Childbirth-related post-traumatic stress disorder is a psychological disorder that can develop in women who have recently given birth.^[1] This disorder can also affect men or partners who have observed a difficult birth.^[2] Its symptoms are not distinct from post-traumatic stress disorder (PTSD).^[3][4] It may also be called post-traumatic stress disorder following childbirth (PTSD-FC).^[5]

Signs and symptoms

Examples of symptoms of childbirth-related post-traumatic 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), uncomfortable sexual intimacy, discomfort being touched, abstinence, fear of pregnancy, and avoidance of birth- and pregnancy-related issues. Symptoms of increasing stress can be sweating, trembling, being irritated, and sleep disturbances.^[6] In some cases it can delay the Mother and child attachment.

Other examples of symptoms of paternal childbirth-related post-traumatic stress disorder include anxiety, or intense fear of losing either the child or their partner who is giving birth to it. This can lead to difficulties in the father-child connection.^[2]

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.^[7] 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.^[8] 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.^[8]

The following are correlated with PTSD:

• Medical complications before, during, or after childbirth:
  • Pregnancy complications^[9]
  • Emergency C-section^[9]
  • Instrumental delivery^[9]
  • Episiotomy^[9]
  • Severe pain during birth^[9]
  • Postpartum complications^[9]
  • Preterm labour^[10][7]
  • History of infertility^[10][11]
  • Inadequate care during labour^[9]
• Social, psychological, and other factors:
  • Unwanted pregnancy^[10][11]
  • Low socioeconomic status^[10][11]
  • Primiparous (first labour)^[10]
  • Parenting (infant caring) problems^[10]
  • Social support following childbirth^[12][13][14]
  • Cultural factors^[12][13][14]
  • History of mental health issues^[9]
  • Other life stressors^[9]

Diagnosis

Childbirth-related PTSD is not a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders.^[3] Many women presenting with symptoms of PTSD after childbirth are misdiagnosed with postpartum depression or adjustment disorders. These diagnoses can lead to inadequate treatment.^[15]

Epidemiology

Prevalence of PTSD following normal childbirth in women (excluding stillbirth or major complications) is estimated to be between 2.8% and 5.6% at six weeks postpartum,^[6] with rates dropping to 1.5% at six months postpartum.^[6][15] Symptoms of PTSD are common following childbirth, with prevalence of 24–30.1%^[6] at six weeks, dropping to 13.6% at six months.^[16]

See also

• Miscarriage
• Pain management during childbirth
• Miscarriage and mental illness

References

Further reading