Abstract
ABSTRACT
For a long time it has been known that a childbirth can bee traumatic for some women. With the changes in DSM-IV in 1994, the diagnosis of Posttraumatic Stress Disorder (PTSD) can be made based upon a traumatic birth experience.
Based on a literature search, this paper look at the experience of a traumatic birth, and how it can develop into postnatal PTSD. It also looks at the incident, potential risk factors and treatment for postnatal PTSD.
A MEDLINE, PSYCHLIT and COCHRANE database search using the key words: “childbirth”, “trauma”, “PTSD”, “support”, “treatment”, and “traumatic delivery”, was performed. The list of articles where supplemented by a review of their references.
Case studies and qualitative studies show that PTSD can occur in the postnatal period. Quantitative studies show that one in three women appraise childbirth as traumatic, about 10 % have posttraumatic stress symptoms and between 0,9-5,9 % develop PTSD postnatalt. The studies are mostly retrospective, and it is difficult to know how many women who already have PTSD when in labour. The only study of PTSD in pregnancy, found a PTSD incident of 8.1 % prenatal. The research in this field is limited, and differs widely in terms of measures, screening tool,, methods used, and look at different risk factors. The current research suggests however, that a history of previous trauma or psychiatric problems, level of obstetric intervention, and low support during delivery, can increase a woman`s risk of developing PTSD. Other identified risk factors where: The subjective experience of pain, unmet expectations, lack of control, and peritraumatic dissociation. There is no simple answer to the question why some women develop PTSD after a traumatic childbirth, but a combination of risk factors is suggested. There is also some controversy whether a debriefing session is effective in preventing the development of PTSD postnatalt. Despite this controversy, debriefing seems to be increasingly used, and the women report feeling better when getting the opportunity to talk about their traumatic experience. There are just a few studies looking at treatment of Posttraumatic Stress Symptoms postnatalt. They suggest that a brief cognitive behaviour therapy is most effective. When it comes to postnatal PTSD, no study has looked at the treatment. However in the general trauma literature, it suggests the usefulness of a longer cognitive behaviour therapy. There is an urgent need for more research on this topic!