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Background: Measurement is critical in postnatal posttraumatic stress disorder (PTSD) because symptoms may be influenced by normal postnatal phenomena such as physiological changes and fatigue. Objective: This study examined: (1) whether hyperarousal symptoms differ between women who have traumatic or nontraumatic births; (2) whether the construct of hyperarousal is coherent in postnatal women; and (3) whether hyperarousal symptoms are useful for identifying women who have traumatic births or PTSD.\ud \ud Methods: A survey of PTSD symptoms in 1,078 women recruited via the community or Internet who completed an online or paper questionnaire measuring childbirth-related PTSD symptoms between 1 and 36 months after birth. Women who had a traumatic birth as defined by DSM-IV criterion A (n = 458) were compared with women who did not have a traumatic birth (n = 591). \ud \ud Results: A one-factor dimension of hyperarousal was identified that included all five hyperarousal items. Diagnostic criteria of two or more hyperarousal symptoms in the previous week were reported by 75.3% of women with traumatic birth and 50.5% of women with nontraumatic births. The difference in mean hyperarousal symptoms between groups was substantial at 0.76 of a standard deviation (Hedge’s g, CI = 0.64, 0.89). A larger difference was observed between women with and without diagnostic PTSD (g = 1.64, CI 1.46, 1.81). However, receiver operating characteristic analyses showed hyperarousal symptoms have poor specificity and alternative ways of calculating symptoms did not improve this. Comparison with other PTSD symptoms found re-experiencing symptoms were most accurate at identifying women with traumatic births. \ud \ud Conclusions: Results suggest hyperarousal symptoms are associated with traumatic birth and are a coherent construct in postnatal women. However, they have poor specificity and should only be used as part of diagnostic criteria, not as a sole indicator.

Evidence suggests between 1% and 6% of women develop post-traumatic stress disorder (PTSD) after childbirth. 'Hotspots' are moments of extreme distress during traumatising events that are implicated in symptoms of PTSD. This cross-sectional internet survey of hotspots examined (1) the content of intrapartum hotspots and (2) whether particular events, cognitions or emotions during hotspots are related to PTSD. Women (N = 675) who experienced a difficult or traumatic birth completed a questionnaire composed of a validated measure of PTSD, questions concerning the existence of hotspots, and a newly developed measure of emotions and cognitions during hotspots. The majority of women (67.4%) reported at least one hotspot during birth and 52.9% had re-experiencing symptoms of these hotspots. Women were more likely to have PTSD if hotspots involved fear and lack of control (odds ratio (OR) 1.30, 95% CI 1.17-1.43) or intrapartum dissociation (OR 1.12, 95% CI 1.05-1.19). Risk of PTSD was higher if hotspots concerned interpersonal difficulties (OR 4.34, 95% CI 2.15-8.77) or obstetric complications (OR 3.35, 95% CI 1.64-6.87) compared to complications with the baby.

This paper considers the effect of traumatic delivery on the mother's state of mind and on her relationship with her new baby. Thought is also given to the parental couple's relationship when they have experienced a traumatic delivery. Research associated with traumatic birth experience, post-traumatic stress disorder and the effect on the developing foetus of high levels of anxiety during pregnancy are further discussed. Clinical material is used to illustrate the distress experienced by two mothers when they have felt traumatised by a difficult labour and birth.

The childbirth experience can be a wonderful event, or one of horror. One in 3 adult mothers appraises her childbirth experience as traumatic, with up to 10% of women reporting a severe traumatic stress response post-delivery. The impact of the birth experience on adolescents is unknown.Eighty-five Latinas ages 13 to 19 appraised their childbirth experience and reported symptoms of trauma impact as measured via the Impact of Event Scale (IES) within 72 hours of delivery. Descriptive statistics included demographic, obstetrical, and personal factors, and trauma scores. ANOVAs were used to examine differences in birth appraisal and trauma impact by demographic, obstetrical, and personal factors. Spearman rho and Pearson's r was used to compute correlations between birth appraisal, depression, and trauma impact.One-third of adolescents appraised their childbirth as traumatic; one-half displayed symptoms of trauma impact. Items influencing appraisal of the birth experience included marital status, fear of dying, fear of loss of control, and partner violence. Birth appraisal and symptoms of depression were found to influence trauma impact.One-third of teens appraised childbirth as traumatic with 50% displaying symptoms suggestive of acute trauma at immediate postpartum. Nursing recommendations focus on providing a non-traumatic birth experience and follow-up by mental health professionals for assessment of potential chronic trauma, posttraumatic stress and depression. Teens can enter labor and delivery with stressors, depression, and past traumas; collaboration of care between maternal-child and mental health professionals is encouraged.

This paper reports on how women prepared for, experienced, and internalised a positive birth following a traumatic birth event. An interpretive phenomenological approach was adopted. Analysis was based on Gadamerian philosophical hermeneutics. Fourteen women were recruited through purposive sampling methods. Unstructured in‐depth interviews were conducted across two recruitment phases. The constitutive theme was ‘changing the future to change the past’. The birth stories illustrated how women changed their previous negative childbearing narratives through preparing for and experiencing a positive, joyful birth. Four key themes have been presented: ‘Resolving the past and preparing for the unknown’, ‘Being connected’, ‘Being redeemed’ and ‘Being transformed’. Participants included two women who ended their childbearing experiences with a traumatic birth. Exploration of differences between women who ended their childbearing experiences on trauma or joy has been offered to further develop a theory of redempt...

Reported international rates of posttraumatic stress disorder due to birth trauma range as high as 5.9%. Trauma associated with perinatal events, however, is often lacking in discussions of women's trauma. The main focus of this article is on the description of 3 qualitative studies on birth trauma, posttraumatic stress disorder due to birth trauma, and the anniversary of a traumatic birth. Birth trauma is placed in the context of trauma theory. Implications for clinical practice are addressed.

How is a first time mother able to claim her new identity when a traumatic birth is experienced as a sudden loss, evoking previous unresolved issues of separation? This paper explores a young Bangladeshi mother's gradual reconfiguration of identity amidst the strain of motherhood. This process is reworked within the environment of her family, which presents its own problems in light of the sharing of mothering practices and the conflict with a more traditional Bangladeshi model. Weaning and the importance of a third position provide some internal space in order to work through these issues and encounter the nourishing aspects of motherhood.

Despite the myriad psychosocial aspects of childbirth, psychologists have not contributed extensively to the childbirth literature nor are they identified as a resource for women who are either anticipating or adjusting after an inherently challenging life event. The purpose of this article is to review the current literature on psychosocial aspects of birthing to identify a variety of issues that would be of relevance to psychotherapists. We discuss both normative issues such as women's fears or concerns about giving birth as well as clinical issues such as traumatic birth experiences and complications for women with psychological disorders. Finally, we provide specific suggestions for practitioners so that they are better able to work with women and their partners during this pivotal time in their lives. We argue that psychotherapists are in an ideal position to provide women, particularly those at risk for adverse outcomes, with the support and skills necessary to prepare for, cope during, and...