Abstract
Problem
Post-traumatic stress disorder and post-traumatic stress symptoms following birth
occur amongst a small proportion of women but can lead to poor maternal mental health,
impairment in mother-infant bonding and relationship stress. This integrative review
aims to examine the associated risk factors and women's own experiences of postnatal
post-traumatic stress in order to better understand this phenomenon.
Method
Fifty three articles were included and critically reviewed using the relevant Critical
Appraisal Skills Program checklists or Strengthening the Reporting of Observational
studies in Epidemiology assessment tool.
Findings
Risk factors for postnatal post-traumatic stress symptoms and disorder include factors
arising before pregnancy, during the antenatal period, in labour and birth and in
the postnatal period. Potential protective factors against postnatal post-traumatic
stress have been identified in a few studies. The development of postnatal post-traumatic
stress can lead to negative outcomes for women, infants and families.
Discussion
Risk factors for post-traumatic stress symptoms and disorder are potentially identifiable
pre-pregnancy and during the antenatal, intrapartum and postnatal periods. Potential
protective factors have been identified however they are presently under researched.
Predictive models for postnatal post-traumatic stress disorder development have been
proposed, however further investigation is required to test such models in a variety
of settings.
Conclusions
Postnatal post-traumatic stress symptoms and disorder have been shown to negatively
impact the lives of childbearing women. Further investigation into methods and models
for identifying women at risk of developing postnatal post-traumatic stress following
childbirth is required in order to improve outcomes for this population of women.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Women and BirthAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Birth trauma: in the eye of the beholder.Nurs Res. 2004; 53: 28-35
- Childbirth and criteria for traumatic events.Midwifery. 2014; 30: 255-261
- Diagnostic and statistical manual of mental disorders.5 ed. American Psychiatric Publishing, Arlington, VA2013
- Posttraumatic stress disorder in new mothers: results from a two-stage U.S. National Survey.Birth. 2011; 38: 216-227
- Post-traumatic stress disorder related to birth: a prospective longitudinal study in a French population.J Reprod Infant Psychol. 2011; 29: 125-135
- Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms.Psychol Health. 2011; 26: 1553-1570
- Post-traumatic stress symptoms, parenting stress and mother-child relationships following childbirth and at 2 years postpartum.J Psychosom Obstet Gynecol. 2011; 32: 141-146
- Post-traumatic stress symptoms after childbirth and early mother-child interactions: an exploratory study.J Reprod Infant Psychol. 2014; 32: 163-181
- The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study.Psychol Health Med. 2006; 11: 389-398
- The integrative review: updated methodology.J Adv Nurs. 2005; 52: 546-553
- Posttraumatic stress following childbirth: a review.Clin Psychol Rev. 2006; 26: 1-16
- CASP checklists.2014
Strengthening the reporting of observational studies in epidemiology (STROBE) statement. STROBE statement — checklist of items that should be included in reports of cross-sectional studies. 2007. http://www.strobe-statement.org/index.php?id=available-checklists.
- Maintaining factors of posttraumatic stress symptoms following childbirth: a population-based, two-year follow-up study.J Affect Disord. 2014; 172: 146-152
- Predictors of posttraumatic stress symptoms following childbirth.BMC Psychiatry. 2014; 14
- PTSD following childbirth: a prospective study of incidence and risk factors in Canadian women.J Psychosom Res. 2012; 73: 257-263
- Post-traumatic stress disorder post partum: the impact of birth on the prevalence of post-traumatic stress disorder (PTSD) in multiparous women.Geburtshilfe Frauenheilkd. 2012; 72: 56-63
- Postpartum post-traumatic stress disorder symptoms: the uninvited birth companion.Isr Med Assoc J. 2012; 14: 347-353
- Predicting posttraumatic stress disorder after childbirth.Midwifery. 2014; 30: 935-941
- Posttraumatic stress disorder after pregnancy labor, and delivery.J Womens Health. 2004; 13: 315-324
- Posttraumatic stress disorder after childbirth: analysis of symptom presentation and sampling.J Affect Disord. 2009; 119: 200-204
- Childhood sexual abuse, intimate partner violence during pregnancy, and posttraumatic stress symptoms following childbirth: a path analysis.Arch Womens Ment Health. 2017; 20: 297-309
- Prediction of posttraumatic stress disorder symptomatology after childbirth — a Croatian longitudinal study.Women Birth. 2017; 30: e17-e23
- Bio-socio-demographic factors associated with post-traumatic stress disorder in a sample of postpartum Brazilian women.Arch Womens Ment Health. 2011; 14: 435-439
- A simple model for prediction postpartum PTSD in high-risk pregnancies.Arch Womens Ment Health. 2015;
- PTSD after childbirth: a predictive ethological model for symptom development.J Affect Disord. 2015; 185: 135-143
- Predictors of birth-related post-traumatic stress symptoms: secondary analysis of a cohort study.Arch Womens Ment Health. 2016; : 1-13
- Relational factors in psychopathological responses to childbirth.J Psychosom Obstet Gynecol. 2006; 27: 91-97
- Fear of childbirth and obstetrical events as predictors of postnatal symptoms of depression and post-traumatic stress disorder.J Psychosom Obstet Gynecol. 2007; 28: 239-242
- Risk factors associated with post-traumatic stress symptoms following childbirth in Turkey.Midwifery. 2016; 41: 96-103
- Symptoms of post-traumatic stress after preeclampsia.J Psychosom Obstet Gynecol. 2011; 32: 126-134
- Prevalence and risk factors of childbirth-related post-traumatic stress symptoms.BMC Pregnancy Childbirth. 2012; : 12
- Post-traumatic stress disorder after childbirth in Nigerian women: prevalence and risk factors.BJOG. 2006; 113: 284-288
- Postpartum anxiety in a cohort of women from the general population: risk factors and association with depression during last week of pregnancy, postpartum depression and postpartum PTSD.Isr J Psychiatry Relat Sci. 2014; 51: 128-134
- Aetiological relationships between factors associated with postnatal traumatic symptoms among Japanese primiparas and multiparas: a longitudinal study.Midwifery. 2017; 44: 14-23
- Post-traumatic stress disorder after childbirth and the influence of maternity team care during labour and birth: a cohort study.Midwifery. 2015;
- Testing a cognitive model to predict posttraumatic stress disorder following childbirth.BMC Pregnancy Childbirth. 2017; 17: 1-12
- The role of adult attachment style, birth intervention and support in posttraumatic stress after childbirth: a prospective study.J Affect Disord. 2014; 155: 295-298
- Posttraumatic stress following childbirth in homelike- and hospital settings.J Psychosom Obstet Gynecol. 2011; 32: 88-97
- The psychological consequences of childbirth.J Reprod Infant Psychol. 2008; 26: 108-122
- Exploration of a cognitive model to predict post-traumatic stress symptoms following childbirth.J Anxiety Disord. 2010; 24: 353-359
- Psychological trauma symptoms of operative birth.Br J Midwifery. 2005; 13: 218-224
- The influence of childbirth experiences on women's postpartum traumatic stress symptoms: a comparison between Israeli Jewish and Arab women.Midwifery. 2015; 31: 625-632
- Anxiety, post-traumatic stress disorder and social supports among parents of premature and full-term infants.Iran Red Crescent Med J. 2014; 16
- Effects of an early intervention on maternal post-traumatic stress symptoms and the quality of mother-infant interaction: the case of preterm birth.Infant Behav Dev. 2014; 37: 624-631
- What makes labour and birth traumatic? A survey of intrapartum ‘hotspots’.Psychol Health. 2012; 27: 1166-1177
- Progress of PTSD symptoms following birth: a prospective study in mothers of high-risk infants.J Perinatol. 2015; 35: 575-579
- A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events.Psychol Med. 2010; 40: 1849-1859
- Symptoms of post-traumatic stress disorder in couples after birth: association with the couple's relationship and parent-baby bond.J Reprod Infant Psychol. 2007; 25: 40-50
- Post-traumatic stress disorder in parturients delivering by caesarean section and the implication of anaesthesia: a prospective cohort study.Health Qual Life Outcomes. 2017; 15: 1-13
- Predisposing and precipitating factors for dissociation during labor in a cohort study of posttraumatic stress disorder and childbearing outcomes.J Midwifery Womens Health. 2016; 61: 68-76
- Postnatal debriefing: have we thrown the baby out with the bath water?.Behav Res Ther. 2011; 49: 367-372
- Psychological assessment of the adult posttraumatic state: phenomenology, diagnosis and measurement.2nd ed. 2004 (Washington, D.C.)
- riedman M. Keane T. Resick P. Handbook of PTSD. 2nd ed. The Guildford Press, New York, NY2014
- Posttraumatic stress symptoms following childbirth and mothers' perceptions of their infants.Infant Mental Health J. 2008; 29: 537-554
- In first-time mothers, post-partum depressive symptom prospectively predict symptoms of post-traumatic stress.J Affect Disord. 2015; 186: 168-170
- Hyperarousal symptoms after traumatic and nontraumatic births.J Reprod Infant Psychol. 2015; 33: 282-293
- The effect of the magical hour on post-traumatic stress disorder (PTSD) in traumatic childbirth: a clinical trial.J Reprod Infant Psychol. 2016; 34: 403-412
- Cognitive biases in processing infant emotion by women with depression, anxiety and post-traumatic stress disorder in pregnancy or after birth: a systematic review.Cogn Emot. 2015; 29: 1278-1294
- Post-traumatic stress disorder due to childbirth: the aftermath.Nurs Res. 2004; 53: 216-224
- Childbirth-related post-traumatic stress disorder in couples: a qualitative study.Br J Health Psychol. 2007; 12: 491-509
- The impact of postpartum post-traumatic stress disorder symptoms on child development: a population-based, 2-year follow-up study.Psychol Med. 2017; 47: 161-170
- Narratives of traumatic birth: quality and changes over time.Psychol Trauma. 2015; 7: 234-242
- Changing the future to change the past: women’s experiences of a positive birth following a traumatic birth experience.J Reprod Infant Psychol. 2010; 28: 102-112
- Mother-infant attachment and the intergenerational transmission of posttraumatic stress disorder.Dev Psychopathol. 2014; 26: 41-65
- Think pink! A sticker alert system for psychological distress or vulnerability during pregnancy.Br J Midwifery. 2014; 22: 590-595
- Midwife-led continuity models versus other models of care for childbearing women.Cochrane Database Syst Rev. 2016;
- A cognitive model of posttraumatic stress disorder.Behav Res Ther. 2000; 38: 319-345
- The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework.Psychol Med. 2016; 46: 1121-1134
- Child and family outcomes of a long-term nurse home visitation programme: a randomised controlled trial.Arch Dis Child. 2011; 96: 533
- Therapeutic interventions in perinatal and infant mental health services: a mixed methods inquiry.Issues Ment Health Nurs. 2014; 35: 372-385
- Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial.Birth. 2005; 32: 11-19
Article info
Publication history
Published online: January 11, 2018
Accepted:
December 4,
2017
Received in revised form:
November 24,
2017
Received:
August 13,
2017
Identification
Copyright
© 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
