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Childbirth-related posttraumatic stress disorder

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Childbirth-related posttraumatic stress disorder is well described in the medical literature,[1] but is not recognized as a condition distinct from posttraumatic stress disorder (PTSD).[2]

Signs and symptomsEdit

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 sex in order to prevent another pregnancy, and avoidance of birth and pregnancy related issues. Symptoms of increased arousal involve sweating, trembling, being irritated, and sleep disturbances.[3]

CauseEdit

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. However, 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. Even if others perceive the birth as normal, if the mother perceives it as traumatic, it was traumatic. Childbirth related PTSD can be caused even by a normal birth and should be diagnosed based on symptoms of the mother, not by the events.[citation needed]

DiagnosisEdit

Childbirth-related PTSD is not a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders.[2] Many women presenting with symptoms of PTSD after childbirth are diagnosed with postpartum depression or adjustment disorders. These diagnoses can lead to inadequate treatment.[4]

Several studies have focused on the impact of emergency caesarean sections (EmCs). "Women who underwent EmCs reported the most negative cognitions and emotions regarding delivery overall. Women who underwent EmCs or instrumental vaginal delivery (IVD) reported more symptoms of posttraumatic stress compared to women who had an elective caesarean section (EIC) or a normal vaginal delivery (NVD)." [3]

ManagementEdit

"Several interventions can prevent the development of clinically relevant PTSD, however there is a lack of evaluated treatment strategies: provide opportunity to talk about the birth experience, promotion of expression of feelings, responding to patient's questions about the course of birth, connect events with emotions, psychoeducation about post-traumatic stress symptoms and assessment of self-perceived severity and ability to cope, concrete suggestions like writing down her own birth narrative, and enhancement of stabilizing steps focusing on intra- and interpersonal resources. More specifically, the strengthening of partner support and of the emotional relationship between the spouses.[sic]

 In addition, a network of psychosocial support should be activated to avoid exhaustion of the partners' resources, and consequently of the couple."[4]

EpidemiologyEdit

Alder et al (2006) say that most studies show about 1.5% of women develop PTSD after childbirth;[4] Olde et al (2006) say the range is between 2.8 and 5.6%.[3]

ReferencesEdit

  1. Lapp LK, Agbokou C, Peretti CS, Ferreri F (September 2010). Management of post traumatic stress disorder after childbirth: a review. J Psychosom Obstet Gynaecol 31 (3): 113–22.
  2. 2.0 2.1 Condon J (February 2010). Women's mental health: a "wish-list" for the DSM V. Arch Womens Ment Health 13 (1): 5–10.
  3. 3.0 3.1 3.2 Olde E, van der Hart O, Kleber R, van Son M (January 2006). Post-traumatic stress following childbirth: a review. Clin Psychol Rev 26 (1): 1–16.
  4. 4.0 4.1 4.2 Alder J, Stadlmayr W, Tschudin S, Bitzer J (June 2006). Post-traumatic symptoms after childbirth: what should we offer?. J Psychosom Obstet Gynaecol 27 (2): 107–12.

Further reading Edit

  • Beck CT (2009). Birth trauma and its sequelae. J Trauma Dissociation 10 (2): 189–203.
  • Elmir R, Schmied V, Wilkes L, Jackson D (October 2010). Women's perceptions and experiences of a traumatic birth: a meta-ethnography. J Adv Nurs 66 (10): 2142–53.
  • Lev-Wiesel R, Daphna-Tekoah S (2010). The role of peripartum dissociation as a predictor of posttraumatic stress symptoms following childbirth in Israeli Jewish women. J Trauma Dissociation 11 (3): 266–83.
  • Sawyer A, Ayers S, Smith H (June 2010). Pre- and postnatal psychological wellbeing in Africa: a systematic review. J Affect Disord 123 (1-3): 17–29.
  • Vythilingum B (February 2010). Should childbirth be considered a stressor sufficient to meet the criteria for PTSD?. Arch Womens Ment Health 13 (1): 49–50.
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