Abstract
BackgroundPost-Traumatic Stress Disorder (PTSD) usually follows a catastrophic event. However, the experience of child birth can be severe enough to cause PTSD in some women.MethodsA cross-sectional study was conducted in field clinics of a semi-urban area. A pre-tested interviewer administered checklist was used to collect socio-demographic and pregnancy related data. Pre-existing self-administered, validated Sinhalese versions of the Edinburgh Postnatal Depression Scale (EPDS) and PTSD Symptom Scale-Self Report (PSS-SR) were used to assess the presence of Post-Partum Depression (PPD) and PTSD, respectively. Each participant was assessed at one, two and six months after the delivery for PTSD and PPD. Scores of PPD >9 and PSS-SR >13 were taken as positive for the two conditions, respectively. ResultsData was obtained from 225 women who were at their first month postpartum, for the initial study. The response rate at their follow-up visits at the second and sixth months were 95% (n=214) and 94% (n=211). The point prevalence of postpartum PTSD was recorded as 2.7% (n=6), 0.9% (n=2) and 0.5% (n=1) at their first, second and sixth month postpartum, respectively. A period prevalence of 3.6% was observed over 6 months. Verbal abuse during labour (p=0.04) and the presence of postpartum depression (P≤0.001) were significantly associated with postpartum PTSD. There were no significant associations between PTSD and gestational age at delivery, whether it was a pregnancy planned ahead or not, a history of subfertility, family history of psychiatric disorders, intimate partner violence, receiving antenatal counseling, type and mode of delivery, duration of labour, presence of a labour companion, mental trauma, presence of post-partum hemorrhage, manual removal of placenta, negative birth experience, low APGAR score of the baby at delivery, receiving neonatal and maternal intensive care, birth defects, problems with breast feeding or opportunities to discuss problems with a health care worker. ConclusionsPrevalence of postpartum PTSD in this semi-urban community during the study period was 3.6%; which is in par with the overall global prevalence. PTSD was significantly associated with verbal abuse during labour and postpartum depression.