Postpartum Symptoms of PTSD Are Higher Than Expected

More than 25% of women may exhibit symptoms of post-traumatic stress disorder (PTSD) after childbirth, a new study reports.¹ Some fear and anxiety during pregnancy is normal, but some women during childbirth truly believe that they or their baby are going to die or that their bodies will be irreversibly destroyed, write the study authors.

To determine the prevalence of postpartum PTSD and to assess which factors affect the development of PTSD, researchers evaluated the responses of 89 women in Israel who completed a questionnaire within a few days after delivery and a follow-up interview a month later. The study results indicated that 3.4% of women (n=3) had full PTSD 1 month after giving birth, 7.9% (n=7) had nearly complete PTSD, and 25.9% (n=23) had significant partial disorder.

None of the women who had postpartum PTSD symptoms reported a previous traumatic event, but more women with PTSD symptoms had previous psychiatric treatment compared with those without PTSD symptoms (60% vs 29.8%, respectively). Of note is that 80% of the women who experienced PTSD symptoms had an analgesic-free birth. Other factors associated with the development with PTSD were a poor body image, a previous difficult birth experience, complications during their pregnancy, a high level of fear of giving birth, a feeling that their or their babies lives or health were endangered during delivery, and a lack of confidence in their ability to handle labor.

Overall, 25.9% of women in this study experienced some PTSD symptoms after giving birth. The authors noted that being a first-time mother did not predispose women to postpartum PTSD. A significant protective factor against PTSD was perceived social support.

Although it is impossible to accurately predict which patients will experience symptoms of postpartum PTSD, the authors suggest that obstetricians can help mitigate these symptoms in patients who may be predisposed to this disorder by discussing options for analgesia during delivery early in the pregnancy. According to the authors, this is the first study to link postpartum PTSD with a discomfort with nakedness during delivery.

Pertinent Points:
- Pain management during delivery is one of the most important modifiable factors in attempts to help make childbirth less traumatic for women.
- Preserving a woman’s dignity by minimizing the undressed state (better draping, etc) is a simple way to help alleviate anxiety in women who are uncomfortable with nakedness and should not be underestimated.
- Sufficient social support was a protective factor against postpartum PTSD.
 

References:

1.Polacheck IS, Harari LH, Baum M, Strous RD. Postpartum post-traumatic stress disorder symptoms: the uninvited birth companion. Isr Med Assoc J. 2012;14:347-353.