Post-traumatic stress disorder in women who have undergoneobstetric and/or gynecological procedures

Abstract

500 women volunteers took part in a study about the psychological stress associated with obstetric and gynecological procedures. The sample was recruited by advertisements in local and national newspapers and in women's magazines and newsletters. Women completed a preliminary questionnaire on their experiences of obstetric and gynecological procedures, their biographical data, and their feelings associated with the procedures both at the time and now. Out of the 500 subjects, over 100 women gave an history of an obstetric and/or gynaecological which was 'very distressing' or 'terrifying', which was 'out of the ordinary' and which occurred 'more than one month previously'. These women were sent follow-up PTSD-I questionnaires and 30 of them fulfilled the DSM-III-R criteria for a diagnosis of post-traumatic stress disorder (PTSD). Significant differences between the 30 women with PTSD, and 30 respondents who rated their experiences from 'very good' to 'slightly distressing', were found on a range of findings, including feelings of powerlessness during the procedures, lack of information given to the patient, the experience of physical pain, a perceived unsympathetic attitude on the part of the examiner, and a lack of clearly-understood consent by the patient for the procedure. The results are discussed in relation to the literature on women's emotional reactions to the childbirth process and also to sexual violence and other causes of PTSD. The present findings suggest a cause of PTSD not previously described and challenge current medical working practices in the area of obstetrics and gynaecology.