Introduction
Childbirth is generally considered a natural process. However, 19.74%
~ 45.03% of women think it as a
trauma[1]. Beck [2,3]believed that traumatic childbirth could be defined as delivery with a
feeling of intimidating damage or serious harm, or even death to the
mother, baby, or both, during labor, including physiological trauma and
psychological trauma. Greenfield et al [4]indicated that psychological trauma was the necessary condition of
childbirth trauma, namely, childbirth trauma included either
psychological and physical trauma or just psychological trauma. Previous
studies[5,6] focused on physiological trauma
caused by mechanical factors in a mother, fetus, or newborn during
childbirth. Gradually, the focus of childbirth trauma shifted from
physiological trauma to psychological trauma which was a subjective
painful birth experience[4] . A systematic
review[7] with 13studies revealed that the
incidence of psychological distress experienced by childbirth trauma was
9% to 44%. Traumatic childbirth experiences could affect the
mother-child bond, the general adaptability[3,
8-10], as well as the partnership[2, 11, 12],
and also negatively impact the decision to have more
children[2,11, 13-15]. Moreover, a traumatic
childbirth experience also has adverse effects on postpartum woman’s
mental health. A prospective longitudinal
study[16] reported that PTSD could result from a
traumatic birth experience, and develop symptoms of PTSD at 4–6 weeks
after traumatic birth events.
PTSD has three distinct types of symptoms consisting of re-experiencing
the event, avoidance of reminders of the event, and hyperarousal, which
must be presented together for at least one month to meet the diagnostic
criteria for PTSD[17].
PTSD is one of the common mental health disorders in women after birth.
A systematic review[18] including 21 studies with
8,511 general postpartum women showed that childbirth-related PTSD was
4.0%. Birth trauma may be a key risk factor for postpartum PTSD.
Beck[8] indicated that the psychological trauma of
childbirth might lead to postnatal PTSD. Ford et al[19] also showed that negative post-traumatic
cognition appeared a predictive factor of the early development of PTS
symptoms after childbirth. However, no systematic review on the
incidence of postpartum PTSD in women who have experienced traumatic
childbirth has been conducted. Thus, the aim of this study is to
estimate the incidence of PTSD following traumatic childbirth through a
systematic review and meta-analysis.