International prevalence of childbirth-related post-traumatic stress disorder: INTERSECT study
Journal
The British Journal of Psychiatry
Date Issued
2026-08-28
Author(s)
Ayers, Susan
Handelzalts, Jonathan E.
Webb, Rebecca
Constantinou, Georgina
Grollman, Christopher
Lucas, Grace
Awad-Sirhan, Natalia
Baird, Kathleen
Baldisserotto, Marcia L.
Batool, Rami
Batool, Shahida
Brekalo, Maja
Caparros-Gonzalez, Rafael A.
Chorwe-Sungani, Genesis
Christoforou, Andri
Costa, Raquel
Dikmen-Yildiz, Pelin
Ďuríčeková, Barbora
Dušová, Bohdana
Enea, Violeta
Garthus-Niegel, Susan
Grundström, Hanna
Gureje, Oye
Hadjigeorgiou, Eleni
Haga, Silje Marie
Horsch, Antje
Ionio, Chiara
Jarašiūnaitė-Fedosejeva, Gabija
Jomeen, Julie
Kazmierczak, Maria
Lalor, Joan
Milosavljevic Markovic, Maja
Nagle, Ursula
Nakić Radoš, Sandra
Nieminen, Katri
Oladeji, Bibilola Damilola
Osório, Flávia de Lima
Pawlicka, Paulina
Peled, Yoav
Pinto, Tiago Miguel
Rattaz, Valentine
Riklikiene, Olga
Schellong, Julia
Seefeld, Lara
Sigurðardóttir, Valgerður L.
Škodová, Zuzana
Dörr, Petra
Stepisnik Perdih, Tjasa
Stewart, Robert
Swift, Emma Marie
Thagunna, Narendra Singh
Uriko, Kristiina
Vally, Zahir
Vezmar, Milica
Wright, Daniel B.
Zedan, Haya S.
Type
Article
Abstract
Background
Around 140 million births occur worldwide annually. For some women, childbirth is traumatic and can lead to childbirth-related post-traumatic stress disorder (CB-PTSD), with adverse consequences for both women and their families. However, international evidence remains limited.
Aims
To estimate the international prevalence of traumatic birth and CB-PTSD.
Method
The International Survey of Childbirth-Related Trauma (INTERSECT) is a cross-sectional survey conducted in 31 countries. Women were eligible if they were 6–12 weeks postpartum, legally adults and provided informed consent. Recruitment was through routine maternity services and data were collected from April 2021 to January 2024. Outcomes were assessed using the City Birth Trauma Scale. Traumatic birth was coded using DSM-5 criteria for a traumatic stressor, and CB-PTSD classified when all PTSD criteria were met. Dissociative subtype and differential diagnoses were also assessed.
Results
A total of 11 302 women from 31 countries took part. Most participants were married, aged 30–34 years, with average household income and higher education, and 9.7% identified as being from ethnic or racial minority groups. The prevalence of traumatic birth and CB-PTSD varied across countries: traumatic birth ranged from 7 to 69% (mean 23.3, 95% CI 22.4–24.0), and CB-PTSD ranged from 1 to 36% (mean 6.7, 95% CI 3.7–9.7). CB-PTSD subtypes also varied: the dissociative subtype ranged from 1 to 24% (mean 3.8, 95% CI 2.1–5.4) and acute CB-PTSD from 0 to 7% (mean 1.3, 95% CI 0.7–1.9). Removal of participants with potential differential diagnoses did not affect prevalence rates in most countries. Many participants reported distress and impairment from symptoms, even when they did not meet CB-PTSD diagnostic criteria.
Conclusions
Results show that a notable proportion of women experience traumatic birth and CB-PTSD. The wide variation in prevalence suggests that cultural and healthcare factors unique to each country are important. Results emphasise the importance of routine trauma-informed assessment and culturally informed support in perinatal mental healthcare.
Around 140 million births occur worldwide annually. For some women, childbirth is traumatic and can lead to childbirth-related post-traumatic stress disorder (CB-PTSD), with adverse consequences for both women and their families. However, international evidence remains limited.
Aims
To estimate the international prevalence of traumatic birth and CB-PTSD.
Method
The International Survey of Childbirth-Related Trauma (INTERSECT) is a cross-sectional survey conducted in 31 countries. Women were eligible if they were 6–12 weeks postpartum, legally adults and provided informed consent. Recruitment was through routine maternity services and data were collected from April 2021 to January 2024. Outcomes were assessed using the City Birth Trauma Scale. Traumatic birth was coded using DSM-5 criteria for a traumatic stressor, and CB-PTSD classified when all PTSD criteria were met. Dissociative subtype and differential diagnoses were also assessed.
Results
A total of 11 302 women from 31 countries took part. Most participants were married, aged 30–34 years, with average household income and higher education, and 9.7% identified as being from ethnic or racial minority groups. The prevalence of traumatic birth and CB-PTSD varied across countries: traumatic birth ranged from 7 to 69% (mean 23.3, 95% CI 22.4–24.0), and CB-PTSD ranged from 1 to 36% (mean 6.7, 95% CI 3.7–9.7). CB-PTSD subtypes also varied: the dissociative subtype ranged from 1 to 24% (mean 3.8, 95% CI 2.1–5.4) and acute CB-PTSD from 0 to 7% (mean 1.3, 95% CI 0.7–1.9). Removal of participants with potential differential diagnoses did not affect prevalence rates in most countries. Many participants reported distress and impairment from symptoms, even when they did not meet CB-PTSD diagnostic criteria.
Conclusions
Results show that a notable proportion of women experience traumatic birth and CB-PTSD. The wide variation in prevalence suggests that cultural and healthcare factors unique to each country are important. Results emphasise the importance of routine trauma-informed assessment and culturally informed support in perinatal mental healthcare.