Postnatal depression and post-traumatic stress after childbirth: Prevalence, course and co-occurrence

Research relating to the postnatal mental health of women has tended to focus on postnatal depression. There have been increasing calls to consider the issue of post-partum anxiety disorders, including post-traumatic stress disorder (PTSD). This study sought to provide further evidence regarding the prevalence and longitudinal course of post-traumatic stress symptoms resulting from traumatic birth experiences. The study also investigated the extent to which symptoms of trauma and depression occur together in the postnatal period. Four hundred women were recruited from the maternity ward of a public hospital in South West Sydney. Symptoms of birth trauma and postnatal depression were assessed via questionnaires given at birth, 6 weeks, 6 months and 12 months post-partum. The prevalence of having a PTSD profile at 6 weeks post-partum was 2%. A further 10.5% of women reported experiencing significant distress related to childbirth and several symptoms of post-traumatic stress without meeting full diagnostic criteria. The prevalence of a PTSD profile remained relatively stable across the first 12 months post-partum, with estimates being 2.6% at 6 months and 2.4% at 12 months. The co-morbidity between post-traumatic stress and postnatal depression was high at all three time points. The study highlights the potentially chronic nature of PTSD after childbirth and the importance of viewing post-partum emotional distress in a broader context than simply postnatal depression.