Abstract

Childbirth-related posttraumatic stress disorder is a psychological disorder that can develop in women who have recently given birth. Its symptoms are not distinct from posttraumatic stress disorder (PTSD).

Signs and symptoms

Examples of symptoms of childbirth-related posttraumatic stress disorder include: intrusive symptoms such as flashbacks and nightmares, as well as symptoms of avoidance (including amnesia for the whole or parts of the event), problems in developing a mother-child attachment, not having sexual intercourse in order to prevent another pregnancy, and avoidance of birth and pregnancy related issues. Symptoms of increasing stress can be sweating, trembling, being irritated, and sleep disturbances.

Cause

Birth can be traumatic in different ways. Medical problems can result in interventions that can be frightening. The near death of a mother or baby, heavy bleeding, and emergency operations are examples of situations that can cause psychological trauma. Premature birth may be traumatic.

Emotional difficulties in coping with the pain of childbirth can also cause psychological trauma. Lack of support, or insufficient coping strategies to deal with the pain are examples of situations that can cause psychological trauma. However, even normal birth can be traumatic, and thus PTSD is diagnosed based on symptoms of the mother and not whether or not there were complications.

Additionally, in the process of birth, medical professionals who are there to aid the birthing mother may need to examine and perform procedures in the genital regions.

The following are correlated with PTSD:

- Medical complications before, during, or after childbirth:

- Pregnancy complications

- Emergency C-section

- Instrumental delivery

- Episiotomy

- Severe pain during birth

- Postpartum complications

- Preterm labour

- History of infertility

- Inadequate care during labour

- Social, psychological, and other factors:

- Unwanted pregnancy

- Low socioeconomic status

- Primiparous (first labour)

- Parenting (infant caring) problems

- Social support following childbirth

- Cultural factors

- History of mental health issues

- Other life stressors

Diagnosis

Childbirth-related PTSD is not a recognized diagnosis in the "Diagnostic and Statistical Manual of Mental Disorders". Many women presenting with symptoms of PTSD after childbirth are misdiagnosed with postpartum depression or adjustment disorders. These diagnoses can lead to inadequate treatment.

Epidemiology

Prevalence of PTSD following normal childbirth (excluding stillbirth or major complications) is estimated to be between 2.8 and 5.6% at 6 weeks postpartum, with rates dropping to 1.5% at 6 months postpartum. Symptoms of PTSD are common following childbirth, with prevalence of 24-30.1% at 6 weeks, dropping to 13.6% at 6 months.