Birth Experience, Postpartum PTSD and Depression before and during the Pandemic of COVID-19 in Russia

The aim of the study is to investigate the changes in the maternal healthcare system during the pandemic and their associations with maternal mental health in Russia. A sample of Russian women who gave birth during the first year of the COVID-19 pandemic (n = 1645) and matched controls, i.e., women who gave birth before the COVID-19 pandemic (n = 611), completed an anonymous Internet survey about recent childbirth. They were assessed for childbirth-related posttraumatic stress disorder (PTSD) and postpartum depression (PPD). Clinically relevant symptoms of PPD and PTSD were high before the pandemic and showed no significant change during the pandemic (p = 0.48 and p = 0.64, respectively). We found a notable increase in the frequency of obstetric violence (p = 0.015) during the pandemic, which, in turn, has a strong correlation with birth-related PTSD and PPD. The problem of ethical communication with patients among maternal healthcare professionals is acute in Russia, and it has been exacerbated by the pandemic. Family and doula support during labor can be a potential protective factor against obstetric violence.

Prevalence and associated factors of post-traumatic stress disorder (PTSD) among a cohort of Srilankan post-partum mothers: a cross-sectional study

Background Post-Traumatic Stress Disorder (PTSD) usually follows a catastrophic event. However, the experience of child birth can be severe enough to cause PTSD in some women. The aim of this study is to highlight the prevalence of Post Traumatic Stress Disorder among a cohort of postpartum mothers. Methods A cross-sectional study was conducted in field clinics of a semi-urban area in Sri Lanka. A pre-tested interviewer administered checklist was used to collect socio-demographic and pregnancy related data. Pre-existing self-administered, validated Sinhalese versions of the Edinburgh Postnatal Depression Scale (EPDS) and PTSD Symptom Scale-Self Report (PSS-SR) were used to assess the presence of Post-Partum Depression (PPD) and PTSD, respectively. Each participant was assessed for PTSD and PPD after one, two and six months following delivery. Scores of PPD > 9 and PSS-SR > 13 were taken as screening positive for the two conditions, respectively. Results Two hundred and twenty-five mothers at the end of postpartum one month were recruited for the study. The response rate at their follow-up visits at the second and sixth months were 95 % (n = 214) and 93 % (n = 211). The prevalence of postpartum PTSD was 2.7 % (n = 6), 0.9 % (n = 2) and 0.5 % (n = 1) after one, two and sixth months respectively. Prevalence of postpartum PTSD was 3.6 % over 6 months. Verbal abuse during labour (p = 0.04) and the presence of postpartum depression (P ≤ 0.001) were significantly associated with postpartum PTSD. There were no significant associations between PTSD and gestational age at delivery, index pregnancy being a planned pregnancy, a history of subfertility, family history of psychiatric disorders, intimate partner violence, receiving antenatal counseling, type and mode of delivery, duration of labour, presence of a labour companion, post-partum hemorrhage, manual removal of placenta, negative birth experience, low APGAR score of the baby at delivery, receiving neonatal and maternal intensive care, birth defects, problems with breast feeding or opportunity to discuss with a health care worker. Conclusions Prevalence of postpartum PTSD in this community-based study is 3.6 %; which is comparable with the overall global prevalence. PTSD was significantly associated with verbal abuse during labour and postpartum depression.

Prevalence and Associated Factors of Post-Traumatic Stress Disorder (PTSD) Among a Cohort of Post-Partum Sri Lankan women: A Cross Sectional Study

BackgroundPost-Traumatic Stress Disorder (PTSD) usually follows a catastrophic event. However, the experience of child birth can be severe enough to cause PTSD in some women.MethodsA cross-sectional study was conducted in field clinics of a semi-urban area. A pre-tested interviewer administered checklist was used to collect socio-demographic and pregnancy related data. Pre-existing self-administered, validated Sinhalese versions of the Edinburgh Postnatal Depression Scale (EPDS) and PTSD Symptom Scale-Self Report (PSS-SR) were used to assess the presence of Post-Partum Depression (PPD) and PTSD, respectively. Each participant was assessed at one, two and six months after the delivery for PTSD and PPD. Scores of PPD >9 and PSS-SR >13 were taken as positive for the two conditions, respectively. ResultsData was obtained from 225 women who were at their first month postpartum, for the initial study. The response rate at their follow-up visits at the second and sixth months were 95% (n=214) and 94% (n=211). The point prevalence of postpartum PTSD was recorded as 2.7% (n=6), 0.9% (n=2) and 0.5% (n=1) at their first, second and sixth month postpartum, respectively. A period prevalence of 3.6% was observed over 6 months. Verbal abuse during labour (p=0.04) and the presence of postpartum depression (P≤0.001) were significantly associated with postpartum PTSD. There were no significant associations between PTSD and gestational age at delivery, whether it was a pregnancy planned ahead or not, a history of subfertility, family history of psychiatric disorders, intimate partner violence, receiving antenatal counseling, type and mode of delivery, duration of labour, presence of a labour companion, mental trauma, presence of post-partum hemorrhage, manual removal of placenta, negative birth experience, low APGAR score of the baby at delivery, receiving neonatal and maternal intensive care, birth defects, problems with breast feeding or opportunities to discuss problems with a health care worker. ConclusionsPrevalence of postpartum PTSD in this semi-urban community during the study period was 3.6%; which is in par with the overall global prevalence. PTSD was significantly associated with verbal abuse during labour and postpartum depression.

Posttraumatic Stress Disorder Postpartum of a Woman Recovered from Drug Addiction: A Case Report

There is high degree of prevalence and variety of risk factors of postpartum Posttraumatic Stress Disorder (PTSD). However, some postpartum women seem to struggle with their past traumatic life events and previous PTSD can result in them sinking deeper into a new PTSD, a postpartum PTSD. The person who has undergone detoxification has endured a very painful process and there is a strong association between drug addiction and mortality. The aim of this case report study is to raise the understanding of health professionals regarding the impact that these two factors might have on ex-drug addicted women. Data were collected from the Maternity unit of the University Hospital of Larisa in Greece. A mother on day 2 after elective cesarean section confirmed her participation and filled in a Life Events Checklist (LEC-5), Posttraumatic Checklist (PCL-5), Criteria A, and a socio-demographic questionnaire. After the sixth postpartum week, the woman answered via telephone, adapted for postpartum PCL-5. This case study describes vividly and painfully the impact of past drug addiction not only on her cesarean section but also how it affected her postpartum period. Eight past traumatic life events led to the creation of a chronic PTSD, i.e., trauma re-experiencing, avoidance, negative thoughts and feelings, agitation, and reactivity. Unfortunately, in cases of traumatic childbirth, especially cesarean section, when there are past traumatic experiences, such as addiction or sexual abuse, postpartum PTSD is an unbearable experience.

The Use of Prolonged Exposure Therapy Augmented With CBT to Treat Postpartum Trauma

Approximately 1% to 2% of women suffer from posttraumatic stress disorder (PTSD) following childbirth, with obstetric emergencies being a key risk factor for birth-related PTSD. The current study augmented prolonged exposure (PE) with cognitive behavioral therapy (CBT) to treat symptoms of PTSD, anxiety, depression, panic disorder, and agoraphobia in a 28-year-old married Hispanic female following a life-threatening case of postpartum preeclampsia. To target distressing symptoms and reach treatment goals, the patient engaged in two preparatory sessions, 12 active PE sessions, and five supplementary CBT sessions. Posttreatment assessment indicated a significant reduction of anxiety and depressive symptoms. Panic attacks reduced in frequency and severity, and by the end of treatment, the patient no longer met criteria for PTSD, major depressive disorder (MDD), or agoraphobia. In the case of postpartum PTSD, CBT can augment PE treatment to reduce symptomatology.

The impact of postpartum post-traumatic stress disorder symptoms on child development: a population-based, 2-year follow-up study

BackgroundAgainst the background of very limited evidence, the present study aimed to prospectively examine the impact of maternal postpartum post-traumatic stress disorder (PTSD) symptoms on four important areas of child development, i.e. gross motor, fine motor, communication and social–emotional development.MethodThis study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record as well as questionnaire data from 8 weeks and 2 years postpartum were used (n = 1472). The domains of child development that were significantly correlated with PTSD symptoms were entered into regression analyses. Interaction analyses were run to test whether the influence of postpartum PTSD symptoms on child development was moderated by child sex or infant temperament.ResultsPostpartum PTSD symptoms had a prospective relationship with poor child social–emotional development 2 years later. This relationship remained significant even when adjusting for confounders such as maternal depression and anxiety or infant temperament. Both child sex and infant temperament moderated the association between maternal PTSD symptoms and child social–emotional development, i.e. with increasing maternal PTSD symptom load, boys and children with a difficult temperament were shown to have comparatively higher levels of social–emotional problems.ConclusionsExamining four different domains of child development, we found a prospective impact of postpartum PTSD symptoms on children's social–emotional development at 2 years of age. Our findings suggest that both boys and children with an early difficult temperament may be particularly susceptible to the adverse impact of postpartum PTSD symptoms. Additional studies are needed to further investigate the mechanisms at work.