Nine percent of women find giving birth traumatic. Every year, over 2000 women develop Posttraumatic Stress Disorder (PTSD) after giving birth, according to UMCG researcher and gynaecologist in training Claire Stramrood. After a traumatic delivery experience, many women decide to avoid future pregnancies, or ‘demand’ an elective caesarean section when they do become pregnant again. ‘Suffering from psychological disorders is taboo for pregnant women and those who have just given birth, although many of them are afflicted. I would like to see PTSD better recognized in women who have just given birth’, says Stramrood, who will receive her PhD from the University of Groningen on 26 June 2013.
PTSD symptoms occur more often when the pregnancy ends in an unplanned (emergency) caesarean, in women who experience a great deal of pain during labour and in those who deal poorly with stress. When delivery complications and interventions are factored in, there is no difference in how often PTSD occurs after home births or after hospital deliveries.
Women who develop complications during pregnancy, with (very) premature birth as a result, have a high risk of developing PTSD. Stramrood diagnosed PTSD in 14% of the women suffering from pre-eclampsia/HELLP-syndrome or women whose waters had broken prematurely. ‘In this group of women the chances of developing PTSD are considerable, and therefore screening after birth should be standard protocol’, says Stramrood. Fifteen months after having given birth, 11% of the women suffering from pre-eclampsia were still dealing with PTSD.
The partners of women suffering from complications during pregnancy may also develop PTSD following the birth of their child. Stramrood discovered a remarkably strong relationship between the women and their partners with regard to the gravity of the PTSD symptoms. As a result, she believes that the partners’ psychological wellbeing should be kept in mind as well.
Little research has been done into effective treatment of PTSD after childbirth. Stramrood conducted an initial exploratory study into Eye Movement Desensitization and Reprocessing ( EMDR) treatment. This method involves rapid eye movements that could have a positive effect on dealing with trauma. She discovered that women who received EMDR treatment found their symptoms fading. At the same time, women regained confidence in giving birth vaginally. According to Stramrood, it would be desirable to conduct more research into EMDR to see if it contributes towards a positive experience during a following pregnancy and delivery.
Claire Stramrood (Apeldoorn, 1983) went to medical school at Utrecht University. She conducted her research at the Gynaecology and Obstetrics department of the University Medical Center Groningen (UMCG) within the Psychosomatic Obstetrics & Gynaecology and pre-eclampsia research lines. She was supervised by Prof. W.C.M. Weijmar Schultz, Prof. A.J.J.M. Vingerhoets, Prof. P.P. van den Berg, Dr. M.G. van Pampus and Dr. K.M. Paarlberg. Stramrood is a gynaecologist in training at Meander Medisch Centrum in Amersfoort. Her thesis is titled ‘Posttraumatic stress following pregnancy and childbirth’.
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