Objective The postpartum period is recognized as a time of vulnerability to affective disorders, particularly postpartum depression. In contrast, the prevalence and clinical presentation of anxiety disorders during pregnancy and the postpartum period have received little research attention. In this article, we review the medical literature as it relates to the prevalence and clinical presentation of panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder during pregnancy and the postpartum period. Data sources MEDLINE (1966 to July 2005 week 1) and PsycInfo (1840 to July 2005 week 1) were searched using combinations of the following search terms: pregnancy, childbirth, postpartum, panic disorder, phobia, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder. Study selection All relevant papers published in English and reporting original data related to perinatal anxiety disorders were included. Data extraction Studies were examined for data related to the prevalence, presentation, predictors/risk factors, new onset, course, and treatment of anxiety disorders during pregnancy and the postpartum period. Data synthesis Anxiety disorders are common during the perinatal period, with reported rates of obsessive-compulsive disorder and generalized anxiety disorder being higher in postpartum women than in the general population. The perinatal context of anxiety disorders presents unique issues for detection and management. Conclusions Future research is needed to estimate the prevalence of perinatal anxiety disorders more precisely, to identify potential implications of maternal anxiety disorders for maternal quality of life and child development, and to determine safe and effective treatment methods.

Anxiety disorders during pregnancy and the postpartum period: A systematic review.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(04)15858-3.pdf

Postpartum psychiatric disorders

Introduction:The postpartum period represents the time of risk for the emergence of maternal postpartum depression. There are no systematic reviews of the overall maternal outcomes of maternal post...

https://journals.sagepub.com/doi/pdf/10.1177/1745506519844044

Consequences of maternal postpartum depression: a systematic review of maternal and infant outcomes

→ Background: The reported prevalence of posttraumatic stress disorder after childbirth ranges from 1.5% to 6%. → Objective: To describe the meaning of women's birth trauma experiences. → Methods: Descriptive phenomenology was the qualitative research design used to investigate mothers' experiences of traumatic births. Women were recruited through the Internet, primarily through Trauma and Birth Stress (TABS), a charitable trust located in New Zealand. The purposive sample consisted of 40 mothers: 23 in New Zealand, 8 in the United States, 6 in Australia, and 3 in the United Kingdom. Each woman was asked to describe the experience of her traumatic birth and to send it over the Internet to the researcher. Colaizzi's method was used to analyze the 40 mothers'stories. → Results: Four themes emerged that described the essence of women's experiences of birth trauma: To care for me: Was that too much too ask? To communicate with me: Why was this neglected? To provide safe care: You betrayed my trust and I felt powerless, and The end justifies the means: At whose expense? At what price? → Conclusions: Birth trauma lies in the eye of the beholder. Mothers perceived that their traumatic births often were viewed as routine by clinicians.

Birth trauma: in the eye of the beholder.

Preeclampsia is a leading cause of maternal and perinatal death. This systematic review, conducted to support the U.S. Preventive Services Task Force, assessed the benefits and harms of low-dose as...

Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force

Background: The increased acceptance of the prevalence of trauma in human experience as well as its psychological consequences has led to revisions of diagnostic criteria for the disorder. The three purposes of this study were to examine the rates at which women experienced psychological trauma in childbirth, to explore possible causal factors, and to examine possible factors in the development of the disorder.

Methods: One hundred and three women from childbirth education classes in the Atlanta metropolitan area completed a survey in late pregnancy and a follow-up interview approximately 4 weeks after the birth.

Results: The childbirth experience was reported as traumatic by 34 percent of participants. Two women (1.9%) developed all the symptoms needed to diagnose posttraumatic stress disorder, and 31 women (30.1%) were partially symptomatic. Regression analysis showed that antecedent factors (e.g., history of sexual trauma and social support) and event characteristics (e.g., pain in first stage of labor, feelings of powerlessness, expectations, medical intervention, and interaction with medical personnel) were significant predictors of perceptions of the childbirth as traumatic. The pain experienced during the birth, levels of social support, self-efficacy, internal locus of control, trait anxiety, and coping were significant predictors of the development of posttraumatic stress disorder symptoms after the birth.

Conclusions: These findings suggest several intervention points for health care practitioners, including careful prenatal screening of past trauma history, social support, and expectations about the birth; improved communication and pain management during the birth; and opportunities to discuss the birth postpartum. (BIRTH 30:1 March 2003)

Gregory A. Brack

Papers

Prevalence and predictors of women's experience of psychological trauma during childbirth.