From the Research
Traumatic childbirth can have severe psychological consequences, including posttraumatic stress disorder (PTSD), and it is essential to identify the essential components of traumatic birth and provide proper support to prevent long-term negative consequences. The article "Childbirth and criteria for traumatic events" 1 examines how women can experience childbirth as traumatic, leading to significant psychological consequences. Essential components of traumatic birth identified include perceived threat to life or physical integrity, feelings of powerlessness, inadequate pain management, lack of support from healthcare providers, emergency interventions like unplanned cesarean sections, and perceived loss of dignity or control during labor.
The authors found that short-term impacts include acute stress reactions, anxiety, depression, and difficulties with mother-infant bonding in the immediate postpartum period. Long-term consequences can include full posttraumatic stress disorder (PTSD) in a significant percentage of women, with symptoms persisting for months or years, affecting maternal self-concept, intimate relationships, and future reproductive decisions. Some women develop fear of future childbirth (tokophobia) and may avoid subsequent pregnancies.
Some of the key factors that contribute to the development of PTSD after traumatic childbirth include pre-existing psychiatric morbidity, being a first-time mother, and experiencing an emergency caesarean section 1. The study also highlights the importance of the fear response as a diagnostic criterion for assessing psychologically traumatic childbirth.
Interestingly, the article "The childbirth experience: A systematic review of predictors and outcomes" 2 also noted potential positive outcomes indicative of posttraumatic growth, including increased personal strength, deeper appreciation for life, enhanced empathy for others experiencing trauma, improved interpersonal relationships, and development of effective coping strategies. Some women reported that working through their traumatic birth experience led to personal transformation, advocacy for improved maternity care, and a deeper connection with their children after processing their trauma.
The most recent and highest quality study, "The childbirth experience: A systematic review of predictors and outcomes" 2, suggests that a salutogenic perspective is required to fully understand childbirth experiences, and that understanding the range of experiences is essential to support women's rights in achieving a positive birth. This study highlights the need for further research into the factors that contribute to positive birth experiences and the development of effective interventions to prevent traumatic birth and promote posttraumatic growth.
In terms of treatment, the study "Medication versus trauma-focused psychotherapy for adults with posttraumatic stress disorder: A systematic review and meta-analysis" 3 found that there is insufficient evidence to determine whether selective serotonin reuptake inhibitors (SSRIs) or trauma-focused psychotherapies are more effective for PTSD symptom reduction among adults with PTSD. However, the study "Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: systematic review and meta-analysis" 4 found that eye movement desensitization and reprocessing (EMDR) may be more suitable than cognitive-behavioral therapy (CBT) for PTSD patients with prominent intrusion or arousal symptoms.
Overall, the evidence suggests that traumatic childbirth can have severe psychological consequences, but with proper support, some women can experience meaningful psychological growth through the process of recovery. It is essential to prioritize the prevention of traumatic birth and the promotion of posttraumatic growth, and to provide women with access to effective treatments, including trauma-focused psychotherapies and medication, to reduce the risk of long-term negative consequences.