Birth Trauma and Postpartum Childbirth-related Posttraumatic Stress Disorder: A Narrative Review of Pathology, Risk Factors, and Practice Recommendations.

IMPORTANCE: Trauma and childbirth-related posttraumatic stress disorder (c-PTSD) are underrecognized possible consequences of birth and obstetric care that may affect maternal well-being, parent-infant bonding, and future reproductive decisions. Despite a growing body of research, gaps remain in the implementation of robust screening, timely diagnosis, and trauma-informed practices to prevent and address c-PTSD. OBJECTIVE: Review our current understanding of psychological birth trauma and c-PTSD, emphasizing provider roles in prevention, identification, and management. EVIDENCE ACQUISITION: PubMed and Google Scholar literature search from 2000 to 2024. RESULTS: Birth trauma is a subjective experience, often driven by factors such as poor communication, lack of informed consent, and perceived loss of control. Only a subset of individuals with traumatic births develops c-PTSD. Prior trauma, mental health conditions, obstetric complications, and inadequate support exacerbate risk. c-PTSD affects approximately 3% to 6% of low-risk, postpartum individuals and up to 18% of postpartum individuals in high-risk populations. Diagnosis requires assessment of associated symptoms with validated tools. Interventions range from psychosocial support, medications, and trauma-focused therapies. Preventive strategies include maternal mental health collaborative models and trauma-informed care that emphasizes respectful communication, autonomy, and continuity of care. CONCLUSIONS AND RELEVANCE: Obstetric providers are key actors in shaping a positive childbirth experience through respectful communication and shared decision-making. Early follow-up, mental health screening, and collaborative, trauma-informed care may help mitigate long-term psychological sequelae of birth trauma and c-PTSD to improve outcomes for birthing individuals and families.

Duke Scholars

Author Jeffrey Adam Kuller Obstetrics and Gynecology, Maternal Fetal Medicine

Author Sarah K. Dotters-Katz Obstetrics and Gynecology, Maternal Fetal Medicine