Post traumatic stress disorder post childbirth versus postnatal depression: a guide for midwives

Abstract

Post traumatic stress disorder-post childbirth (PTSD-PC) is a powerful pathophysiological reaction that occurs in response to experiencing a traumatic birth and affects between 1–6% of women. Regardless of its trigger, PTSD-PC causes significant impairment to women's social interactions, ability to work, and daily life. A key symptom of PTSD-PC is re-experiencing the birth in the form of nightmares, flashbacks, continual replay, intrusive thoughts, and images. When these symptoms persist beyond 1 month, a diagnosis of PTSD-PC should be considered. In awareness that there are additional mental health problems that a childbearing woman could encounter, the authors have elected to focus on two of the more commonly experienced diagnoses; specifically PTSD and postnatal depression (PND). It is important for midwives to be able to differentiate between PTSD-PC and PND, because diagnoses and treatments differ. Generally, PND is treated with antidepressants and cognitive behavioural therapy (CBT), while PTSD is treated with eye movement desensitisation and reprocessing (EMDR) therapy or emotional freedom technique (EFT). There is potential for a women to develop a dual diagnosis, with partner and family also affected. Clarity surrounding the differences between PND and PTSD are key to accessing appropriate diagnosis, referral, and treatment