Her condition is more similar to the PTSD experienced by veterans than it is to postpartum depression. Postpartum PTSD sufferers like Sarah experience typical PTSD symptoms like hyper-vigilance, intrusive memories, flashbacks, severe emotional distress, irritability, trouble sleeping, and nightmares, explains Anastasia Pollock, a therapist who specializes in treating trauma. Mothers who suffer from PTSD often end up structuring their lives around their disorder, doing everything they can to avoid triggers that remind them of their trauma.

The traumatic experience can come before or during pregnancy, like a bad reaction to fertility treatment or severe morning sickness, explains Jennifer Zimmerman, the cofounder of Solace for Mothers, an organization that helps women to emotionally heal after traumatic childbirths.

Other times, it can come during labor and delivery: When a newborn has a medical problem, as Sarah’s did, or when a woman feels coerced into undergoing invasive procedures during the birthing process. An experience that may not be a big deal to some women may be traumatic for others, Zimmerman explains:

“What looks like a normal labor and delivery to the outsider can be experienced as traumatic to her.”

* * *

The psychology behind developing PTSD is complicated, but it frequently has a lot to do with expectations. Mothers often don’t anticipate having a problematic birth, so when it happens, it can leave lasting psychological scars.

That certainly seemed to be the case with Sarah.

She had a relatively easy pregnancy—but in her 33rd week, while waiting in the car for her husband to bring her ice cream, her water broke unexpectedly. Her husband rushed her to the hospital, where a whirlwind of doctors and nurses ran tests in the birthing room. A doctor said her baby had underdeveloped lungs.

When it came time for Sarah to deliver, the doctors wheeled her out of the birthing room and into a room on the NICU floor so that her newborn could be treated immediately.

Once she gave birth, the doctors whisked the baby girl away before Sarah could hold her, and her husband rushed off with them.

At that moment, Sarah told me, she remembered a couple in her birthing class that had planned the trendiest birth possible, complete with hypnotherapy and a birthing pool. At the time, she had laughed at the idea; now she envied them.

“I didn’t care about low lighting, I didn’t care about Enya playing in the background,” remembers Sarah. “I just wanted to see my daughter when she was born, and I wanted to see my husband’s face. And I didn’t get either."

The doctor cleaned Sarah up, brought her back to her room, and left her alone.

“It was grief and fear when it should have been joy and excitement,” she says. “And it was emptiness.”

A couple of hours later, nurses finally wheeled Sarah back to the NICU to see her daughter. At the sight of her baby—wires everywhere, a tube in her mouth—she felt a wave of intense melancholy. She started stroking her daughter, Eloise, but a nurse told her she was doing it wrong, she recalls—the touch was too rough for newborn skin. I can’t even touch my baby right, she thought.