Natural childbirth is a major cause of post-traumatic stress disorder (PTSD), according to new research.
A Tel Aviv University researcher has discovered that approximately one-third of all postpartum women exhibit some symptoms of PTSD, and a smaller percentage develop full-blown PTSD following labor.
Of the women who developed symptoms, 80 percent opted for natural childbirth without pain relief, reported Professor Rael Strous of TAU’s Sackler Faculty of Medicine.
Other significant factors identified in the study include the woman’s body image, including discomfort about being in an undressed state for a relatively prolonged period of labor and undergoing elective Caesarean sections; fear during labor; and complications in not only this pregnancy, but in earlier ones as well.
Researchers interviewed 89 post-partum women between the ages of 20 and 40, first within five days after delivery and then again one month after delivery.
They discovered that of these women, 25.9 percent displayed symptoms of PTSD, 7.8 percent suffered from partial PTSD, and 3.4 percent exhibited symptoms of full-blown PTSD.
Symptoms included flashbacks of the labor, the avoidance of discussion of the event, physical reactions, such as heart palpitations during such discussions, and a reluctance to consider having another child.
According to Strous, one of the most influential factors was pain management during delivery. Of the women who experienced PTSD symptoms, 80 percent had gone through a natural childbirth, without any form of pain relief.
“The less pain relief there was, the higher the woman’s chances of developing post-partum PTSD,” he said. Of the women who did not develop any PTSD symptoms, only 48 percent experienced a natural childbirth, he added.
A full 80 percent of the PTSD group reported feeling discomfort with being unclothed, and 67 percent had previous pregnancies which they described as traumatic. Fear of the labor itself, both in terms of expected pain levels and danger to themselves and their children, was also influential.
The researchers also discovered that support during labor, in the form of a midwife or doula, had no impact when it came to avoiding PTSD symptoms. Other factors, such as socioeconomic and marital status, level of education, and religion, also had no effect.
Strous suggests doctors become familiar with the profile of women more disposed to suffer from PTSD symptoms, and be on the look-out for warning signs after labor. He also advocates additional research to develop better treatment plans and make more resources available for women.
There are some immediate steps medical professionals can take, Strous added, including better counseling about pain relief and making sure that patients’ bodies are properly covered during delivery.
“Dignity is a factor that should be taken into account,” he said. “It’s an issue of ethics and professionalism, and now we can see that it does have physical and psychological ramifications.”
The study was published in the Israel Medical Association Journal.