PTSD Study

I’m new to del.icio.us (now delicious.com) [my user name is katsyfga, if you’re curious to see what I’ve got saved], and just subscribed to the “birth” tag, and came across this article which was extremely interesting to me:

Study Indicates Higher Incidence of PTSD Than Previously Thought

I’d suggest you read the full article for more information, as well as several links, but here are a couple of quotes:

Some medical experts say that PTSD, most commonly linked to people who have experienced violent events, can also be triggered by a painful or complicated labor and delivery in which a woman believes she or her child might die. PTSD can set in immediately or months after a traumatic event. According to the Journal, the condition often occurs when someone has experienced an event that includes actual or threatened serious injury or death and evokes intense fear or a feeling of helplessness. Symptoms of the condition can include anxiety, flashbacks and a “numbness to daily life,” the Journal reports…..

Health care providers believe the increasing number of obstetric procedures used in labor and delivery could be playing a role in PTSD. Cheryl Beck — a professor at the University of Connecticut School of Nursing, who served as an adviser for the study — said the mothers reporting signs of PTSD had a higher rate of medical intervention and were more likely to describe feeling helpless in a threatening environment. A history of sexual abuse or other trauma also can increase a woman’s risk of experiencing PTSD related to childbirth, the Journal reports.

This makes perfect sense to me. I can’t tell you how many birth stories I’ve read where women relate these feelings — thinking their babies are going to die, feeling helpless and vulnerable on the operating table, being threatened by their so-called “care” providers. While it’s important to note that not everyone who has a difficult or traumatic birth will struggle with depression, the “baby blues” or even post-traumatic stress disorder, it is something to keep in mind.

There may be some limitations to this study, including how scientifically rigorous it is — one time it is described as a “survey”, so it might be biased based on selection criteria. I won’t say that 9% of U.S. mothers will definitely fit the PTSD criteria, while 18% will have several symptoms, just because that’s the results of this study; but I don’t disbelieve it either. I think it is something worth further study, and perhaps a larger study.

The above-mentioned professor said that women who showed more symptoms of PTSD also had more medical interventions. The way this survey was conducted, apparently, was in the form of a questionnaire sent to new mothers, in which they described and rated numerous things, including how breastfeeding was going and how helpful their husbands were with the new baby. So those who interpreted the results had every reason to know how interventive the births were, since that was also included in the survey. But it only makes sense for women who are traumatized while in labor or during birth would feel the effects of post-traumatic stress! Just like those who survive a car wreck or a house fire might.

What to do with the results of this study is another thing. Granting, first, that birth interventions lead to higher rates of trauma and/or stress in the birthing time, and that this can lead to PTSD, what should be done? There were two things mentioned or alluded to in the article, which I might take to be “suggestions” for what to do. 1) Screen women before they leave the hospital (and/or at the 6-week postpartum checkup) for signs and symptoms of depression. 2) Screen women in pregnancy for risk factors for PPD. Some states have mandated the first; a bill recently failed in Congress concerning the second. I’ve got a third suggestion, which seems so obvious it’s almost embarrassing that they didn’t mention it — REDUCE THE NUMBER OF INTERVENTIONS!! Doctors and nurses need to make sure that women don’t feel stressed, traumatized, threatened, scared — anything that is a known risk factor for PTSD — unless absolutely necessary (which is almost never). Secondly, since the level of interventions is somewhat tied to the level of PTSD, doctors and nurses ought to be made aware that their routine use of interventions may be increasing the mental health burden of new mothers. “Congratulations — a bouncing baby… stress disorder!” Just what every new mom really needs, right?

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