Peripartum Trauma: Role of the C-L Psychiatrist. Sponsored by ACLP's Women's Health SIG

Abstract: Posttraumatic stress disorder (PTSD) can pose significant implications for pregnant and postpartum women. About 4% of women report PTSD symptoms postpartum. However, the onset of PTSD can precede pregnancy, occur during pregnancy or childbirth, or arise during the postpartum period. Maternal history of adverse childhood experiences (ACES) and PTSD may impact pregnancy outcomes including maternal mental health, mother-infant bonding, and the socioemotional wellbeing of the child. As CL psychiatrists, we are aptly positioned to provide early intervention and education to both the patient and the treatment team. This workshop is structured to provide insight into various risk factors that contribute to traumatic pregnancy and childbirth with the intention to create discussion about our role as advocates for our perinatal patients.

Dr. Meredith Spada will utilize a case-based format to discuss the impact of ACES on obstetric and psychiatric outcomes as they relate to childbirth. She will additionally describe the impact of ACES and birth trauma on the mother-infant dyad.

Dr. Fiona Fonseca will share current findings in the literature addressing the psychiatric impact of perinatal loss including both elective and spontaneous abortion. They will describe strategies to support patients navigating this unique spectrum of loss through a phenomenological and psychodynamic lens ways to support patients navigating this unique spectrum of loss while exploring the influence it might have on them in both the immediate and longer term.

Dr. Katherine Crist will discuss the psychological ramifications of intimate partner violence (IPV) during pregnancy and how it contributes to a traumatic birth experience and development of postpartum PTSD. Additionally, she will describe effective interventions for patients experiencing IPV and evidence based treatments for postpartum PTSD.

Dr. Deepika Sundararaj will discuss the impact of the COVID-19 pandemic on perinatal and postpartum care and how this relates to psychiatric outcomes in the peripartum period. She will conclude by discussing methods that CL psychiatrists can utilize to increase awareness and advocacy efforts as they relate to this topic.

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< !Cook N, Ayers S, Horsch A. Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review. J Affect Disord. 2018 Jan 1;225:18-31. doi: 10.1016/j.jad.2017.07.045. Epub 2017 Jul 27.

Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, Kaimal AJ, Dekel S. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord. 2021 Mar 1;282:122-125.