Post-traumatic stress disorder after childbirth: different from depression

Around 3 to 6 per cent of all women giving birth develop PTSD. While depression is often recognised, this is not the case for postpartum PTSD.

What is postpartum PTSD?

Post-traumatic stress disorder after childbirth: does it really exist?

For many people, the birth of a child is a most natural and common process. People often are aware that it is not a pleasant experience, but what many people don't realise is that the birth process can actually be traumatic. It is irrelevant whether the delivery was medically simple or complicated. The traumatisation threshold is individual for each person. Experts estimate that around 3% to 6% of all women giving birth develop full-blown post-traumatic stress disorder.

Is PTSD the same as depression?

Postnatal PTSD and postnatal depression are not the same thing. Whilst both occur after or during childbirth, there are clear differences. For example, depression is characterised by listlessness, a depressed mood or a feeling of worthlessness and even suicidal tendencies, for most hours of the day for at least two weeks.

PTSD, however, is characterised by flashbacks, re-experiencing, avoidance behaviour and unstable attachments. The symptoms persist for at least four weeks. Only then can PTSD be diagnosed. However, a much longer period of time can pass before a diagnosis is made.

What are the consequences of untreated PTSD?

Similar to untreated depression, inadequately treated PTSD can significantly impair the patient's quality of life. Suicidal behaviour is also possible. In addition, studies have shown that the child's social and emotional development can be negatively affected if the mother is not treated.

What to do if PTSD is suspected?

It is important to take the mother seriously and to enquire directly if a traumatic birth experience is suspected. Many women are reluctant to raise the subject on their own initiative for fear of unappreciative reactions - but also for fear of being seen as a bad mother. It is also not uncommon for them to worry that the youth welfare office might become involved.

If postnatal PTSD is suspected, the affected person should be referred to a specialist, preferably a psychiatrist. Most post-traumatic stress disorders can be treated well with appropriate therapy.

Take-away for medical practice

Post-traumatic stress disorders after childbirth are not uncommon and can often be found even in an objectively uncomplicated labour process. Any woman giving birth can suffer from it. The diagnosis is not made until four weeks after the stressful event, which is why it is particularly important to screen patients in private practice and take them seriously. Treatment should be provided by a psychiatrist.

  1. BMJ 2022;377:e067659