The Impact of Mode of Birth on Childbirth-Related Post Traumatic Stress Symptoms beyond 6 Months Postpartum: An Integrative Review

Abstract

(1) Background: A traumatic birth can lead to the development of childbirth-related posttraumatic stress symptoms or disorder (CB-PTS/D). Literature has identified the risk factors for developing CB-PTS/D within the first six months postpartum thoroughly. However, the impact of mode of birth on CB-PTS/D beyond 6 months postpartum is scarcely studied. (2) Methods: A systematic search of the literature was conducted in the databases PubMed, Embase and CINAHL and PRISMA guidelines were followed. Studies were included if they reported the impact of mode of birth on CB-PTS/D beyond 6 months postpartum. (3) Results: In total, 26 quantitative and 2 qualitative studies were included. In the quantitative studies the percentage of women with CB-PTS/D ranged from 0.7% to 42% (between six months and five years postpartum). Compared with vaginal birth, operative vaginal birth, and emergency caesarean section were associated with CB-PTS/D beyond 6 months postpartum. Qualitative studies revealed that some women were suffering from CB-PTS/D as long as 18 years after birth. (4) Conclusions: Long- term screening of women for PTSD in the postnatal period could be beneficial. More research is needed on models of care that help prevent CB-PTS/D, identifying women at risk and factors that maintain CB-PTS/D beyond 6 months postpartum.

„Hilflosigkeit, das Abgeben jeglicher Selbstverantwortung und Selbstbestimmtheit“ – eine qualitative Auswertung von traumatisierenden Geburtserlebnissen in Relation zum Geburtsmodus

“…Die emotionale Vulnerabilität der Mutter wird in Akutsituationen bei der professionellen Versorgung häufig nicht wahrgenommen. Wenn Hilflosigkeit und das Gefühl des Ausgeliefertseins das mütterliche Geburtserleben dominieren, kann eine psychische Belastungsreaktion und im schwerwiegendsten Fall eine posttraumatischen Belastungsstörung (PTBS) daraus resultieren 1 . Bereits in den 1990er Jahren rückte diese Thematik in den Fokus 2 .…”

“…Ungeplante Entbindungsmodi wie eine Notsectio oder vaginal operative Geburt sind häufiger mit einer PTBS und postpartalen Depression (PPD) assoziiert 18 19 . Aktuelle systematische Reviews liefern hierzu eine Übersicht der Datenlage, allerdings mit einem überwiegendem Anteil an quantitativen Studien 1 20 . Die quantitative Auswertung der Daten aus validierten und standardisierten Instrumenten lässt dabei jedoch kaum Raum für die individuelle Erzählung wahrgenommener Belastungen 21 .…”

Post-traumatic stress syndromes following childbirth influenced by birth mode—is an emergency cesarean section worst?

“…Again, ECS as a birth-related variable showed significantly higher risk for developing a post-traumatic stress response [ 23 ]. In two recent literature reviews, the impact of birth mode involving emergency interventions on CB-PTSD were identified both in quantitative and qualitative study designs [ 24 , 25 ].…”

Risk Factors for Post-Traumatic Stress Disorder after Childbirth: A Systematic Review

“…Cesarean delivery was more closely associated with PTSD than vaginal delivery (VD), emergency cesarean delivery (EmCB) more than elective cesarean delivery (ElCB), instrumental vaginal delivery (IVD) more than spontaneous vaginal delivery (SVD), and EmCB more than SVD. Emergency caesarean section and operative vaginal delivery have been found to be particularly associated with CB-PTS/D [ 33 , 34 ]. The systematic reviews from Ginter et al, 2022; Carter et al, 2022 and Heyne et al, 2022 were focused on the association between the type of delivery and its relationship with PTSD.…”

“…The systematic reviews from Ginter et al, 2022; Carter et al, 2022 and Heyne et al, 2022 were focused on the association between the type of delivery and its relationship with PTSD. Our review about PTSD risk factors, have considered social, psychological, obstetric, and medical factors [ 3 , 33 , 34 ].…”