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, 2000, P104). In England And Wales, For Example, The Incidence Of Caesarean ...

, 2000, p104). In England and Wales, for example, the incidence of caesarean section is about twenty-two percent (Liston, 2003, p559). Ayres (2004, p552) suggests that ten percent of women have severe symptoms of traumatic stress in the weeks following birth but the majority of these women recover without any intervention. However, between two to six percent of women go on to develop PTSD as a result of a traumatic birth experience and require treatment. Although the number of women with clinical PTSD is a relatively small percentage, the number of women giving birth means that up to thirteen thousand new cases of postnatal PTSD occur every year in the United Kingdom alone.

The symptoms of PTSD are upsetting and incapacitating at a time when a woman has to cope with the added demands of caring for her baby. In a linked theme, a study on postpartum emotional distress found that the cost can be wide-ranging. Children of women who suffer mood disorders can have an enduring instability to their emotional, behavioural and cognitive development (Sinclair & Murray, 1998, p58). A study by Campbell et al., (1992, p29) found that very young babies of depressed mothers received less appropriate and responsive care and more negative and rejecting care than those of non-depressed or traumatised mothers. Similarly, mood disorders might also result in marital problems that if left unresolved could lead to separation and divorce (Boyce & Stubbs, 1994, p471). Importantly, it is suggested that acute PTSD and postnatal depression can progress to become chronic conditions that are disabling and difficult to treat successfully (Friedman, 2000b, p27).
As previously mentioned, it is important to note that postpartum symptoms of PTSD might be due to previous antenatal trauma. Therefore, the difficulty lies in the diagnosis of PTSD whether or not it is as a direct result of a traumatic birth experience. Having said this however, one survey separated the incidence and prevalence of the condition. This study found that although a small proportion of the women who participated in the study could be said to be true new PTSD cases as a direct result of the birth experience, it was more likely that other reasons for the disorder existed before and during pregnancy (Ayers & Pickering, 2001, pp112-113). Arguably, therefore, for postnatal debriefing or counselling to be effective it is important to establish that any psychological morbidity and PTSD symptoms do arise from the perinatal experience. Similarly, it is proposed that although operative delivery cannot normally be avoided as if it often a question of maternal or neonatal morbidity (Liston, 2003, p560); there might be opportunities to prevent any subsequent psychological morbidity.

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