studied more than once in the past. Research has also shown that experiences that cause PTSD may also be related to experiences of crisis, however to date there have been no studies examining the experiences of crisis that women experience after giving birth. An experience of crisis is defined as a psychological imbalance in which normal coping mechanisms fail to the point that the woman is incapacitated, and as a result she experiences despair, helplessness, stress and fear. According to Dr. Tomsis, while PTSD is a well-defined syndrome with defined symptoms, the experience of crisis is a much more ambiguous phenomenon that so far has received very little attention.

This current study, based on the doctoral dissertation by Dr. Tomsis under the direction of Prof. Hanoch Yerushalmi and Prof. Marc Gelkopf, aimed to examine for the first time to what extent giving birth is perceived as an experience of crisis, and what correlations exist between symptoms of the experience of crisis and those of post partum PTSD. The study included 188 women aged 18 to 46 who were giving birth for the first time, to one child. All the births were on time and all the children were born healthy.

The study findings reveal that the first birth experience a woman has is related to the experience of moderate or severe crisis for about 45 percent of women, with only 23 percent of women reporting experiencing mild crisis or having no experience of crisis at all. There was no difference in the experience of crisis between women of different ethnicity (Jewish, Muslim, Christian, Druze), while the overall average for women was 2.81 (on a scale of 1-5). That is, on average a woman in Israel experiences moderate crisis after giving birth.

Regarding PTSD, only a small percentage (1.1 percent) of the women met the full criteria for full PTSD. About 5 percent had symptoms from two of the categories for PTSD, and another 22 percent had symptoms from one category, so in total, 28 percent of the women had suffered varying degrees of post-traumatic symptoms such as recurrent dreams, flashbacks, evasion of memories associated with childbirth, recurring  and anxiety-causing thoughts of the birth, and more.

The study also showed that there are several risk factors for PTSD: feelings of distress during labor, a sense of loss of resources and a tendency to cope through self-blame and rumination (absorption in thoughts and reflections on the event). Regarding the experience of  crisis, it was found that personal factors relating to the experience of crisis are non-preparedness for parenthood, a sense of loss of resources and coping strategies characterized by self-blame, by blaming others and rumination. The experience of crisis, like PTSD symptoms, causes great emotional distress in women.

The researcher also studied for the first time the interrelations between the experience of crisis and PTSD symptoms. The findings indicate that giving birth causes PTSD symptoms in some women that lead to the experience of crisis — as is known to occur in other cases of trauma. However, for the first time, the researcher has found another direction of influence: “There were situations in which the experience of crisis appeared first and was so severe that in itself it triggered PTSD symptoms,” Dr. Tomsis concluded.