Psychological Medicine

Original Articles

A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events

K. L. Alcorna1, A. O'Donovana1, J. C. Patricka2, D. Creedya3 and G. J. Devillya1a4 c1

a1 School of Psychology, Griffith University, Queensland, Australia

a2 Department of Psychology, University of Southern Queensland, Queensland, Australia

a3 Griffith Health, Griffith University, Queensland, Australia

a4 Griffith Institute for Health & Medical Research, Griffith University, Queensland, Australia

Abstract

Background Childbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology.

Method Pregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4–6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum.

Results Of the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4–6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4–6 weeks postpartum, 6.3% at 12 weeks postpartum and 5.8% at 24 weeks postpartum. When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinically significant anxiety and depression during pregnancy, PTSD rates were less at 1.2% at 4–6 weeks, 3.1% at 12 weeks and 3.1% at 24 weeks postpartum.

Conclusions This is the first study to demonstrate the occurrence of full criteria PTSD resulting from childbirth after controlling for pre-existing PTSD and partial PTSD and clinically significant depression and anxiety in pregnancy. The findings indicate that PTSD can result from a traumatic birth experience, though this is not the normative response.

(Received September 15 2009)

(Revised November 18 2009)

(Accepted November 21 2009)

(Online publication January 11 2010)

Correspondence

c1 Address for correspondence: Dr G. J. Devilly, School of Psychology and Griffith Institute for Health & Medical Research, Griffith University, Mt Gravatt, Qld 4122, Australia. (Email: grant@devilly.org) (Email: a.odonovan@griffith.edu.au)

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