Journal article
International prevalence of childbirth-related post-traumatic stress disorder: INTERSECT study
British journal of psychiatry, Vol.First online, pp.1-10
28/08/2026
PMID: 42661555
Metrics
1 Record Views
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.
Details
- Title
- International prevalence of childbirth-related post-traumatic stress disorder: INTERSECT study
- Creators
- Susan Ayers - City St George's, University of LondonJonathan E Handelzalts - Academic College of Tel Aviv-YafoRebecca Webb - City St George's, University of LondonGeorgina Constantinou - City St George's, University of LondonChristopher Grollman - City St George's, University of LondonGrace Lucas - City St George's, University of LondonNatalia Awad-Sirhan - Universidad del Desarrollo del Estado de PueblaKathleen Baird - University of Technology SydneyMarcia L Baldisserotto - Universidade Federal do Rio de JaneiroRami Batool - Beaconhouse National UniversityShahida Batool - University of LahoreMaja Brekalo - Catholic University of CroatiaRafael A Caparros-Gonzalez - Instituto de Investigación Biosanitaria de GranadaGenesis Chorwe-Sungani - Kamuzu Central HospitalAndri Christoforou - European University CyprusSoledad Coo - Universidad del Desarrollo del Estado de PueblaRaquel Costa - Universidade LusófonaPelin Dikmen-Yildiz - Kırklareli UniversityBarbora Ďuríčeková - Comenius University BratislavaBohdana Dušová - University of OstravaVioleta Enea - Alexandru Ioan Cuza UniversitySusan Garthus-Niegel - Norwegian Institute of Public HealthHanna Grundström - Region of Southern DenmarkOye Gureje - University of IbadanEleni Hadjigeorgiou - Cyprus University of TechnologySilje Marie Haga - Infants and Young Children, Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, NorwayAntje Horsch - University of LausanneChiara Ionio - University of MilanGabija Jarašiūnaitė-Fedosejeva - Vytautas Magnus UniversityJulie Jomeen - Southern Cross UniversityMaria Kazmierczak - Czech Academy of Sciences, Institute of PsychologyJoan Lalor - Trinity College DublinMaja Milosavljevic Markovic - University of BelgradeUrsula Nagle - Trinity College DublinSandra Nakić Radoš - Catholic University of CroatiaKatri Nieminen - Region ÖstergötlandBibilola Damilola Oladeji - University of IbadanFlávia de Lima Osório - São Paulo State University (UNESP) (Brazil)Paulina Pawlicka - Czech Academy of Sciences, Institute of PsychologyYoav Peled - Tel Aviv UniversityTiago Miguel Pinto - Universidade LusófonaValentine Rattaz - University of LausanneOlga Riklikiene - Lithuanian University of Health SciencesJulia Schellong - Technische Universität DresdenLara Seefeld - Technische Universität DresdenValgerður L Sigurðardóttir - University of IcelandZuzana Škodová - Comenius University BratislavaPetra Dörr - University of OstravaTjasa Stepisnik Perdih - Nova Southeastern UniversityRobert Stewart - University of EdinburghEmma Marie Swift - University of IcelandNarendra Singh Thagunna - The Dia Foundation for Research on Ageing SocietiesKristiina Uriko - Tallinn UniversityZahir Vally - United Arab Emirates UniversityMilica Vezmar - University of BelgradeDaniel B Wright - University of Nevada, RenoHaya S Zedan - Saudi Electronic University
- Publication Details
- British journal of psychiatry, Vol.First online, pp.1-10
- Publisher
- Cambridge University Press; CAMBRIDGE
- Grant note
- The International Survey of Childbirth-Related Trauma (INTERSECT, www.intersectstudy.org) was conducted by the INTERSECT Consortium, funded by the Myriam de Senarclens Foundation and City St. George’s, University of London. Funding was also obtained in some countries for the survey to be conducted in that country (see list).
- Identifiers
- 991013396893102368
- Copyright
- © The Author(s), 2026
- Academic Unit
- Office of Deputy Vice-Chancellor (Academic)
- Language
- English
- Resource Type
- Journal article