Traumatic Childbirth and the Sequelae of Depression

Avatar photoLaurell Haapanen
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Investigators found that comorbid childbirth-related PTSD is often overlooked in postpartum depression screening.

In the postpartum period, women suffer from comorbid depression and post-traumatic stress disorder (PTSD) following a traumatic childbirth experience, according to study results published in the Archives of Women’s Mental Health.

Participants were recruited via study announcements posted on postpartum websites. Eligible women were ≥18 years of age and had given birth to a live infant in the past 6 months. Investigators used various tools to measure general distress and dissociation following childbirth, PTSD symptoms, depressive symptoms, and historical trauma.

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The final sample included 685 women who were an average of 3 months post-childbirth. Elevated postpartum depression symptoms were reported by 57% of the women (n=391); 33% (n=130) experienced prechildbirth depressive symptoms. Probable childbirth-related PTSD was identified in 18% of participants (n=122); 19% (n=26) reported prechildbirth PTSD symptoms. Elevated postpartum depression symptoms were reported by 90% of women (n=123) classified with childbirth-related PTSD, while 31% of women (n=123) classified as having postpartum depression had also experienced childbirth-related PTSD. Investigators determined that the risk for comorbid childbirth-related PTSD and depression comorbidity is higher in mothers who are younger, had prechildbirth mental health problems, experienced a longer childbirth, had an emergency cesarean, and reported higher peritraumatic distress and postpartum general distress.

Future studies could be longitudinal in nature and include a baseline clinical assessment of a woman’s mental health prior to childbirth, as well as objective measures of the childbirth process.

“The findings suggest that beyond postpartum depression, postpartum women suffer from a posttraumatic stress-depressive response in the wake of a traumatic childbirth experience. Increasing awareness in routine postpartum care about traumatic childbirth and its associated emotional sequela is warranted,” the investigators concluded.

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Reference

Dekel S, Ein-Dor T, Dishy GA, Mayopoulos PA. Beyond postpartum depression: posttraumatic stress-depressive response following childbirth [published online October 25, 2019]. Arch Womens Ment Health. doi:10.1007/s00737-019-01006-x