Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 43
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Agius, Andee Xuereb, Rita Borg Carrick-Sen, Debbie Sultana, Roberta and Rankin, Judith 2016. The co-existence of depression, anxiety and post-traumatic stress symptoms in the perinatal period: A systematic review. Midwifery, Vol. 36, p. 70.

    Anderson, Cheryl Ann and Rahn, Brittani 2016. Factors Related to the Seeking and Contribution of Prenatal Care Among Ethnically Diverse Adolescents. Journal of Child and Family Studies, Vol. 25, Issue. 7, p. 2211.

    Ayers, S. Bond, R. Bertullies, S. and Wijma, K. 2016. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychological Medicine, Vol. 46, Issue. 06, p. 1121.

    Davis, Gregory K. Roberts, Lynne Mangos, George Henry, Amanda Pettit, Franziska O’Sullivan, Anthony Homer, Caroline S.E. Craig, Maria Harvey, Samuel B. and Brown, Mark A. 2016. Postpartum physiology, psychology and paediatric follow up study (P4 Study) – Study protocol. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health,

    Gökçe İsbİr, Gözde İncİ, Figen Bektaş, Murat Dikmen Yıldız, Pelin and Ayers, Susan 2016. Risk factors associated with post-traumatic stress symptoms following childbirth in Turkey. Midwifery, Vol. 41, p. 96.

    Leinweber, Julia Creedy, Debra K. Rowe, Heather and Gamble, Jenny 2016. Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. Women and Birth,

    Milosavljevic, Maja Lecic Tosevski, Dusica Soldatovic, Ivan Vukovic, Olivera Miljevic, Cedo Peljto, Amir Kostic, Milutin and Olff, Miranda 2016. Posttraumatic Stress Disorder after Vaginal Delivery at Primiparous Women. Scientific Reports, Vol. 6, p. 27554.

    Oh, Wonjung Muzik, Maria McGinnis, Ellen Waxler Hamilton, Lindsay Menke, Rena A. and Rosenblum, Katherine Lisa 2016. Comorbid trajectories of postpartum depression and PTSD among mothers with childhood trauma history: Course, predictors, processes and child adjustment. Journal of Affective Disorders, Vol. 200, p. 133.

    Park, Yu Kyung Ju, Hyeon Ok and Na, Hunjoo 2016. Reliability and Validity of the Korean Version of the Perinatal Post-Traumatic Stress Disorder Questionnaire. Journal of Korean Academy of Nursing, Vol. 46, Issue. 1, p. 29.

    Shlomi Polachek, Inbal Dulitzky, Mordechai Margolis-Dorfman, Lilia and Simchen, Michal J. 2016. A simple model for prediction postpartum PTSD in high-risk pregnancies. Archives of Women's Mental Health, Vol. 19, Issue. 3, p. 483.

    Thomson, Gill and Downe, Soo 2016. Emotions and support needs following a distressing birth: Scoping study with pregnant multigravida women in North-West England. Midwifery, Vol. 40, p. 32.

    Üstündağ Budak, A. Meltem Harris, Gillian and Blissett, Jacqueline 2016. Perinatal trauma with and without loss experiences. Journal of Reproductive and Infant Psychology, Vol. 34, Issue. 4, p. 413.

    Williams, Charlotte Patricia Taylor, Emily and Schwannauer, Matthias 2016. A WEB-BASED SURVEY OF MOTHER-INFANT BOND, ATTACHMENT EXPERIENCES, AND METACOGNITION IN POSTTRAUMATIC STRESS FOLLOWING CHILDBIRTH. Infant Mental Health Journal, Vol. 37, Issue. 3, p. 259.

    Dorahy, Martin J. Rowlands, Amy Renouf, Charlotte Hanna, Donncha Britt, Eileen and Carter, Janet D. 2015. Impact of average household income and damage exposure on post-earthquake distress and functioning: A community study following the February 2011 Christchurch earthquake. British Journal of Psychology, Vol. 106, Issue. 3, p. 526.

    Garthus-Niegel, Susan Ayers, Susan von Soest, Tilmann Torgersen, Leila and Eberhard-Gran, Malin 2015. Maintaining factors of posttraumatic stress symptoms following childbirth: A population-based, two-year follow-up study. Journal of Affective Disorders, Vol. 172, p. 146.

    Haagen, Joris F.G. Moerbeek, Mirjam Olde, Eelco van der Hart, Onno and Kleber, Rolf J. 2015. PTSD after childbirth: A predictive ethological model for symptom development. Journal of Affective Disorders, Vol. 185, p. 135.

    Halperin, Ofra Sarid, Orly and Cwikel, Julie 2015. The influence of childbirth experiences on women׳s postpartum traumatic stress symptoms: A comparison between Israeli Jewish and Arab women. Midwifery, Vol. 31, Issue. 6, p. 625.

    Leach, Liana S. Poyser, Carmel and Fairweather-Schmidt, Kate 2015. Maternal perinatal anxiety: A review of prevalence and correlates. Clinical Psychologist, p. n/a.

    Sawyer, Alexandra Nakić Radoš, Sandra Ayers, Susan and Burn, Erin 2015. Personal growth in UK and Croatian women following childbirth: A preliminary study. Journal of Reproductive and Infant Psychology, Vol. 33, Issue. 3, p. 294.

    Sheen, Kayleigh and Slade, Pauline 2015. The efficacy of ‘debriefing’ after childbirth: Is there a case for targeted intervention?. Journal of Reproductive and Infant Psychology, Vol. 33, Issue. 3, p. 308.


A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events

  • K. L. Alcorn (a1), A. O'Donovan (a1), J. C. Patrick (a2), D. Creedy (a3) and G. J. Devilly (a1) (a4)
  • DOI:
  • Published online: 11 January 2010

Childbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology.


Pregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4–6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum.


Of the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4–6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4–6 weeks postpartum, 6.3% at 12 weeks postpartum and 5.8% at 24 weeks postpartum. When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinically significant anxiety and depression during pregnancy, PTSD rates were less at 1.2% at 4–6 weeks, 3.1% at 12 weeks and 3.1% at 24 weeks postpartum.


This is the first study to demonstrate the occurrence of full criteria PTSD resulting from childbirth after controlling for pre-existing PTSD and partial PTSD and clinically significant depression and anxiety in pregnancy. The findings indicate that PTSD can result from a traumatic birth experience, though this is not the normative response.

Corresponding author
*Address for correspondence: Dr G. J. Devilly, School of Psychology and Griffith Institute for Health & Medical Research, Griffith University, MtGravatt, Qld 4122, Australia. (Email: (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S Allen (1998). A qualitative analysis of the process, mediating variables and impact of traumatic childbirth. Journal of Reproductive and Infant Psychology 16, 107131.

S Ayers (2001). Assessing psychopathology in pregnancy and postpartum. Journal of Psychosomatic Obstetrics and Gynecology 22, 91–102.

S Ayers , AD Pickering (2001). Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth: Issues in Perinatal Care 28, 111118.

D Bailham , S Joseph (2003). Post-traumatic stress following childbirth: a review of the emerging literature and directions for research and practice. Psychology, Health and Medicine 8, 159168.

CG Ballard , AK Stanley , IF Brockington (1995). Post-traumatic stress disorder (PTSD) after childbirth. British Journal of Psychiatry 166, 525528.

C Beck (2004 a). Post-traumatic stress disorder due to childbirth: the aftermath. Nursing Research 53, 216224.

C Beck (2004 b). Birth trauma: in the eye of the beholder. Nursing Research 53, 2835.

S Brown , J Lumley (1998). Maternal health after childbirth: results of an Australian population based survey. British Journal of Obstetrics and Gynaecology 105, 156161.

JL Cox , J Holden , R Sagovsky (1987). Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150, 782786.

M Creamer , AC McFarlane , P Burgess (2005). Psychopathology following trauma: the role of subjective experience. Journal of Affective Disorders 86, 175782.

DK Creedy , IM Shochet , J Horsfall (2000). Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth 27, 104111.

M Eberhard-Gran , A Eskild , K Tambs , S Opjordsmoen , SO Samuelsen (2001). Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatrica Scandinavica 104, 243249.

IM Engelhard , MA van den Hout , M Kindt (2003). The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: a prospective study. Personality and Individual Differences 35, 381388.

E Foa , L Cashman , L Jaycox , K Perry (1997). The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychological Assessment 9, 445451.

E Foa , E Meadows (1997). Psychosocial treatments for posttraumatic stress disorder: a critical review. Annual Review of Psychology 48, 449480.

SA Freedman , N Gluck , R Tuval-Mashiach , D Brandes , T Peri , A Shalev (2002). Gender differences in responses to traumatic events: a prospective study. Journal of Traumatic Stress 15, 407413.

L Greening , L Stoppelbein , R Docter (2002). The mediating effects of attributional style and event-specific attributions on post-disaster adjustment. Cognitive Therapy and Research 26, 261274.

MG Griffin , MH Uhlmansiek , PA Resick , MB Mechanic (2004). Comparison of the Posttraumatic Stress Disorder Scale versus the Clinician-Administered Posttraumatic Stress Disorder Scale in Domestic Violence Survivors. Journal of Traumatic Stress 17, 497503.

I Johnston-Robledo , J Barnack (2004). Psychological issues in childbirth: potential roles for psychotherapists. Women and Therapy 27, 133150.

E Keogh , S Ayers , H Francis (2002). Does anxiety sensitivity predict post-traumatic stress symptoms following childbirth? A preliminary report. Cognitive Behaviour Therapy 31, 145155.

RC Kessler , A Sonnega , E Bromet , M Hughes , CB Nelson (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 10481060.

ME Long , JD Elhai , A Schweinle , MJ Gray , AL Grubaugh , C Frueh (2008). Differences in posttraumatic stress disorder diagnostic rates and symptom severity between criterion A1 and non-criterion A1 stressors. Journal of Anxiety Disorders 22, 12551263.

RJ McNally (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology 54, 229252.

S Matthey (2004). Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale. Journal of Affective Disorders 78, 269272.

S Matthey , B Barnett , P Howie , DJ Kavanagh (2003). Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? Journal of Affective Disorders 74, 139147.

D Murray , J Cox (1990). Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). Journal of Reproductive and Infant Psychology 8, 99–107.

E Olde , O van der Hart , RJ Kleber , MJ van Son , HA Wijnen , VJ Pop (2005). Peritraumatic dissociation and emotions as predictors of PTSD symptoms following childbirth. Journal of Trauma and Dissociation 6, 125142.

M Righetti-Veltema , E Conne-Perreard , A Bousquet , J Manzano (2002). Postpartum depression and mother-infant relationship at 3 months old. Journal of Affective Disorders 70, 291306.

E Ryding , A Persson , C Onell , L Kvist (2003). An evaluation of midwives' counselling of pregnant women in fear of childbirth. Acta Obstetricia et Gynecologica Scandinavica 82, 1017.

T Saisto , K Salmela-Aro , JE Nurmi , T Kononen , E Halmesmaki (2001). A randomized controlled trial of intervention in fear of childbirth. Obstetrics and Gynecology 98, 820826.

K Sjostrom , L Valentin , T Thelin , K Marsal (2002). Maternal anxiety in late pregnancy: effect on fetal movements and fetal heart rate. Early Human Development 67, 87–100.

J Söderquist , B Wijma , K Wijma (2006). The longitudinal course of post-traumatic stress after childbirth. Journal of Psychosomatic Obstetrics and Gynaecology 27, 113119.

JE Soet , GA Brack , C Dilorio (2003). Prevalence and predictors of women's experience of psychological trauma during childbirth. Birth 30, 3646.

I Sommer , U Ehlert (2004). Adjustment to trauma exposure: prevalence and predictors of posttraumatic stress disorder symptoms in mountain guides. Journal of Psychosomatic Research 57, 329335.

MB Stein , JR Walker , DR Forde (2000). Gender differences in susceptibility to posttraumatic stress disorder. Behaviour Research and Therapy 38, 619628.

GE Switzer , MA Dew , K Thompson , JM Goycoolea , T Derricott , SD Mullins (1999). Posttraumatic stress disorder and service utilization among urban mental health center clients. Journal of Traumatic Stress 12, 2539.

M van Hooff , AC McFarlane , J Baur , M Abraham , DJ Barnes (2009). The stressor Criterion-A1 and PTSD: a matter of opinion? Journal of Anxiety Disorders 23, 7786.

K Wijma , J Soderquist , B Wijma (1997). Posttraumatic stress disorder after childbirth: a cross sectional study. Journal of Anxiety Disorders 11, 587597.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *