Study: Giving birth may increase risk of PTSD

Of the women surveyed following childbirth, study finds that 3.4% suffered from complete PTSD.

Post-traumatic stress disorder (PTSD), a severe anxiety disorder, is usually connected to road accidents, terror attacks and other emotionally shocking events in a person's life that overwhelm the person and his or her ability to cope. Symptoms for PTSD include reexperiencing the original trauma through flashbacks or nightmares, lack of interest in what the victim previously enjoyed and difficulty sleeping, among others that cause serious functional impairment.

Could it be that giving birth - a natural and normal process - could cause PTSD? Doctors at the Beer Ya'acov Mental Health Center and Sheba Medical Center's obstetrics department studied this question by examining 89 women who had just given birth and following them up a month later. The results of the study were published recently in the Israel Medical Association Journal (IMAJ).

The women were examined and questioned about childbirth expectations and delivery, personality, demographic variables and other factors.

When assessed for PTSD, 3.4% of the women were found to suffer from the complete form, 7.9% from the nearly complete form and 25.8% from significant partial PTSD. Prof. Rael Strous, Dr. Inbal Shlomi Polachek and colleagues wrote that women who developed PTSD symptoms had higher prevalence of trauma in previous births, followed by subsequent depression and anxiety. They also suffered more medical complications and "mental crises" during pregnancy and had anticipated more pain and fear while giving birth. Giving birth by cesarean section was not linked to PTSD, but most of the women with the symptoms who had regular vaginal births reported getting fewer painkillers, had stronger feelings of danger, were uncomfortable about being undressed or had higher rates of not wanting to have more children.

The team recommended that before women give birth, obstetric department staffers should ask them about their previous pregnancies and birthing experiences and to identify at-risk populations.

The authors concluded that doctors and midwives should be more aware of the possibility of PTSD, which can be treated - and the sooner the better - among mothers giving birth. Their dignity, including modesty, should be respected and preserved. Presenting the woman with a short questionnaire after delivery could make it possible to identify PTSD rapidly for the benefit of the patient, they concluded.