Nearly two years after unexpectedly giving birth in her bedroom closet, reality TV star Jade Roper still tears up when recounting the first moments she held her son Brooks.
"I felt like he didn't want me, which was the hardest part," Roper told TODAY Parents. "I felt like I would look at him and I felt so disconnected and he didn't know I was his mom or he didn't want me as his mom."
Roper was crying as she cradled her swaddled son for the first time, her knees pressed into the rug as paramedics huddled around her — a snapshot of chaos and pain captured across social media. Now the 34-year-old is opening up about the trauma that resulted from that unexpected birth and her experience with postpartum PTSD, which may be on the rise among women during the COVID-19 pandemic.
"From the second I went into labor until pretty much until I got pregnant with my (second) son Reed, I was dealing with post-traumatic stress disorder," said Roper, who starred on season 19 of "The Bachelor" and later on "Bachelor in Paradise," where she met her husband, Tanner Tolbert.
"When I was giving birth, I had such a precipitous labor I thought something wrong was happening," she said. "I thought that he was going to die. I thought I was going to die. And so after that experience, I would have flashbacks. That we were ... not safe. And I would get bouts of dizziness out of nowhere, where it was almost like vertigo. I would have intrusive thoughts that weren't healthy. It was really intense for me."
She was familiar with postpartum depression and even briefly considered she may have postpartum psychosis, but deep down she knew what she was experiencing was something different.
PTSD affects 9% of women after childbirth, according to Postpartum Support International — in other words, about 1 in 11 new moms. While postpartum depression and the overall mental health of new mothers has been getting more attention in recent years, experts say there still isn't much awareness of postpartum PTSD in particular.
It can share symptoms with depression and the conditions may overlap, but what differentiates PTSD is an intrusive recollection of the trauma — in this case, childbirth — and a resulting hyper-vigilance, said Sharon Dekel, Ph.D., an assistant professor of psychology at Harvard Medical School, whose lab at the Massachusetts General Hospital studies childbirth trauma and postpartum PTSD.
"A mother who has maternal PTSD is likely to be on this very fight-or-flight mode, and very hyper-alert — especially hyper-alert to any kind of reminder of the trauma," Dekel told TODAY.
That poses a significant problem, since the baby itself is of course a reminder of the childbirth experience.
"It might be that we will see women who are trying to avoid the baby," Dekel said. "Clearly we know that the early postpartum period is a very important time for the formation of the mother-infant bonding, and therefore a mother who's avoiding the baby — that could be a very dangerous scenario."
Roper, who has three children and also hosts a parenting podcast called "Mommies Tell All," said she didn't feel immediately connected with her second child after his traumatic birth. On a recent episode of Spill the Milk, a video series from the United Kingdom-based baby bottle company Tommee Tippee, she said she's still processing her guilt. She also called for more support for moms in the "fourth trimester," which describes the 12 weeks following childbirth.
Roper told TODAY that her newborn time with Brooks was especially challenging because she'd had such a different experience with her first child, Emerson.
"I had a great birth with her," she said. "I felt instantly connected. It was this really beautiful, amazing thing. So when I experienced this with Brooks, it really rocked me."
Roper said she now wishes she'd sought help and spoken up about her feelings sooner.
"I kept telling myself, 'I'm just going to get through it,'" she said. "'Just one more week and I'll be better.' I was also afraid of going (to a doctor) and that somebody was going to just dismiss it. I was really afraid no one was going to validate my feelings. And that maybe I was just making a big deal out of something, that maybe I was just being weak. I finally had a breakdown with Tanner at one point because I was going down a really dark path. ...So I told him."
Roper eventually sought treatment through hypnotherapy. When she was five and a half months postpartum, she found herself pregnant again, with her third child, and said the subsequent hormonal changes also helped her mood.
Dekel's research shows that 20% of women who have traumatic birth experiences suffer from PTSD. Yet it's a complicated area of study because PTSD can cause mild symptoms or catastrophic ones. And our experiences as humans are subjective. Birth trauma can occur when there is a threat to a woman or baby's life during labor or childbirth — when there is an emergency cesarean section or extreme blood loss or an infection, for example. But women can also experience trauma after having what doctors would consider routine childbirths. It depends on their personal perception and experience.
During the pandemic, Dekel has seen a "substantial" increase in the number of traumatic childbirths. She pointed to women who had to give birth without their partners because of visitor restrictions, or the general stress of being in a health care facility as a deadly virus circulates, often in the same building.
It's important to better identify those mothers who have PTSD, Dekel said, especially since it's possible to prevent the disorder from turning into something more serious if it's caught and treated early.
"We often talk about these 'golden hours' — basically, if intervention is offered in the early time period after traumatic exposure, then the intervention could possibly avert the PTSD trajectory of the person," she said. "In the context of general PTSD, we often don't have access to trauma survivors immediately after trauma exposure. With maternal PTSD, women are followed after childbirth, especially when the delivery is difficult. ... We could screen women and offer them treatment before they might develop a full-blown PTSD."
Doctors regularly screen new moms for postpartum depression, but not for PTSD specifically, Dekel added.
Treatment for postpartum PTSD can include therapy and medication.
Roper added that learning to be an advocate for herself has also helped — advice any new mom, regardless of her mental state, could probably use.
"People talk so much about pregnancy and taking care of your health when you're pregnant, and then you have a baby and nobody checks in on the mom."
"That was really hard for me," Roper said. "I felt like I had to be supermom."
"It was like, I'm OK, I don't need to shower and get dressed today. I don't need to take time for myself for that. I would go three days sometimes without brushing my teeth, which is disgusting, but I felt like, I can't even do that for myself. I have to feed the baby. I have to do this. I have to do that. So telling my husband, 'I need you to take Reed for 20 minutes. I need to go shower. I need to just go in there and breathe, and check in with myself.'"
Roper shared her story with the hope that it helps other moms struggling with their mental health to know that they're not alone, and that help is out there.
"People talk so much about pregnancy and taking care of your health when you're pregnant, and then you have a baby and nobody checks in on the mom," she said. "There are all these things going on — we're navigating how to take care of a newborn and meeting their needs, but there's also this transformation. We're this new person, we have a whole new identity. That's a big deal."