Posttraumatic Stress Disorder in New Mothers: Results from a Two-Stage U.S. National Survey

Authors

  • Cheryl Tatano Beck DNSc, CNM, FAAN,

    1. Cheryl Tatano Beck is a Distinguished Professor in the School of Nursing and has a joint appointment in the School of Medicine, Department of Obstetrics & Gynecology at the University of Connecticut, Storrs, Connecticut; Robert K. Gable is a Professor and Director of the Center for Research and Evaluation in the Educational Leadership Doctoral Program at Johnson & Wales University, Providence, Rhode Island; Carol Sakala is the Director of Programs at Childbirth Connection, New York, New York; and Eugene R. Declercq is a Professor in Community Health Sciences and Assistant Dean for Doctoral Education at Boston University School of Public Health, Boston, Massachusetts, United States of America.
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  • Robert K. Gable EdD,

    1. Cheryl Tatano Beck is a Distinguished Professor in the School of Nursing and has a joint appointment in the School of Medicine, Department of Obstetrics & Gynecology at the University of Connecticut, Storrs, Connecticut; Robert K. Gable is a Professor and Director of the Center for Research and Evaluation in the Educational Leadership Doctoral Program at Johnson & Wales University, Providence, Rhode Island; Carol Sakala is the Director of Programs at Childbirth Connection, New York, New York; and Eugene R. Declercq is a Professor in Community Health Sciences and Assistant Dean for Doctoral Education at Boston University School of Public Health, Boston, Massachusetts, United States of America.
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  • Carol Sakala PhD, MSPH,

    1. Cheryl Tatano Beck is a Distinguished Professor in the School of Nursing and has a joint appointment in the School of Medicine, Department of Obstetrics & Gynecology at the University of Connecticut, Storrs, Connecticut; Robert K. Gable is a Professor and Director of the Center for Research and Evaluation in the Educational Leadership Doctoral Program at Johnson & Wales University, Providence, Rhode Island; Carol Sakala is the Director of Programs at Childbirth Connection, New York, New York; and Eugene R. Declercq is a Professor in Community Health Sciences and Assistant Dean for Doctoral Education at Boston University School of Public Health, Boston, Massachusetts, United States of America.
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  • Eugene R. Declercq PhD, MBA

    1. Cheryl Tatano Beck is a Distinguished Professor in the School of Nursing and has a joint appointment in the School of Medicine, Department of Obstetrics & Gynecology at the University of Connecticut, Storrs, Connecticut; Robert K. Gable is a Professor and Director of the Center for Research and Evaluation in the Educational Leadership Doctoral Program at Johnson & Wales University, Providence, Rhode Island; Carol Sakala is the Director of Programs at Childbirth Connection, New York, New York; and Eugene R. Declercq is a Professor in Community Health Sciences and Assistant Dean for Doctoral Education at Boston University School of Public Health, Boston, Massachusetts, United States of America.
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Address correspondence to Cheryl Tatano Beck, DNSc, CNM, FAAN, School of Nursing, University of Connecticut, 231 Glenbrook Road, Storrs, CT 06269-2026, USA.

Abstract

Abstract:  Background:  Prevalence rates of women in community samples who screened positive for meeting the DSM-IV criteria for posttraumatic stress disorder after childbirth range from 1.7 to 9 percent. A positive screen indicates a high likelihood of this postpartum anxiety disorder. The objective of this analysis was to examine the results that focus on the posttraumatic stress disorder data obtained from a two-stage United States national survey conducted by Childbirth Connection: Listening to Mothers II (LTM II) and Listening to Mothers II Postpartum Survey (LTM II/PP).

Methods:  In the LTM II study, 1,373 women completed the survey online, and 200 mothers were interviewed by telephone. The same mothers were recontacted and asked to complete a second questionnaire 6 months later and of those, 859 women completed the online survey and 44 a telephone interview. Data obtained from three instruments are reported in this article: Posttraumatic Stress Disorder Symptom Scale-Self Report (PSS-SR), Postpartum Depression Screening Scale (PDSS), and the Patient Health Questionnaire-2 (PHQ-2).

Results:  Nine percent of the sample screened positive for meeting the diagnostic criteria of posttraumatic stress disorder after childbirth as determined by responses on the PSS-SR. A total of 18 percent of women scored above the cutoff score on the PSS-SR, which indicated that they were experiencing elevated levels of posttraumatic stress symptoms. The following variables were significantly related to elevated posttraumatic stress symptoms levels: low partner support, elevated postpartum depressive symptoms, more physical problems since birth, and less health-promoting behaviors. In addition, eight variables significantly differentiated women who had elevated posttraumatic stress symptom levels from those who did not: no private health insurance, unplanned pregnancy, pressure to have an induction and epidural analgesia, planned cesarean birth, not breastfeeding as long as wanted, not exclusively breastfeeding at 1 month, and consulting with a clinician about mental well-being since birth. A stepwise multiple regression revealed that two predictor variables significantly explained 55 percent of the variance in posttraumatic stress symptom scores: depressive symptom scores on the PHQ-2 and total number of physical symptoms women were experiencing at the time they completed the LTM II/PP survey.

Conclusion:  In this two-stage national survey the high percentage of mothers who screened positive for meeting all the DSM-IV criteria for a posttraumatic stress disorder diagnosis is a sobering statistic. (BIRTH 38:3 September 2011)

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