PTSD, risk factors, and expectations among women having a baby: A two-wave longitudinal study

Abstract

Childbirth is a risk condition for PTSD, depression during pregnancy influences the intrusion subscale, while having physical problems influences the arousal subscale. Expectations and support are modulated by the anxiety levels and they are not directly related to chronic PTSD.

Stressful events and support during birth: The effect on anxiety, mood and perceived control

“…Recent studies suggest that anxiety disorders may be under-estimated in the post-natal period and may actually be more common than depression, with up to 16% of women suffering some type of anxiety disorder such as panic, phobia, acute adjustment disorder or post-traumatic stress disorder (PTSD; Matthey, Barnett, Howie, & Kavanagh, 2003;Wenzel et al, 2005). Notably, evidence suggests up to a third of women appraise their experience of birth as traumatic, and between 1 and 2% of women develop diagnostic PTSD following birth, with up to 30% showing sub-diagnostic symptoms (Ayers & Pickering, 2001;Czarnocka & Slade, 2000;Maggioni, Margola, & Filippi, 2006;Soderquist, Wijma, & Wijma, 2006;Soet, Brack, & Dilorio, 2003). Appraisal of birth as traumatic and PTSD do not only follow births in which complications threaten the mother or the baby.…”

Exploration of a cognitive model to predict post-traumatic stress symptoms following childbirth

“…During the birth, instrumental deliveries (e.g. use of forceps) and emergency caesarean sections (Creedy et al, 2000;MacLean, McDermott, & May, 2000;Ryding, Wijma, & Wijma, 1998;Soderquist, Wijma, & Wijma, 2002), a lack of control (Czarnocka & Slade, 2000), feeling powerlessness (Soet et al, 2003), experiencing a lack of communication from staff (Lyons, 1998), experiencing inadequate support and care (Cigoli et al, 2006;Creedy et al, 2000;Czarnocka & Slade, 2000;Maggioni et al, 2006;Wijma et al, 1997), and coping by using dissociation during the birth (Olde et al, 2005), have all been associated with having more PTS symptoms following the birth. Following the birth, higher levels of symptoms have been associated with low social support (Cigoli et al, 2006;Lyons, 1998) and negative appraisals or beliefs (Czarnocka & Slade, 2000;Edworthy, Chasey, & Williams, 2008;Wijma et al, 1997).…”

“…Other women may have a seemingly "normal" birth but may feel traumatized by aspects such as loss of control, loss of dignity, or the hostile, difficult or disrespectful attitudes of the people around them. The interpersonal environment during birth may be particularly important in determining trauma responses (Charuvastra & Cloitre, 2008;Cigoli, Gilli, & Saita, 2006;Creedy et al, 2000;Czarnocka & Slade, 2000;Ford & Ayers, 2009;Lyons, 1998;Maggioni et al, 2006;Soet et al, 2003;Wijma, Soderquist, & Wijma, 1997).…”

“…For example, prior psychiatric problems and previous trauma have been associated with PTS symptoms following birth (Cigoli et al, 2006;Cohen, Ansara, Schei, Stuckless, & Stewart, 2004;Czarnocka & Slade, 2000;Kennedy & MacDonald, 2002;Maggioni et al, 2006;Soderquist, Wijma, & Wijma, 2006;Soet et al, 2003;Wijma et al, 1997). During the birth, instrumental deliveries (e.g.…”

“…This disorder affects between 1 and 6% of women in the first year following the birth of their child. In addition to full clinical cases, around 30% of women rate their experience as traumatic (Creedy, Shochet, & Horsfall, 2000;Soet, Brack, & Dilorio, 2003), and a similar number meet symptom criteria on at least one of the PTSD symptom subscales (re-experiencing, avoidance, and hyperarousal; Maggioni, Margola, & Filippi, 2006).…”