Predicting Posttraumatic Stress Disorder after Childbirth
O’Donovan, A.; Alcorn, K.L.; Patrick, J.C.; Creedy, D.K.; Dawe, S. & Devilly, G.J. (2014).
A prospective longitudinal study of which factors predict PTSD after childbirth in a sample of 933 women. Fourteen predictors distinguished women who reported childbirth related PTSD from those who did not. Of these, 11 were pre-birth factors and 3 were birth-related. Pre-birth factors predominantly consisted of previous traumatic events, with personal characteristics and psychological history. Birth-related predictors were feelings, pain and poor perceived control/dissociation during labour.
Partner experiences of ‘near-miss’ events in pregnancy and childbirth in the UK: A qualitative study.
Hinton, L., Locock, L., Knight, M. (2014 )
Qualitative study of 35 women who experienced a life-threatening obstetric emergency during the birth of their child and 11 of their partners. Partners reported the emergency during birth as shocking and distressing and they felt powerless and excluded. Support and good communication from staff were very important. Some reported severe long-term emotional effects, including depression, flashbacks and PTSD. Partners felt there was little support or acknowledgement of these experiences.
Transition to parenthood and mental health in first-time parents.
Parfitt, Y., & Ayers, S. (2014)
A study of 40 couples having their first baby using semi-structured clinical interviews five months after birth. One in four men and women reported anxiety in pregnancy, reducing to 21% of women and 8% of men after birth. Postpartum PTSD was experienced by 5% of parents. Postpartum mental health problems were significantly associated with postpartum sleep deprivation, complications in labour, lack of support, feeling unworthy as a parent, and anger toward the infant. Few gender differences were found.
Factors associated with posttraumatic stress disorder and its coping styles in parents of preterm and full-term infants.
Ghorbani, M., Dolatian, M., Shams, J., Alavi-Majd, H., Tavakolian, S.
This study of 82 couples compared psychological distress and trauma in parents of pre-term infants compared to full-term infants. Mothers of pre-term babies were significantly more likely to experience post-traumatic stress disorder than mothers of full-term infants, but this was not found amongst fathers in the two groups. Furthermore, differences in coping were identified between mothers in the two groups and between fathers in the two groups. The authors recommend that education strategies should consider means of facilitating adaptive coping styles in parents of pre-term infants.
Iranian mothers’ perceptions of the impact of the environment on psychological birth trauma: A qualitative study.
The authors conducted interviews with 23 women in Iran in order to ascertain environmental effects upon their childbirth experience. Content analysis identified two main themes: human and non-human environment. Within these, a number of categories emerged: communication with the mother, awareness of mother’s needs, support for mother, medical clinical competence, professional responsibility, hospital’s physical structure, hospital’s equipment, routine care in hospital and rules governing the hospital environment. The authors discuss the need for interventions to improve human and non-human environment in pursuit of reduced childbirth related trauma.
A Quasi-experimental Outcomes Analysis of a Psychoeducation Intervention for Pregnant Women with Abuse-related Posttraumatic Stress.
This study, part of a larger trial, aimed to test the effectiveness of a psycho-educational intervention in women exposed to childhood mistreatment. Women were recruited in pregnancy. They either participated as part of a pre-test post-test intervention study (N = 17) or as part of a matched prospective observational study during which women received treatment as usual (N = 43). Women in the intervention group had better mean scores on measures of post-traumatic stress, depression, mother-infant bonding, perceptions of care, dissociation of labour and experience of labour, but only dissociation in labour and perceptions of care were statistically significant. The authors conclude that the intervention appears to improve the labour experience of women exposed to prior trauma.
Childbirth related fears and psychological birth trauma in younger and older age adolescents.
This study explored adolescents’ fears about traumatic birth. A convenience sample of 201 adolescents completed measures of childbirth fear and childbirth related trauma. The majority of the sample reported fear. There were some differences between ages, with younger participants more likely to report higher overall fear ratings and less likely to report fear of loss of control and fear of dying. Just over 29% of adolescents reported subclinical traumatic stress scores, 32% scored mild to moderate on traumatic stress and 6.7% scored in the severe range. There were no significant differences across ages.
The role of labor pain and overall birth experience in the development of posttraumatic stress symptoms: a longitudinal cohort study.
A prospective longitudinal study of 1893 women who delivered their babies by SVD. Data was collected during pregnancy, whilst on the maternity ward and eight weeks post-partum. Labour pain and birth experience both significantly contributed to post-traumatic stress symptoms, with overall birth experience mediating the relationship between labour pain and post-traumatic stress. The authors recommend further work to identify childbirth factors that may protect women from negative experience with the aim of improving clinical care.
Exploring the process of writing about and sharing traumatic birth experiences online.
A qualitative study concerned with the acceptability and usefulness of writing about traumatic birth experience. Twelve women who had written stories about their traumatic experience for posting on-line were interviewed just after writing their story and again one month after the story was posted on-line. Overall, women evaluated the intervention positively, particularly being able to organise their experience and to distance themselves from it. The authors suggest that the intervention is worthy of systematic evaluation.
Screening for symptoms of postpartum traumatic stress in a sample of mothers with preterm infants.
This study aimed to identify risk factors for anxiety, depression and traumatic stress in mothers of premature babies. Mothers of babies born at 26 – 34 weeks gestation (N = 135) completed measures of socio-demographic status and of psychological distress. It was not possible to distinguish mothers who scored within ranges indicative of psychological distress from those who did not on the basis of either maternal socio-demographic status or severity of the infant’s medical condition. It is advocated that universal screening should be conducted for symptoms of psychological distress.
Modification and preliminary use of the five-minute speech sample in the postpartum: associations with postnatal depression and posttraumatic stress.
This study considered partner support during birth and its role in birth-related traumatic stress. Speech samples from 372 couples were coded for couple support. Measures of postnatal depression and traumatic stress were completed at six and thirteen weeks’ post-partum. Maternal traumatic stress was associated with criticisms of the partner during childbirth, general relationship criticisms and men’s perception of helplessness. Absence of partner empathy and any positive comments regarding the partner’s support during childbirth were associated with postnatal depression.