Childbirth-related post-traumatic stress disorder: Difference between revisions - Wikipedia

Line 1:

 {{broader|Psychiatric disorders of childbirth}}

{{Infobox medical condition (new)

| name = <!--{{PAGENAME}} by default-->

Line 8:

| caption =

| pronounce =

| specialty = <!-- from WikidataOB/GYN, can be overwritten -->psychiatry

| symptoms =

| complications =

Line 25:

| deaths =

}}

'''Childbirth-related posttraumatic stress disorder''' is a psychological disorder that can develop in women who have recently [[Childbirth|given birth]].<ref>{{cite journal |vauthors=Lapp LK, Agbokou C, Peretti CS, Ferreri F |title=Management of post traumatic stress disorder after childbirth: a review |journal=J Psychosom Obstet Gynaecol |volume=31 |issue=3 |pages=113–22 |date=September 2010 |pmid=20653342 |doi=10.3109/0167482X.2010.503330 }}</ref> Its symptoms are not distinct from [[posttraumatic stress disorder]] (PTSD).<ref name=Condon2010/><ref>{{cite book | last = Martin | first = Colin | title = Perinatal Mental Health : a Clinical Guide | publisher = M & K Pub | location = Cumbria England | year = 2012 | isbn = 9781907830495 | page = 26}}</ref>▼

{{Pregnancy and mental health}}

▲'''Childbirth-related posttraumaticpost-traumatic stress disorder''' is a psychological disorder that can develop in women who have recently [[Childbirth|given birth]].<ref>{{cite journal | vauthors = Lapp LK, Agbokou C, Peretti CS, Ferreri F | title = Management of post traumatic stress disorder after childbirth: a review | journal =J PsychosomJournal Obstetof GynaecolPsychosomatic Obstetrics and Gynaecology | volume = 31 | issue = 3 | pages =113–22 113–122 | date = September 2010 | pmid = 20653342 | doi = 10.3109/0167482X.2010.503330 | s2cid = 23594561 }}</ref> This disorder can also affect men or partners who have observed a difficult birth.<ref name=sdf>{{cite journal | vauthors = Fisher SD | title = Paternal Mental Health: Why Is It Relevant? | journal = American Journal of Lifestyle Medicine | volume = 11 | issue = 3 | pages = 200–211 | date = May 2017 | pmid = 30202331 | pmc = 6125083 | doi = 10.1177/1559827616629895 }}</ref> Its symptoms are not distinct from [[posttraumaticpost-traumatic stress disorder]] (PTSD).<ref name=Condon2010/><ref>{{cite book | lastvauthors = Martin | first = ColinC | title = Perinatal Mental Health : a Clinical Guide | publisher = M & K Pub | location = Cumbria England | year = 2012 | isbn = 9781907830495 | page = 26}}</ref> It may also be called '''post-traumatic stress disorder following childbirth''' (PTSD-FC).<ref>{{cite journal | vauthors = Ertan D, Hingray C, Burlacu E, Sterlé A, El-Hage W | title = Post-traumatic stress disorder following childbirth | journal = BMC Psychiatry | volume = 21 | issue = 1 | pages = 155 | date = March 2021 | pmid = 33726703 | pmc = 7962315 | doi = 10.1186/s12888-021-03158-6 | doi-access = free }}</ref>

==Signs and symptoms==

Examples of symptoms of childbirth-related [[posttraumaticpost-traumatic stress disorder]] include: [[intrusive thoughts|intrusive symptoms]] such as [[Flashback (psychology)|flashbackflashbacks]]<nowiki/>s and [[nightmare]]<nowiki/>s, as well as symptoms of [[avoidance coping|avoidance]] (including [[amnesia]] for the whole or parts of the event), problemsuncomfortable insexual developingintimacy, adiscomfort [[Maternalbeing bond|mother-childtouched, attachment]]abstinence, notfear having [[sexual intercourse]] in order to prevent anotherof [[pregnancy]], and avoidance of birth- and pregnancy -related issues. Symptoms of increasing stress can be [[Perspiration|sweating]], [[Tremor|trembling]], being irritated, and sleep disturbances.<ref name=Olde2006>{{cite journal | vauthors = Olde E, van der Hart O, Kleber R, van Son M | title =Post-traumatic Posttraumatic stress following childbirth: a review | journal =Clin PsycholClinical RevPsychology Review | volume = 26 | issue = 1 | pages = 1–16 | date = January 2006 | pmid = 16176853 | doi = 10.1016/j.cpr.2005.07.002 | hdl-access = free | s2cid = 22137961 | hdl = 1874/16760 }}</ref>

Other examples of symptoms of paternal childbirth-related post-traumatic stress disorder include anxiety, or intense fear of losing either the child or their partner who is giving birth to it. This can lead to difficulties in the father-child connection.<ref name=sdf/>

==Cause==

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. [[Premature birth]] may be traumatic.<ref name=":6Goutaudier_2011">{{cite journal | vauthors = Goutaudier, N, Lopez, A, Séjourné, N, etDenis al.A, Chabrol H | date = September (2011). | title = Premature birth: subjective and psychological experiences in the first weeks following childbirth, a mixed-methods study. | journal = Journal of Reproductive and Infant Psychology, | volume = 29, 364-373| issue = 4 | pages = 364–373 | doi = 10.1080/02646838.2011.623227 | s2cid = 71379594 }}</ref>

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. However, even normal birth can be traumatic, and thus PTSD is diagnosed based on symptoms of the mother and not whether or not there were complications.<ref name="Beck">{{cite journal | authorvauthors = Beck CT | title = Birth Traumatrauma: Inin the Eyeeye of the Beholderbeholder | journal = Nursing Research | volume = 53 | issue = 1 | pages = 28–35 | date = January–February 2004 | pmid = 14726774 | doi = 10.1097/00006199-200401000-00005 | s2cid = 35279461 }}</ref>

Additionally, in the process of birth, medical professionals who are there to aid the birthing mother may need to examine and perform procedures in the genital regions.<ref>{{Cite journal|lastname="Beck|first=Cheryl Tatano|date=January 2004|title=Birth trauma: in the eye of the beholder|journal=Nursing Research|volume=53|issue=1|pages=28–35|issn=0029-6562|pmid=14726774}}<"/ref>

The following are correlated with PTSD:

* Medical complications before, during, or after childbirth:

** [[Complications of pregnancy|Pregnancy complications]]<ref name=":0Andersen_2012">{{Citecite journal |last vauthors = Andersen|first=Louise B.|last2=LB, Melvaer|first2=Lisa B.|last3=LB, Videbech|first3=Poul|last4= P, Lamont|first4=Ronald F.|last5=RF, Joergensen|first5=Jan S.JS |date=November 2012|title = Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review | journal = Acta Obstetricia et Gynecologica Scandinavica | volume = 91 | issue = 11 | pages = 1261–1272 | date = November 2012 | pmid = 22670573 | doi = 10.1111/j.1600-0412.2012.01476.x |issn=1600-0412|pmid=22670573}}</ref><ref names2cid =":7">{{Cite journal205802183 |last=Shaban|first=Zainab|last2=Dolatian|first2=Mahrokh|last3=Shams|first3=Jamal|last4=Alavi-Majd|first4=Hamid|last5=Mahmoodi|first5=Zohreh|last6=Sajjadi|first6=Homeira|date=March 2013|title=Postdoi-Traumaticaccess Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors|journal=Iranian Redfree Crescent Medical Journal|volume=15|issue=3|pages=177–182|doi=10.5812/ircmj.2312|issn=2074-1804|pmc=3745743|pmid=23983994}}</ref>

** [[Caesarean section|Emergency/unwanted C-section]]<ref name=":0Andersen_2012" />

** [[Forceps in childbirth|Instrumental delivery]]<ref name=":0Andersen_2012" />

** [[Episiotomy]]<ref name=":0Andersen_2012" />

** Severe pain during birth<ref name=":0" /><ref name=":7Andersen_2012" />

** [[Complications of pregnancy#Complications following childbirth|Postpartum complications]]<ref name=":0" /><ref name=":7Andersen_2012" />

** [[Preterm birth|Preterm labour]]<ref name=":1Beck_2011">{{Citecite journal |last vauthors = Beck|first=Cheryl Tatano|last2=CT, Gable|first2=Robert K.|last3=RK, Sakala|first3=Carol|last4= C, Declercq|first4=Eugene R.|date=2011-09-01ER | title = Posttraumatic Stressstress Disorderdisorder in Newnew Mothersmothers: Resultsresults from a Twotwo-Stagestage U.S. Nationalnational survey Survey| journal = Birth |language=en| volume = 38 | issue = 3 | pages = 216–227 | date = September 2011 | pmid = 21884230 | doi = 10.1111/j.1523-536X.2011.00475.x|pmid=21884230|issn=1523-536X }}</ref><ref name=":6Goutaudier_2011" />

** History of [[infertility]]<ref name=":1Beck_2011" /><ref name=":2Söderquist_2002">{{Citecite journal |last vauthors = Söderquist|first= J.|last2=, Wijma|first2= K.|last3=, Wijma|first3= B. |date=March 2002|title = Traumatic stress after childbirth: the role of obstetric variables | journal = Journal of Psychosomatic Obstetrics and Gynaecology | volume = 23 | issue = 1 | pages = 31–39 |issn date =0167-482X March 2002 | pmid = 12061035 | doi = 10.3109/01674820209093413 | s2cid = 7762819 }}</ref>

** Inadequate care during [[Childbirth|labour]]<ref name=":0Andersen_2012" />

* Social, psychological, and other factors:

** [[Unintended pregnancy|Unwanted pregnancy]]<ref name=":1Beck_2011" /><ref name=":2" /><ref name=":7Söderquist_2002" />

** Low [[socioeconomic status]]<ref name=":1Beck_2011" /><ref name=":2Söderquist_2002" />

** [[Gravidity and parity|Primiparous]] (first labour)<ref name=":1Beck_2011" />

** Parenting (infant caring) problems<ref name=":1" /><ref name=":7Beck_2011" />

** Social support following childbirth<ref name=":3Tamaki_1997">{{Citecite journal |last vauthors = Tamaki|first= R.|last2=, Murata|first2= M.|last3=, Okano|first3= T. |date=June 1997|title = Risk factors for postpartum depression in Japan | journal = Psychiatry and Clinical Neurosciences | volume = 51 | issue = 3 | pages = 93–98 |issn date =1323-1316 June 1997 | pmid = 9225370 | doi = 10.1111/j.1440-1819.1997.tb02368.x | s2cid = 25412801 | doi-access = free }}</ref><ref name=":4Creedy_2000">{{Citecite journal |last vauthors = Creedy|first=D. K.|last2=DK, Shochet|first2=I. M.|last3=IM, Horsfall|first3= J. |date=June 2000|title = Childbirth and the development of acute trauma symptoms: incidence and contributing factors | journal =Birth (Berkeley,Birth Calif.)| volume = 27 | issue = 2 | pages = 104–111 |issn date =0730-7659 June 2000 | pmid = 11251488 | doi = 10.1046/j.1523-536x.2000.00104.x }}</ref><ref name=":5Ford_2011">{{Citecite journal |last vauthors = Ford|first=Elizabeth|last2= E, Ayers|first2=Susan|date=December 2011S | title = Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms | journal = Psychology & Health | volume = 26 | issue = 12 | pages = 1553–1570 | date = December 2011 | pmid = 21598181 | doi = 10.1080/08870446.2010.533770 |issn s2cid =1476-8321|pmid=21598181 14015059 | url =http https://openaccess.city.ac.uk/id/eprint/2080/6/Support_during_birth_interacts_with_prior_trauma_and_birth_intervention_to_predict_postnatal_post-traumatic_stress_symptoms.pdf }}</ref>

** Cultural factors<ref name=":3Tamaki_1997" /><ref name=":4Creedy_2000" /><ref name=":5Ford_2011" />

** History of [[Mental health|mental health issues]]<ref name=":0Andersen_2012" />

** Other life stressors<ref name=":0Andersen_2012" />

==Diagnosis==

Childbirth-related PTSD is not a recognized diagnosis in the ''[[Diagnostic and Statistical Manual of Mental Disorders]]''.<ref name=Condon2010>{{cite journal |author vauthors = Condon J | title = Women's mental health: a "wish-list" for the DSM V | journal =Arch WomensArchives Mentof Women's Mental Health | volume = 13 | issue = 1 | pages = 5–10 | date = February 2010 | pmid = 20127444 | doi = 10.1007/s00737-009-0114-1 | s2cid = 1102994 }}</ref> Many women presenting with symptoms of PTSD after childbirth are misdiagnosed with [[postpartum depression]] or [[adjustment disorder]]s. These diagnoses can lead to inadequate treatment.<ref name=Alder2006>{{cite journal | vauthors = Alder J, Stadlmayr W, Tschudin S, Bitzer J | title = Post-traumatic symptoms after childbirth: what should we offer? | journal =J PsychosomJournal Obstetof GynaecolPsychosomatic Obstetrics and Gynaecology | volume = 27 | issue = 2 | pages =107–12 107–112 | date = June 2006 | pmid = 16808085 | doi = 10.1080/01674820600714632 | s2cid = 21859634 }}</ref>

== Treatment ==

In order to treat postpartum PTSD, it is essential to normalize the feelings that arise and alleviate anxiety. In some cases, medication such as antidepressants or anti-anxiety drugs might be prescribed to manage symptoms. Seeking emotional support from support systems is crucial. Mental health professionals can conduct comprehensive assessments and provide evidence-based therapies tailored to individual needs. These therapies include Cognitive Behavioral Therapy [[Cognitive behavioral therapy|(CBT)]], Eye Movement Desensitization and Reprocessing [[Eye movement desensitization and reprocessing|(EMDR)]], Prolonged Exposure Therapy [[Prolonged exposure therapy|(PE)]], and Narrative Exposure Therapy [[Narrative exposure therapy|(NET)]]. These trauma-focused therapies can assist in reshaping thought patterns, processing memories, and reducing anxiety and avoidance behaviors.<ref>{{Cite journal |last1=Ahsan |first1=Areeba |last2=Nadeem |first2=Abdullah |last3=Habib |first3=Ashna |last4=Basaria |first4=Areeba Aamir Ali |last5=Tariq |first5=Rabeea |last6=Raufi |first6=Nahid |date=2023-12-07 |title=Post-traumatic stress disorder following childbirth: a neglected cause |journal=Frontiers in Global Women's Health |volume=4 |doi=10.3389/fgwh.2023.1273519 |doi-access=free |pmid=38130709 |pmc=10733854 |issn=2673-5059}}</ref>

==Epidemiology==

Prevalence of PTSD following normal childbirth in women (excluding stillbirth or major complications) is estimated to be between 2.8% and 5.6% at 6six weeks postpartum,<ref name="Olde2006" /> with rates dropping to 1.5% at 6six months postpartum.<ref name="Olde2006" /><ref name=Alder2006/> Symptoms of PTSD are common following childbirth, with prevalence of 24-3024–30.1%<ref name=":02">{{Cite journal|last=Olde|first=Eelco|last2=van der Hart|first2=Onno|last3=Kleber|first3=Rolf|last4=van Son|first4=Maarten|date=January 2006|title=Posttraumatic stress following childbirth: a review|journal=Clinical Psychology Review|volume=26|issue=1|pages=1–16|doi=10.1016Olde2006/j.cpr.2005.07.002|issn=0272-7358|pmid=16176853|hdl=1874/16760}}</ref> at 6six weeks, dropping to 13.6% at 6six months.<ref>{{cite journal |author1 vauthors = Montmasson H.|author2=, Bertrand P.|author3=, Perrotin F.|author4=, El-Hage W.|year=2012 | title = [Predictors of postpartum post-traumatic stress disorder in primiparous mothers] | journal = Journal de GynecologieGynécologie, ObstetriqueObstétrique et Biologie de la Reproduction | volume = 41 | issue = 6 | pages = 553–560 | date = October 2012 | pmid = 22622194 | doi = 10.1016/j.jgyn.2012.04.010 |pmid s2cid =22622194 196363612 }}</ref>

== See also ==

*[[Miscarriage]]

*[[Pain management during childbirth]]

*[[Miscarriage and mental illness]]

== References ==

{{reflist}}

== Further reading ==

{{refbegin}}

* {{cite journal |author=Beck CT |title=Birth trauma and its sequelae |journal=J Trauma Dissociation |volume=10 |issue=2 |pages=189–203 |year=2009 |pmid=19333848 |doi=10.1080/15299730802624528}}

* {{cite journal | vauthors =Elmir R, Schmied V, WilkesBeck L, Jackson DCT | title =Women's perceptionsBirth trauma and experiencesits ofsequelae a| traumaticjournal birth:= aJournal meta-ethnographyof |journal=JTrauma Adv& NursDissociation | volume =66 10 | issue =10 2 | pages =2142–53 189–203 |date year =October 20102009 | pmid =20636467 19333848 | doi = 10.11111080/j.1365-2648.2010.05391.x15299730802624528 | s2cid = 26695075 }}

* {{cite journal | vauthors =Lev-Wiesel Elmir R, Daphna-TekoahSchmied SV, |title=TheWilkes roleL, ofJackson peripartumD dissociation| astitle a= predictorWomen's ofperceptions posttraumaticand stressexperiences symptomsof followinga childbirthtraumatic inbirth: Israelia Jewish womenmeta-ethnography | journal =J TraumaJournal Dissociationof Advanced Nursing | volume =11 66 | issue =3 10 | pages =266–83 2142–2153 |year date = October 2010 | pmid =20603762 20636467 | doi = 10.10801111/15299731003780887j.1365-2648.2010.05391.x }}

* {{cite journal | vauthors =Sawyer ALev-Wiesel R, AyersDaphna-Tekoah S, Smith H | title =Pre- andThe postnatalrole psychologicalof wellbeingperipartum indissociation Africa:as a systematicpredictor reviewof posttraumatic stress symptoms following childbirth in Israeli Jewish women | journal =J AffectJournal Disordof Trauma & Dissociation | volume =123 11 | issue =1–3 3 | pages =17–29 266–283 |date year =June 2010 | pmid =19635636 20603762 | doi = 10.10161080/j.jad.2009.06.02715299731003780887 |url s2cid =http://openaccess.city.ac.uk/1994/1/Sawyer_Ayers_Field_2010_text_copy.pdf 32719455 }}

* {{cite journal |author vauthors =Vythilingum BSawyer A, Ayers S, Smith H | title =Should childbirthPre- beand consideredpostnatal apsychological stressorwellbeing sufficientin toAfrica: meeta thesystematic criteria for PTSD?review | journal =Arch WomensJournal Mentof HealthAffective Disorders | volume =13 123 | issue =1 1–3 | pages =49–50 17–29 | date =February June 2010 | pmid =20127456 19635636 | doi = 10.10071016/s00737-009-0118-xj.jad.2009.06.027 | url = https://openaccess.city.ac.uk/id/eprint/1994/1/Sawyer_Ayers_Field_2010_text_copy.pdf }}

* {{cite journal | vauthors = Vythilingum B | title = Should childbirth be considered a stressor sufficient to meet the criteria for PTSD? | journal = Archives of Women's Mental Health | volume = 13 | issue = 1 | pages = 49–50 | date = February 2010 | pmid = 20127456 | doi = 10.1007/s00737-009-0118-x | s2cid = 11322225 }}

{{refend}}

{{Pathology of pregnancy, childbirth, and the puerperium}}

[[Category:PosttraumaticPost-traumatic stress disorder]]

[[Category:PathologyMaternal ofdisorders pregnancy,predominantly childbirthrelated andto the puerperiumpregnancy]]

[[Category:Mental disorders associated with pregnancy, childbirth or the puerperium]]