Posttraumatic Stress Disorder, Military Sexual Trauma, and Birth Experiences at the Veterans Health Administration

Abstract

Background

Women are a growing portion of the U.S. veteran population, and every year the Veterans Health Administration (VHA) serves an increasing number of women seeking obstetrics services. Women veterans experience elevated rates of anxiety, depression, posttraumatic stress disorder (PTSD), and traumatic events, including military sexual trauma, as compared with women in the general population. It is possible that mental health disorders may be associated with birth experiences.

Objectives

We investigated the link between anxiety, depression, PTSD, and military sexual trauma (MST; i.e., rape and sexual harassment) with perceived birth experience (i.e., Negative or Neutral vs. Positive).

Methods

Participants included 1,005 veterans who had recently given birth and were enrolled in the multisite, mixed methods study known as the Center for Maternal and Infant Outcomes Research in Translation study (COMFORT). Using χ² tests, we investigated the relationship between mental health conditions including anxiety, depression, and PTSD and MST with birth experience (coded as Negative/Neutral vs. Positive).

Results

Findings indicated that participants who endorsed PTSD (39.5%), MST-rape (32.1%), or MST-harassment (51.4%; all p < .05) were significantly more likely to report a Negative/Neutral birth experience (14.7%) versus a Positive birth experience (85.3%). Anxiety and depression were not associated with birth experience.

Conclusions

Veterans with PTSD and/or who experienced MST were more likely to report a negative or neutral birth experience. Thus, screening for PTSD and MST during obstetrics services as well as providing trauma-informed obstetrics care during pregnancy, labor, birth, and recovery may be important among veterans seeking obstetric services.