Study Indicates Higher Incidence Of Childbirth-Related PTSD Than Previously Thought

Main Category: Pregnancy / Obstetrics
Also Included In: Anxiety / Stress
Article Date: 06 Aug 2008 - 5:00 PDT

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Nearly one in 10 U.S. women who have given birth recently meet the formal criteria for post-traumatic stress disorder resulting from childbirth, according to a survey released this week by the not-for-profit maternity care group Childbirth Connection, the Wall Street Journal reports. Some medical experts say that PTSD, most commonly linked to people who have experienced violent events, can also be triggered by a painful or complicated labor and delivery in which a woman believes she or her child might die. PTSD can set in immediately or months after a traumatic event. According to the Journal, the condition often occurs when someone has experienced an event that includes actual or threatened serious injury or death and evokes intense fear or a feeling of helplessness. Symptoms of the condition can include anxiety, flashbacks and a "numbness to daily life," the Journal reports.

For the survey, titled "New Mothers Speak Out," Childbirth Connection commissioned Harris Interactive to screen 900 U.S. mothers using an established PSTD screening tool. Nine percent of the women surveyed screened positive for all the criteria of PTSD outlined in the Diagnostic and Statistical Manual of Mental Disorders, and 18% of participants showed some signs of the condition, according to the report. Researchers noted that most women enrolled in the survey who experienced PTSD and other depression symptoms did not seek professional help. According to the Journal, the rate of PTSD among mothers has not been studied extensively, but separate studies conducted outside the U.S. estimated that between 1.5% and 5.9% of mothers experience the condition. PTSD is thought to be far less common in mothers than postpartum depression, which affects about 15% of mothers, according to the National Institute of Mental Health.

Health care providers believe the increasing number of obstetric procedures used in labor and delivery could be playing a role in PTSD. Cheryl Beck -- a professor at the University of Connecticut School of Nursing, who served as an adviser for the study -- said the mothers reporting signs of PTSD had a higher rate of medical intervention and were more likely to describe feeling helpless in a threatening environment. A history of sexual abuse or other trauma also can increase a woman's risk of experiencing PTSD related to childbirth, the Journal reports.

According to the Journal, the survey's results are "likely to add fuel to a debate about how to better identify and treat maternal mood disorders and whether widespread, systemic screening is warranted." New Jersey in 2006 passed a law requiring women to be screened for risk of depression after being discharged following childbirth, as well as at the first postpartum doctor's visit. Other states, including Illinois and Texas, have passed laws to increase educational awareness of postpartum mental conditions.

Federal legislation (S 1375) that would fund research into postpartum mood disorders and the effects of screening for the conditions failed to reach the Senate floor last month as part of a legislative package (S 3297), but supporters believe the bill could be reconsidered in the fall. Opponents of the measure have said the bill could lead to increased "drugging of mothers." Shari Lusskin, director of reproductive psychiatry at New York University Medical Center, said many aspects of PTSD are not fully understood, especially childbirth-related PTSD. She said, "We don't want to overmedicalize a normal part of human development. Just because you had a traumatic birth, doesn't mean you'll get PTSD" (Zimmerman, Wall Street Journal, 8/5).

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