Childbirth and the development of post-traumatic stress symptoms: an examination of prevalence and possible contributing factors

Abstract

Prior to the reformulation of diagnostic criteria in the Diagnostic and Statistical Manual -Forth Edition (DSM-IV), it was widely believed that in order to qualify for a diagnosis of post-traumatic stress disorder (PTSD) one had to experience a trauma that was outside the range of normal human experience. However, a growing body of research informed a shift in criteria to include subjective factors in the diagnosis ofthe disorder. Therefore, it was not the event itself that predicted the development ofPTSD, rather a person's reaction to it. Following this shift in thinking it became accepted that women could develop PTSD following childbirth.The aim of the present study was to examine the prevalence of post-traumatic stress symptoms in women one month and three months after giving birth in a NHS hospital in Scotland. In addition a number of potential predictive variables were considered in relation to the development ofPTSD symptoms. They included the number of obstetric interventions experienced by women; locus of control; number of perinatal life events experienced; baby's admission to the Special Care Baby Unit; and co-morbid anxiety and depression in the postpartum period.Sixty-one mothers completed measures assessing PTSD symptomatology and predictive variables one month following delivery. Fifty-two mothers responded three months following delivery.Results revealed that 14.8% of women experienced symptoms suggestive of post¬ traumatic stress disorder one month after giving birth. This figure fell to 9.6% three 1 months after birth. The number of obstetric interventions experienced, locus of control or life events which occurred prior to labour and delivery were not related to the development of symptoms. Events which occurred during labour and delivery significantly differentiated women with more PTSD symptoms at one month but not at three months post-delivery. Events which occurred after delivery significantly differentiated women with PTSD symptoms from those without PTSD symptoms at one month and three months postpartum. Mothers whose infants were admitted to the special care baby unit had more symptoms ofPTSD than those whose infants were not, at one month, but not three months, following delivery. Finally, women who had higher scores for PTSD had significantly higher anxiety and depression scores at one month post-delivery. Only anxiety scores remained significant at three months postdeliveryThe results are discussed in relation to previous research in the area of postpartum PTSD and the limitations of the study and implications for future research are considere

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