Domestic violence, lifetime trauma and psychological health of childbearing women.
OBJECTIVE
Although histories of abuse are associated with psychiatric illness in women, health professionals rarely enquire directly about such experiences. This study examined the association between physical and sexual violence and lifetime trauma and depressive and posttraumatic stress symptoms in women receiving maternity care.


METHODS
Cross sectional study.


METHODS
South London Hospital maternity services.


METHODS
Two hundred women receiving postnatal or antenatal care.


METHODS
Two hundred women receiving postnatal or antenatal care at a South London maternity service were screened for lifetime experiences of trauma and domestic violence. Information was obtained about self-harming behaviour, suicidal thoughts and attempts and psychiatric history. Women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Posttraumatic Diagnostic Scale (PTDS).


METHODS



RESULTS
One hundred and twenty-one (60.5%) women reported at least one traumatic event and two-thirds of these had experienced multiple traumatic events. The most frequent (34%) was witnessing or experiencing physical assault by a family member. Forty-seven (23.5%) women had experienced domestic violence. Physical and sexual abuse commonly co-occurred. Thirteen (10.7%) women with a trauma history had current posttraumatic stress disorder. Severe posttraumatic symptoms were associated with physical and sexual abuse histories and repeat victimisation. Adult and childhood physical and sexual abuse histories were also associated with more severe depressive symptomatology. Significant social factors associated with depression were being single, separated or in a non-cohabiting relationship.


CONCLUSIONS
Traumatic events are under-recognised risk factors in the development of depressive and posttraumatic stress symptoms in childbearing women. Childhood abuse creates a vulnerability to re-traumatisation in adulthood. Awareness of the impact of trauma and abuse on psychological health may enable more appropriate targeting of clinical services and support for women receiving maternity care.
Mezey
Gillian
G
Department of Mental Health (Forensic), St George's Hospital Medical School, London, UK.
Bacchus
Loraine
L
Bewley
Susan
S
White
Sarah
S
D000328:Adult; D000704:Analysis of Variance; D002648:Child; D002649:Child Abuse / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology*; D017579:Domestic Violence / Q000523:psychology*; D005260:Female; D006801:Humans; D008603:Mental Health; D011181:Postnatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011295:Prenatal Care; D012044:Regression Analysis; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D014947:Wounds and Injuries / Q000523:psychology