Post-traumatic Stress Disorder and Birth

Research has suggested that up to 9% women meet the diagnostic criteria for post-traumatic stress disorder after birth, and that 18% women scored above the cutoff score, indicating that they were experiencing a degree of post-traumatic stress symptoms.

Amongst variables that were found to be associated with PTSD were lack of support, unplanned pregnancy, pressure to have an induction and epidural analgesia, planned cesarean and consulting with a clinician about mental well-being since birth.

PTSD is an important issue in birth, and one that is attracting more and more attention. It's time for health services, midwives and obstetricians to become more aware of their practices and treatment of pregnant and birthing women, and for communities to consider how they can best support new mothers.

With almost one in ten women experiencing their birth as traumatic, we also have to wonder if things have really progressed in birth. Pain relief came in in the 1800s with the intention of reducing the trauma associated with a long and painful birth, however in this study, epidural use in labour was associated with PTSD.

The lack of caesareans in years gone by were an important contributor of traumatic births as women endured days of labour only to give birth to a stillborn baby. Nowadays we have ready access (perhaps too ready) to operating theatres and caesareans, yet caesareans are suggested as being associated with PTSD.

I believe that the heart of the issue is a woman feeling supported in the decisions she makes, being able to trust her care providers and ultimately birthing safely. Continuity of care is known to have the lowest rates of PTSD and birth trauma, specifically because women are cared for by one midwife and obstetrician who know the woman, her wishes, fears and hopes, and together they can develop a care plan that places the woman at the centre of her care.

Visit my website for information on birth debriefing, homebirth and hospital birth.