Although health workers and psychologists are increasingly aware of postnatal depression, post-traumatic stress disorder goes widely unrecognised. Some PTSD symptoms are very similar to those experienced by those with postnatal depression, so health professionals sometimes misdiagnose the condition. However, the conditions are distinct and women with PTSD often go undetected by health workers as this is not a condition that is routinely screened for.
Posttraumatic stress can develop after exposure to a frightening event or ordeal in which physical harm occurred or was threatened. Studies suggest between 2 - 5% of women might develop PTSD following difficult and traumatic childbirth, and a much larger number are likely to suffer from some of the symptoms of PTSD, such as intrusive thoughts about what happened and nightmares, even if they don't develop the full syndrome.
Individuals with post-traumatic stress suffer from painful mental images of the traumatic experience, including recurrent dreams. Symptoms also include avoidance of stimuli associated with everything that might remind them of the experience, emotional detachment from others and an inability to relax. Dr Stephen Joseph's study "Post-traumatic stress following childbirth" suggests that sexual avoidance, birth flashbacks, fear of childbirth and parenting problems are symptoms specific to women who undergo difficult childbirth and develop posttraumatic stress symptoms.
Dr Stephen Joseph said: "It's been long recognised that women can go on to develop psychological problems following childbirth, and this study clearly suggests that some suffer from post-traumatic stress. Cases indicate that women who experience PTSD symptoms such as bonding difficulties or fearfulness of their babies could have a detrimental affect on the early relationship between a woman and her baby."
"There is a need for the condition to be more widely recognised by health visitors and other primary care staff as women would benefit from better after-care trauma services, such as counselling. The findings underscore the need to identify the most vulnerable women early in their pregnancy to provide extra support and to be aware of the risk of post-traumatic stress following delivery."
The study also indicates certain factors influence disorder development. A delivery with the aid of an emergency caesarean section or other forms of instrumental delivery increases the risk of post-traumatic stress. Women who felt less well supported by their partner and staff or less well informed about what was happening were also more likely to report PTSD symptoms.
For more information contact: Dr Stephen Joseph, Department of Psychology, University of Warwick, Mobile: 786-780-0320, Tel: 247-652-8182 s.joseph@warwick.ac.uk
Jenny Murray, Assistant Press officer, University of Warwick, Tel: 247-657-4255, Mobile: 787-621-7740 jennifer.murray@warwick.ac.uk
Editor's note: