**4. Clinical presentation and comorbidity of postpartum PTSD**

Postpartum PTSD is manifested through clinical symptoms that do not differ significantly from PTSD symptoms that arise after exposure to any other traumatic experience—with symptoms of intrusion, avoidance, and overstimulation.

The specifics of clinical presentation are directly related to the birth trauma itself. Avoidance symptoms are manifested through avoiding and neglecting obligations related to baby care, avoiding breastfeeding and gynecological check-ups, as well as sexual relations with the aim of preventing possible new pregnancies. Women who have recently given birth often avoid any conversation topics related to childbirth. If the next pregnancy were to occur, they would choose cesarean section as the method of delivery [17, 18]. Breastfeeding can be a trigger and remind a woman of the trauma she has experienced, which is why she may avoid it, but on the other hand, the healing effect that the act of breastfeeding itself can have should not be neglected. Successful breastfeeding helps the mother who has given birth to feel like a "good mother" and thus overcome the symptoms of postpartum PTSD faster and easier.

The specificity of symptoms of overstimulation in postpartum PTSD may resemble symptoms of excessive fatigue and normal physiological changes after childbirth. Women who have given birth can develop traumatic amnesia with the inability to remember the childbirth itself, and even if they do remember it, they often do so while feeling pain, fear, or sadness. Also, negative emotions such as shame or guilt due to the situation they are in can occur [5]. The course of postpartum PTSD is characterized by a reduction of symptoms over time [13], while a chronic form of this disorder can rarely occur.

#### *Postpartum Posttraumatic Stress Disorder DOI: http://dx.doi.org/10.5772/intechopen.114052*

Just as it does not differ from PTSD after any other traumatic experience in terms of clinical presentation, postpartum PTSD does not differ significantly in terms of comorbidities. Most often, this disorder is associated with depressive disorder [19], anxiety disorders, and substance abuse [9, 15, 20]. Postpartum depression and PTSD have several symptoms in common, including sleep disturbances, difficulty concentrating (concentration difficulties), a sense of a shortened future, lack of interest in normal life activities, and a sense of alienation from other people.
