Childbirth Narratives of Women With Posttraumatic Stress Symptoms in the Postpartum Period

Abstract

Objective: To examine cognitive, emotional, and perceptual differences in the childbirth narratives of women with high levels of posttraumatic stress symptoms (PTSS) compared with women with low levels of PTSS in the postpartum period.

Design: A cross-sectional design. Participants were retrospectively assigned to the high or low PTSS group on the basis of their scores on the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) administered at 1 week and 3 months after childbirth.

Setting: Participants' homes and Internet survey.

Participants: Twenty-five women were included in the high PTSS group (PPQ score ≥ 12), and 25 were included in the low PTSS group (PPQ score ≤ 1).

Methods: Participants completed the PPQ and a writing task about the birth experience 1 week after birth and completed an online version of the PPQ 3 months after birth. Characteristics of the narratives were analyzed and compared between the two groups using the Linguistic Inquiry Word Count.

Results: Compared with participants with low levels of PTSS, participants with high levels of PTSS reported more negative emotions, including horrific images connected to labor and birth and fewer positive emotions. Participants with high levels of PTSS used more sensory and perceptual terms (tactile, visual, and auditory). In contrast, women with low levels of PTSS described more active participation during birth and used more future tense verbs.

Conclusion: Our findings suggest the aspects that are involved in the development and maintenance of PTSS after birth and may be considered for use in clinical practice to improve quality of care and women's health during the postpartum period.

Keywords: PTSD symptoms; PTSS; childbirth; emotion; expressive writing; narratives; women.