When the Birth Process Is Traumatic

Research identifies who is at risk for PTSD after delivery.

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While childbirth is generally joyful, popularly branded as a positive experience, such is not always the case. Stigma makes it hard for those suffering to get help, especially when everyone expects parents to be bathed in an idyllic glow. In addition to the trials and tribulations surrounding conception, not to mention the challenges of parenting, there is a growing awareness that the birthing process may be traumatic.

Cross-sectional studies (e.g. those that are but a snapshot in time) suggest that factors including emergency childbirth, prior trauma, and adversity during childbirth increase the risk of maternal PTSD and may interfere with the mother-infant bond (Ertan et al., 2021). Research has estimated the risk of PTSD following childbirth from 0 to 21 percent for usual-risk pregnancies, and up to 43 percent in high-risk pregnancies (Khoramroudi, 2018). Fathers also may experience postpartum problems, and over 7 percent report PTSD symptoms after birth (Shobinger et al., 2018). They, too, may suffer depression and anxiety, which interfere with bonding and childcare.

The Stress of Giving Birth

Prospective studies, those that track participants starting before an event occurs or a problem develops and follows them over time, furnish us with more powerful data on causal factors, versus looking for patterns in retrospect. A recent study of PTSD and childbirth, reported in the Archives of Gynecology and Obstetrics, followed nearly 600 women (there were a total of 2,000 asked to participate in a community delivery setting) who agreed to participate in the study.

Participants completed a PTSD scale (the Impact of Events Scale) within a few days of giving birth and again six months later. PTSD symptoms (e.g. avoidance, intrusions, hyperarousal/agitation) were tracked in relation to factors including maternal age, number of prior children, migration status, pregnancy-related illness, support available to mothers during labor, duration of labor, injuries and complications during birthing (e.g. episiotomy), delivery method (vaginal approaches, Caesarian), and weight and head size of the baby.