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Traumatic birth and posttraumatic stress disorder: a review

OBJECTIVE: The objective of this review was to examine the prevalence and risk factors of traumatic birth and childbirth-related posttraumatic stress disorder. METHODS: A literature search was carried out on the PubMed and BIREME databases using the search strings "traumatic birth", "traumatic delivery", "postpartum posttraumatic stress disorder", "childbirth" and "stress disorder". The search encompassed articles on prevalence and risk factors of traumatic delivery and childbirth-related posttraumatic stress disorder published between 1994 and 2009. RESULTS: Three qualitative and four quantitative studies on traumatic delivery revealed a rate ranging from 21.4% to 34%. Traumatic delivery is defined when, during labor or delivery, the mother presents intense fear of her own death or that of her child, besides feelings of impotence, helplessness and horror. Traumatic deliver is associated with painful delivery, emergency obstetric procedures and inadequate care from the health team. With regard to post partum PTSD, one qualitative and twelve quantitative studies were found, reporting a prevalence of 1.3% to 5.9%. Women who presented dissociation symptoms or negative emotions during delivery, or a history of traumatic events, depression in pregnacy, poor social support and a perception of a staff less suportive proved more vulnerable to post partum PTSD. CONCLUSION: Although not well understood, traumatic delivery a relatively common event which negatively impacts women's lives and may be a precursor to post partum PTSD. Health teams charged with caring for women during the peripartum period should be aware of this condition to allow identification and prevention of cases.

Traumatic birth; posttraumatic stress; disorder; puerperium; postpartum


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