People experience different forms of trauma in their lives; some traumas are transient while others are long lasting with psychological and social effects. Post-traumatic stress disorder (PTSD) is a health issue associated with the problem of anxiety. Often, people experience this condition after undergoing or witnessing a tragic, traumatizing event such as wars, fire, childbirth, and other accidents. Psychosocial and behavioral factors have connections with the degree of symptoms as well as the manner in which the factors affect the normal life functions of individuals with trauma experience (Beck, 2004). Therefore, it is important that people who are experiencing trauma receive care to prevent chronicity. Research documentation indicates that women tend to develop PTSD than men (Davidson, 2000). Post-traumatic stress disorder can be severe for different people including women in their postpartum period and after. It is also a disabling and common disease. PTSD has the possibility of occurring at any age; therefore, all age brackets need to be given attention. Usually, it has an early onset that presents as acute distress disorder, but few cases have delayed onset. The predominant causal factors of PTSD include combat, sexual assault, torture, natural disaster, abuse, loss, terror, and childbirth. Cognitive behavior therapy is the primary effective treatment option for post-traumatic stress disorder. For postpartum women, a greater number demonstrate early onset. A well-defined and clear care plan that is sympathetic and patient centered has the potential of promoting optimal recovery in this group of individuals. Thus, particular clinical attention is required for postpartum women to strengthen child-mother attachment. PTSD can occur at any age, women are prone to the disorder after childbirth trauma, and they should be given assistance and clinical attention.
Survivors of ordeals are predisposed to developing PTSD. The condition is characterized by traumatic memories that are intrusive; individuals avoid triggers and may have a chronic arousal coupled with distress. Some of the risk factors for PTSD include the level of the severity of trauma, the lack of support, and other life stressors (Brewin, Andrews, & Valentine, 2000). Anxiety and emotions are reactionary attributes of PTSD. People with PTSD may be startled easily, lose interest in hobbies, develop difficulties in having affection, and experience some level of rage (hyperarousal), insomnia, and depression. These risk factors and characteristics of the disorder make it a special area of focus for women who have given birth and are prone to developing the disorder. This study seeks to provide insights about the post-traumatic stress disorder, including its diagnosis and medical interventions used to treat it among women following childbirth.
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Background Information
Life, especially in the context of the present culture presents humans with anxiety-inducing elements. The improvement of the quality of life and consequent life expectancy in the last century has not reduced human anxieties. Within the same period is a rise in anxiety levels, and women are not immune (Twenge, 2006). Anxiety is a natural component of human life, abnormal anxiety is debilitating, and PTSD is associated with abnormal stress. Thus, environmental factors, generated by the society or community may create opportunities for PTSD to manifest. Environmental, psychosocial factors, therefore, reinforce genetic disposition to PTSD. Also, the likelihood of PTSD is linked to previous exposure to a traumatic situation.
As an anxiety-related disorder, nurture and nature significantly contribute to its development. Regarding evolution, humans have evolved to fear dangerous circumstances, and PTSD is considered a disorder with hereditary possibilities (Hettema, Neale, &Kendler, 2001). Molecular biology studies have also shown genetic expressions of PTSD (Thoeringer et al., 2009). Further research through neuroimaging reveals that anxiety disorders such as PTSD are connected to the part of the brain responsible for emotions. Also, people with PTSD have a smaller hippocampus compared to those who do not, suggesting that this difference is responsible for the greater degree of sensitivity to traumatic events in their lives.
PTSD can take a learning path through classical and operant conditioning because it falls within anxiety disorders. People with PTSD have strong tendency to react triggers of an event such as a painful childbirth. Stimulus generation is an aspect of classical conditioning where a previous event acting as a stimulus is applied to or generalized. This thinking pattern or process has the potential of limiting and affecting a woman who has just given birth and expressing PTSD. When such women are given the attention and assessment that are required, they can recover quickly. A study conducted by Hoge and Grossman (2014), indicated that upon experiencing an overwhelming trauma, patients mind tends to find it difficult to process information or even feel in a normal way. This difficulty in processing information and feelings of abnormality can be prevented through early detection and screen postpartum.
Childbirth, as the cause of PTSD, has received little attention until recently. It is now known that it can affect mother-child relationship (Soet, Brack, &Dilorio, 2004). Many women are vulnerable during the postnatal period, requiring assessment and support. The subjective nature of childbirth and the close association with anxiety makes it an appropriate inclusion as part of DSM-IV diagnostic criteria. It is noted that one of the greatest challenges regarding PTSD in this women group is the early detection of this psychological disorder. Another difficulty is the identification of women with risk factors and providing a standardized diagnostic procedure.
Evidence-based research provides a qualitative approach to assisting people with PTSD. These people include women who have just given birth and others with previous experience of trauma. For instance, a study conducted by Harold Cohen (2013), described the relationship between trauma and ordinary events. The study used secondary data from research carried out in United States between 2002 and 2012. This study is a broad, macro-analysis of data that covers a wide sample group and period. The study results indicated that pre-traumatic psychological factors such as low self-esteem because of events like rape might only be decreased by reprocessing the traumatic events. Thus, helping postpartum women reprocess the trauma with sympathy, empathy, and reassurance will assist them in their recovery. A psychotherapeutic approach to injury has shown considerable promise. It is known that cognitive behavioral therapy is an effective method for treating and managing people with PTSD and other anxiety disorders.
Other learning models when appropriately utilized can complement therapeutic approaches. One of such is metacognition, a learning process that couples innate responses such as emotions. Through metacognitive experience management, individuals with PTSD can overcome the disorder. Charlotte Williams (2016), conducted a study on PTSD among women due to maternal and childbirth perceptions of women. The study results indicated that metacognition could mediate the relationship that exists between post-natal psychological outcomes and the attachment experiences. This focused investigation highlights the potential application of metacognition in strengthening mother-child bonding and overall adaptability. PTSD in women is a serious condition because it can influence some women from having more children and functioning properly. Essential to metacognition is the capability to have intentionality regarding positive attitude and feelings toward a recovery path. This healing is achievable if these women are given adequate attention.
Based on the study conducted on the need of addressing trauma, causes, symptoms, and prevention, it is clear that ordinary events may be a huge trigger of trauma. Social factors and comorbidity are important predictors of PTSD long term course requiring consideration in clinical evaluations (Steinertet al., 2015). Therefore, it is important to address the problem at the early stages by reprocessing the events that resulted in trauma. Equally important is the application of the metacognitive approach to treatment. The quantitative and qualitative studies researched about women with PTSD after delivery shows consistency about development of posttraumatic stress disorders resulting from traumatic delivery. They confirm that childbirth experience may be emotionally traumatic to elicit PTSD diagnosis. Therefore, this paper asserts that trauma as a result of childbirth is a crucial public health issue that requires collaboration from health care managers, professionals, and policymakers. Such a study will take into consideration women of all age because PTSD is not age-specific.
Conclusion
Based on the findings above, there is an indication that women have suffered Post-traumatic stress because of childbirth and maternal perception hence affecting the relationship between mother and child. The effects are significant because the quality of life of both the mother and child are negatively affected. This influence on the relationship and health of the women creates a need to ensure adequate education and care is offered to the issue and women with PTSD. It is important that women with PTSD receive sufficient attention and treatment early enough during and after childbirth. These early interventions will ensure quick recovery and reinforcement of mother-child bonding. The diagnosis needs to be postpartum and properly undertaken. PTSD occurs at all ages, and it is important no matter the age of the mother to have an assessment to identify any symptoms of this condition. There are different causes of PTSD among women. However, for decades, childbirth as a cause of this problem has received little attention compared to other causes.
References
Brewin, C., Andrews, B., & Valentine, J. (2000).Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68 (5), 748–766. doi:10.1037//0022-006X.68.5.748
Cohen, J. A., Crow, B. E., Foa, E. B., ... &Ursano, R. J. (2013). A Guide to Guidelines for the Treatment of PTSD and Related Conditions. FOCUS, 11 (3), 414-427.
Davidson, J. (2000). Trauma: The impact of post-traumatic stress disorder. Journal of Psychopharmacology, 14 (2Suppl 1), S5–S12.
Hettema, J. M., Neale, M. C., &Kendler, K. S. (2001).A review and meta-analysis of the genetic epidemiology of anxiety disorders. The American Journal of Psychiatry, 158 (10), 1568–1578.
Hoge, C. W., Grossman, S. H., Auchterlonie, J. L., Riviere, L. A., Milliken, C. S., & Wilk, J. E. (2014). PTSD treatment for soldiers after combat deployment: Low utilization of mental health care and reasons for dropout. Psychiatric Services, 65 (8), 997-1004.
Soet J E, Brack G A, Dilorio C.(2003). Prevalence and predictors of womenʼs experience of psychological trauma during childbirth. Birth.30 :30–46.
Steinert.C., Hofmann, M., Leichsenring, F., &Kruse, J. (2015). The course of PTSD in naturalistic long-term studies: High variability of outcomes.A systematic review. Nord J Psychiatry 69 :483–496.
Thoeringer, C., Ripke, S., Unschuld, P., Lucae, S., Ising, M., Bettecken, T.,…Erhardt, A. (2009). The GABA transporter 1 (SLC6A1): A novel candidate gene for anxiety disorders. Journal of Neural Transmission, 116 (6), 649–657. doi:10.1007/s00702-008-0075-y
Twenge, J. (2006). Generation me . New York, NY: Free Press.
Williams, C., Patricia Taylor, E., &Schwannauer, M. (2016). A Web ‐ Based Survey of Mother–Infant Bond, Attachment Experiences, And Metacognition in Posttraumatic Stress Following Childbirth. Infant mental health journal, 37 (3), 259-273.
Writer’s Credibility statement
My previous experience in PTSD as a therapist has informed the choice for this subject. Some of the information in the paper is the result of practical experience. The limitation is due to the lack of adequate academic and peer-reviewed resources on the topic of PTSD and women during childbirth and the effect it may have on the mother child relationship. Thus, the paper is an in-depth review of over 50 research sources that are published recently on women and childbirth concerning PTSD. As stated, the expertise or level of knowledge is connected to years of practice as a stress related disorder therapist. The main inspiration to the study is the need to increase health literacy among the public and government on the issues of PTSD.
Audience Focus
The readers are expected to be the general community, students, government institutions including health ministry and different practitioners, people interested on the topic of PTSD among women during childbirth.
