De gynaecologie (met als aandachtsgebied vrouwenziekten), obstetrie (verloskunde) en de gedragswetenschappen hebben sinds lang veel raakvlakken. Maar ook nieuwe ontwikkelingen illustreren deze verbondenheid. Momenteel zijn er in meerdere ziekenhuizen zogeheten POP-poli's (psychiatrie, obstetrie en pediatrie), waarin gynaecologen, kinderartsen en gedragswetenschappers samenwerken, met als doel de zorg voor zwangeren met psychische en psychiatrische problematiek en voor het (ongeboren) kind te optimaliseren (De Waal, Tuerlings, De Boer, Smal & Van Waarde, 2010). Daarnaast bestaat er een multidisciplinaire Werkgroep Psychosomatische Obstetrie en Gynaecologie (WPOG), die tot doel heeft 'een biopsychosociale attitude onder de aandacht te brengen van de hulpverleners binnen het gynaecologische en verloskundige praktijkgebied' (Werkgroep Psychosomatiek in de de Obstetrie en Gynaecologie, 2010).

Methods. aEuro integral Multi-center cross-sectional study at midwifery practices, general hospitals and a tertiary (university) referral center. An unselected population of 907 women was invited to complete questionnaires on PTSD, demographic, psychosocial, and obstetric characteristics 2 to 6 months after delivery. Prevalence of PTSD was based on women who met all criteria of the diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV), whereas risk factors were determined using the severity (sum-score) of posttraumatic stress symptoms.Results. aEuro integral PTSD following childbirth was found in 1.2%% of the respondents (5/428 women, response rate 47%%), while 9.1%% of women (39/428) had experienced the delivery as traumatic. Posttraumatic stress symptoms were associated with unplanned cesarean section, low sense of coherence (coping skills), and high intensity of pain. Initial differences in posttraumatic stress symptoms between home and hospital deliveries disappeared after taking into account the (by definition) uncomplicated nature of home births.Conclusion. aEuro integral In this Dutch study, 1 in 100 women had PTSD following childbirth, with no differences between home- and hospital deliveries after controlling for complications and interventions. Emergency cesarean section, severe labor pain, and poor coping skills were associated with more posttraumatic stress symptoms.

Objectives. To evaluate instruments used to assess posttraumatic stress disorder ( PTSD) following childbirth with both quantitative ( reliability analysis and factor analysis) and qualitative ( comparison of operationalization) techniques.Methods. An unselected population of 428 women completed the Traumatic Event Scale-B (TES-B) and the PTSD Symptom Scale-Self Report (PSS-SR) 2-6 months after delivery.Results. Assessment of internal consistency yielded similar results for the TES-B and PSS-SR (Cronbach's alpha = 0.87 and 0.82, respectively). Factor analysis revealed two rather than three DSM-IV symptom categories for both instruments: childbirth-related factors (re-experiencing/ avoidance) and symptoms of depression and anxiety (numbing/ hyperarousal). Although the TES-B and the PSS-SR sum-scores show a strong relationship (Spearmans = 0.78), agreement between the instruments on the identification of PTSD cases is low (kappa = 0.24); discrepancy between TES-B and PSS-SR is largely due to differences in instruction to respondents, formulation of items, answer categories, and cut-off values.Conclusions. Large operationalization differences between TES-B and PSS-SR have been identified, i.e., in the formulation of questions, answer categories, cut-off values and instructions to respondents. Comparison between studies using different instruments for measuring PTSD following childbirth should be done with utmost caution.