Perinatal PTSD: A Concept Analysis

Aim. To report an analysis of the concept of Posttraumatic Stress Disorder (PTSD) in the perinatal population. Background. The prevalence of PTSD in the perinatal period is rising with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal child outcomes result in increased morbidity, mortality, and healthcare costs. Design. Concept Analysis. Data Sources. The databases of CINAHL, Medline, PsychInfo, Academic Search Premier, and PsychINFO for articles published between 2004 and 2014, written in English, and using the terms perinatal and PTSD. Method. Walker and Avant’s method of concept analysis was used to explore PTSD in the perinatal period. Results. PTSD in the perinatal period possesses unique attributes, antecedents and outcomes when compared to PTSD in adults and maybe defined as a disorder occurring after a traumatic experience, diagnosed any time before conception to 6 months postpartum, lasting longer than one month, leading to specific negative maternal symptoms, and poor maternal and newborn outcomes. Three antecedents were identified: trauma (specifically perinatal complications and abuse), postpartum depression, and a previous psychiatric history. Perinatal PTSD attributes include the diagnostic time frame from conception until 6 months postpartum of diagnosis, harmful prior or current trauma, and specific diagnostic symptomatology defined in the DSM-5. Consequences are adverse maternal infant outcomes. The application of PTSD in the perinatal period with the Integrated Perinatal Framework is discussed to assist with the concept analysis. Conclusion. Further exploration of PPTSD antecedents and outcomes in ethnically diverse populations is suggested for future research. Nurses are encouraged to increase their awareness of PTSD in the perinatal period to incorporate early maternal assessment and intervention for prevention of adverse maternal infant outcomes in their practice. Health policy advocacy is needed for healthcare provider reimbursement and mandatory screenings to ensure early treatment of perinatal PTSD.