As a certified nurse-midwife in the 1980s, Cheryl Beck saw her patients struggling with postpartum depression, which was poorly understood and under-researched.
“I saw how the women were suffering,” says Cheryl Beck, now a distinguished professor in the University of Connecticut School of Nursing.
Because of this experience, Cheryl Beck has dedicated her career to helping women suffering from the negative mental health impacts of giving birth.
When she turned to available medical textbooks for information about how to help her patients, Beck found there was very little information about postpartum depression beyond a brief note that the condition existed.
Beck began researching postpartum depression, with a focus on qualitative research methods which allowed women to tell their own stories. She also developed the Postpartum Depression Screening Scale.
Since the 1980s, Beck has seen dramatic growth in the amount of research focused on postpartum depression. Her own research has since branched out to other postpartum anxiety and mood disorders.
A Turning Point
In 2000, Beck was presenting her research on postpartum panic disorders at a Marcé International Perinatal Mental Health conference in New Zealand. During the conference, a mother shared her experience with PTSD from her birth trauma. The mother then discussed with Beck the possibility of researching this poorly understood phenomenon, and with that Beck’s research headed in a new direction.
“Sometimes researchers are just really lucky and are at the right place at the right time,” Beck says.
This woman helped connect Beck to a network of women who were suffering from PTSD through the Trauma and Birth Stress (TABS) group. This partnership put Beck in contact with hundreds of women who contributed their stories and experience with PTSD and birth trauma to her research.
“As a researcher, it was the best gift ever – having the potential of connecting with these participants from across the globe,” Beck says.
A woman can experience a traumatic birth even if there were no major medical complications or birth defects, explains Beck. What the women Beck interviewed had in common, regardless of the physical ease or complication of the birth itself, was the feeling that their obstetrical clinicians did not care about them and of being stripped of their dignity during the birth.
“That sets the stage for viewing their birth as traumatic,” Beck says. “They felt like they were being assaulted on the delivery table with everyone watching and no one offering to help.”
Ripple Effect
Beck describes birth trauma as an “ever-widening ripple effect.” The traumatic event may only last minutes or hours but the women who go through a traumatic birth will contend with its effects for years. The trauma is like a small pebble tossed in a pond whose ripples keep expanding, says Beck. Some of the ripples Beck identified in her program of research are the impact on mothers’ ability to bond with their infants, developing PTSD, and subsequent births.
One such ripple of birth trauma Beck has studied is its impact on breastfeeding. Beck found there are typically two paths for women who had traumatic births. Women either breastfeed for an extended period of time as a form of atonement for bringing their child into the world in such a traumatic way, or they do not breastfeed at all or for just a short period of time.
Another ripple Beck has studied focuses on the anniversary of the trauma, in this case their child’s birthday. The women are often forgotten on this day again as celebrations focus on the child.
Beck found that women often begin to experience physical and psychological stress in the days leading up to the anniversary more so than on the date itself. After the trauma anniversary, the women must begin healing all over again.
“They felt like their wounds reopened and it took time to recover,” Beck says.
Beck’s research has reached women around the world from the United States, New Zealand, Australia, Canada, the United Kingdom, and South Africa. Through this global perspective, Beck has seen how universal these women’s experiences are.
“The key is that the themes involved in women’s narratives of their traumatic births are all the same,” Beck says. “No matter where we live in the world or where it took place.”
Beck’s participants span from mothers whose children are only a few weeks old to those with children in their 30s.
Beck’s research has shown that some women who experience traumatic births are able to grow from the experience. This is called posttraumatic growth. As with any kind of trauma, there are five areas of growth: developing a greater appreciation for life, fostering better relationships with others, an increased sense of personal strength, pursuing new paths and possibilities and spiritual developments.
“For some women there is a little positive light at the end of the tunnel that they can experience this growth,” Beck says.
Women Helping Women
Beck often gets inspiration for future research from the women in her studies. “The women, they always teach me,” Beck says.
For Beck, sharing women’s stories in their own voices is one of the most rewarding parts of her research. While quantitative research is critical to understanding these disorders and developing clinical treatments, so is hearing women speak about their own experiences in a way numbers cannot possibly convey.
“There are so many benefits that I’m helping give voices to women,” Beck says.
Another benefit of sharing these stories is that it helps normalize this experience. In a culture which focuses almost exclusively on images of happy new motherhood, women who experienced traumatic births are often sidelined and ignored.
“Most often a society just likes to think about happy motherhood,” Beck says. “They only show happy new mothers. The media doesn’t like to look at the dark side of new motherhood.”
Research participants often tell her they hope sharing their stories will help other women who are struggling. Women experiencing PTSD may feel there is something wrong with them for not fitting with these images of new motherhood.
“Part of my research is to explain to women it’s nothing they did wrong and that they’re not weak,” Beck says.
Beck holds a DNSc from Boston University and a MSN in maternal newborn nursing and a CNM from Yale University in Nurse-Midwifery. She holds a joint appointment in the UConn School of Medicine’s Department of Obstetrics and Gynecology.
