Thousands of women may be living with undiagnosed PTSD after childbirth, study finds

Thousands of women across the UK could be living with undiagnosed post-traumatic stress disorder following childbirth each year, with researchers warning that mothers are falling through gaps in postnatal care.

Researchers led by the University of East Anglia (UEA) estimate that more than 15,000 women a year could develop childbirth-related PTSD without receiving a diagnosis or appropriate treatment.

The research, published in the British Journal of General Practice, examined the evidence available to GPs for identifying and managing childbirth-related PTSD.

Researchers warned that psychological trauma following childbirth can go unrecognised or be mistaken for postnatal depression, despite PTSD requiring different assessment and treatment.

Symptoms of childbirth-related PTSD can include flashbacks, nightmares, severe anxiety, intrusive thoughts, avoidance of reminders of the birth and persistent negative thoughts and feelings.

Separate UK research has found that around 40.6% of women described childbirth as at least moderately traumatic, while 5.9% met the diagnostic criteria for childbirth-related PTSD.

Risk factors identified in research include emergency caesarean sections, complications involving the mother or baby, previous trauma, existing mental health difficulties, lower satisfaction with the birth experience and not having skin-to-skin contact with the baby following delivery.

However, researchers stress that PTSD is not limited to births involving obvious medical emergencies. A woman’s psychological experience of childbirth can differ significantly from how the birth may appear clinically.

One concern highlighted by the researchers is the six-to-eight-week postnatal GP check, which provides an important opportunity to identify mental health problems but does not currently include a structured assessment specifically designed to detect childbirth-related PTSD.

Dr Camilla Rosan Foreman, from UEA’s Norwich Medical School, said GPs are well placed to recognise warning signs but need better evidence, training and practical tools to identify women experiencing trauma following childbirth.

Researchers are calling for improved GP training, greater awareness of childbirth-related PTSD and clearer referral pathways into specialist mental health services.

The findings come amid wider concerns about women’s experiences of maternity care and maternal mental health across the UK.

A national maternity survey published earlier this year found that three in ten women in England reported symptoms of depression, anxiety or post-traumatic stress six months after giving birth. One in five women said they had either not been asked, or could not remember being asked, about their mental health by a healthcare professional during pregnancy or after their baby was born.

Specialist perinatal and maternal mental health services are available across England, including support for women experiencing PTSD following birth trauma, pregnancy loss and severe fear of childbirth.

However, the latest research suggests significant numbers of women may never reach those services because their symptoms are not being identified in the first place.

Researchers say improving recognition within primary care could ensure women receive appropriate treatment sooner and reduce the potentially long-term effects of untreated birth trauma on mothers, babies and wider families.

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