Associated factors of barriers to help-seeking among postpartum women with and without (childbirth-related) posttraumatic stress disorder: results from the cross-sectional study INVITE

Abstract

Background: Mental health disorders are widespread during the postpartum period, yet only a minority of affected women seek professional help for their symptoms. While prior studies have explored barriers to help-seeking, certain factors yielded inconsistent results. Our study aimed to investigate whether these factors do not serve as barriers themselves, but rather as predictors of barrier formation. Given the limited previous research on postpartum women affected by posttraumatic stress disorder (PTSD), we examined those affected by childbirth-related PTSD (CB-PTSD) and general PTSD (gPTSD). Methods: We used data from the cross-sectional study INVITE (INtimate partner VIolence care and Treatment prEferences in postpartum women). For this study, a total of N = 3,874 postpartum women were inquired about their mental health status and barriers keeping them from seeking help. We categorized these women into three distinct groups: (1) women affected by CB-PTSD, (2) women affected by gPTSD, and (3) non-affected women. For each group, we conducted multiple linear regression analyses to examine whether certain factors (self-report of PTSD, knowledge of healthcare services, previous help-seeking, social support, severity of symptoms, and household net income) are associated with previously identified barriers to help-seeking. Results: Our findings revealed that higher social support predicted lower barriers to help-seeking, particularly among women with gPTSD. Self-reporting PTSD predicted lower barriers among women with CB-PTSD. Previous help-seeking predicted lower barriers among women with CB-PTSD, but higher barriers among those with gPTSD. Greater knowledge of healthcare services predicted lower barriers for non-affected women, but higher barriers for women with CB-PTSD. A higher household net income predicted lower barriers only among non-affected women. We found no association between symptom severity and barriers to help-seeking. Conclusions: High levels of social support and self-report of postpartum PTSD emerge as crucial elements in reducing women’s barriers to help-seeking. Strengthening these factors can be achieved by providing psychoeducation to women and their social surroundings, equipping them to identify symptoms and respond accordingly. Moreover, implementing PTSD screenings for all postpartum women may facilitate symptom recognition, thereby reducing barriers to help-seeking. Additionally, educational campaigns could help to reduce stigmatization and shame associated with postpartum mental health disorders within the society, fostering greater understanding and empathy for affected women.