What makes labour and birth traumatic? A survey of intrapartum 'hotspots'

Psychol Health. 2012;27(10):1166-77. doi: 10.1080/08870446.2011.649755. Epub 2012 Jan 31.


Evidence suggests between 1% and 6% of women develop post-traumatic stress disorder (PTSD) after childbirth. 'Hotspots' are moments of extreme distress during traumatising events that are implicated in symptoms of PTSD. This cross-sectional internet survey of hotspots examined (1) the content of intrapartum hotspots and (2) whether particular events, cognitions or emotions during hotspots are related to PTSD. Women (N = 675) who experienced a difficult or traumatic birth completed a questionnaire composed of a validated measure of PTSD, questions concerning the existence of hotspots, and a newly developed measure of emotions and cognitions during hotspots. The majority of women (67.4%) reported at least one hotspot during birth and 52.9% had re-experiencing symptoms of these hotspots. Women were more likely to have PTSD if hotspots involved fear and lack of control (odds ratio (OR) 1.30, 95% CI 1.17-1.43) or intrapartum dissociation (OR 1.12, 95% CI 1.05-1.19). Risk of PTSD was higher if hotspots concerned interpersonal difficulties (OR 4.34, 95% CI 2.15-8.77) or obstetric complications (OR 3.35, 95% CI 1.64-6.87) compared to complications with the baby.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Delivery, Obstetric / adverse effects*
  • Delivery, Obstetric / psychology
  • Fear
  • Female
  • Humans
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / psychology
  • Stress Disorders, Post-Traumatic / psychology*
  • United Kingdom
  • Young Adult