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Evidence Library · Afterward

Three different numbers for three different things

Looking back negatively, finding the birth traumatic, and meeting the diagnosis for post-traumatic stress are not the same thing and do not have the same numbers.

People collapse these three into one figure all the time, in both directions. Here they are separately.

What was measuredHow oftenWhere from
Looked back on the birth negatively7% at one year; 9.3% in a national surveySweden, 2,541 women; Canada, 6,421 women
Described the birth as traumaticBetween 9% and 44% across studies; 18% in one Irish hospitalSystematic review; Ireland, 1,154 women
Met the full diagnosis of post-traumatic stressAbout 3 to 4% in the general populationTwo separate meta-analyses
Met the diagnosis, in high-risk groupsAbout 16 to 19%The same two meta-analyses
4.0%
Post-traumatic stress after birth
Community samples
18.5%
In high-risk groups
Same analysis

The two meta-analyses were done by separate teams, searching separately, with different rules about which studies counted. One found 4.0% in community samples and 18.5% in high-risk groups. The other found 3.1% and 15.7%. Landing that close, independently, is the reason these figures can be trusted more than most in this field.

The Irish study shows how the layers stack. Of 1,154 women asked in the first days after birth, 18%, that is 209 women, said their birth was traumatic. Of those 209, 134 completed a full assessment six to twelve weeks later, and 6 of them, about 4%, met the threshold for post-traumatic stress. The authors put it carefully: The majority of women were resilient to birth trauma, few developed PTSD, but a larger cohort had significant functional impairment associated with sub-clinical postpartum PTSD symptoms.

That last clause is the one to hold on to. Between not meeting a diagnosis and being fine, there is a large group of women whose lives are genuinely affected. Not qualifying for a label is not evidence that you are all right.

If you do not think you meet the criteria for anything"I do not think I have a diagnosis. It is still affecting how I live, and I want help with that."
Where this comes from:
522. Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: a systematic review and meta-analysis. J Affect Disord. 2017;208:634-45.
523. Grekin R, O'Hara MW. Prevalence and risk factors of postpartum posttraumatic stress disorder: a meta-analysis. Clin Psychol Rev. 2014;34(5):389-401.
525. de Graaff LF, Honig A, van Pampus MG, Stramrood CAI. Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review. Acta Obstet Gynecol Scand. 2018;97(6):648-56.
524. Nagle U, Naughton S, Ayers S, Cooley S, Duffy RM, Dikmen-Yildiz P. A survey of perceived traumatic birth experiences in an Irish maternity sample - prevalence, risk factors and follow up. Midwifery. 2022;113:103419.
526. Waldenstrom U, Hildingsson I, Rubertsson C, Radestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17-27.
527. Smarandache A, Kim TH, Bohr Y, Tamim H. Predictors of a negative labour and birth experience based on a national survey of Canadian women. BMC Pregnancy Childbirth. 2016;16(1):114.

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